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Rashes in Newborns
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Rashes are a very common problem in newborns and include neonatal acne, drooling rashes, and flaky skin. Most of these rashes will usually clear up on their own without treatment.
- acrocyanosis: a bluish discoloration of a newborns hands and feet. This is normal when your baby is cold or crying if the rest of your baby's skin is pink.
- epstein's pearls: small white cysts or bumps on the roof of your newborn's mouth that will go away without treatment.
- erythema toxicum: a common rash that begins in the first few days after birth and is characterized by small blotchy red areas with a raised yellow or white center. There may be quite a few lesions, especially on the trunk and they will continue to pop up during the first week to ten days of life and will then go away without treatment in the next 5-7 days.
- forceps marks: or bruises will heal on their own.
- miliaria (heat rash or prickly heat): there are two forms of miliaria, miliaria crystallina, which consists of small clear fluid filled vesicles that rupture and leave behind some scale, and miliaria rubra, which have similar clear fluid filled vesicles, but they are surrounded by red areas. Miliaria is most common on the head, neck, upper chest and in skin folds and is due to blockage of the sweat ducts in the skin. It will resolve on its own, but can be prevented by reducing heat and humidity and not dressing your newborn in tight clothing.
- milia: small white or yellow pinpoint sized spots on your newborn's nose and chin. They are caused by small sebaceous retention cysts and will clear up in a few weeks without treatment.
- neonatal acne: this is a rash that looks like acne in older children and it is thought to be caused by hormonal stimulation. It usually begins between two to four weeks of age and resolves on its own over the next few months. Severe cases may need to be treated with 2.5% benzoyl peroxide or other keratolytic creams.
- sebaceous gland hyperplasia: multiple tiny yellow or flesh colored papules on the nose and cheeks of newborns. It is thought to be from maternal hormonal stimulation of the sweat glands and will resolve on its own in the first month of life.
- seborrheic dermatitis: causes greasy scales and patchy redness on the scalp (cradle cap), face, behind the ears and in skin folds. Most children clear up without treatment in three to four weeks, but more severe or persistent forms can be treated with and antiseborrheic shampoo or a topical steroid cream.
- transient neonatal pustular melanosis: causes tiny 1-2mm pustules to occur on the face, neck, extremities, palms and soles. These pustules are present at birth and can have some scale around them, but they are not red or inflamed. The pustules rupture in the first few days of life and leave behind flat dark areas that resemble freckles. These areas will fade in three weeks to three months without treatment.
- more serious conditions might be considered for children with red scaly skin and a very severe or prolonged course or other symptoms, such as failure to thrive (weight loss or poor weight gain), alopecia (hair loss), chronic diarrhea and involvement of other organs of the body. These conditions include congenital syphilis, congenital candidiasis, icthyosis, immune system disorders, ectodermal dysplasia, and nutritional or metabolic disorders.
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