Doctors’ Notes

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Your Newborn’s Skin

Some of the most frequently asked questions we hear from new parents are about their baby’s skin. So here’s some information to help…

Differences Between Adult & Newborn Skin

A newborn’s skin is different from an adult’s skin in a couple of ways. It has a higher water content and is able both to absorb more water and, conversely, to lose excess water faster that adult skin. A baby’s skin also allows more things to penetrate more easily. Sweat glands are fewer in the newborn.  Their skin grows and heals faster.

Another difference is that a newborns’ ability to regulate their body temperature is not fully developed, so they’re not able to increase their temperature to stay warm, nor can they cool themselves as well. A good rule of thumb is to dress your newborn in one more layer than you would dress yourself in colder weather, and to avoid overdressing in warmer weather.

Common Findings of Newborn Skin

ACROCYANOSIS

You may notice that your newborn’s hands and feet feel cooler and have a bluish color to them. This is because the blood vessels leading to these areas are more responsive to colder temperatures and actually shrink, which decreases the blood flow to these areas.  Moving the arms and legs should quickly change the color to pink. The rest of the newborn’s body and face should be pink. This change in color of the hands and feet typically lasts just 1-2 days.

ERYTHEMA TOXICUM

This sounds a lot more serious than it actually is. Erythema toxicum is a very common rash in the newborn which looks like red blotches with irregular borders. The rash is slightly raised and may have a small white or yellow dot in the center. It can appear and disappear quickly on different areas of the body. No treatment is necessary, and it resolves after a few weeks.

PEELING, DRY SKIN

Most newborns have skin that appears dry and sometimes peels. It is not necessary to apply lotions or creams to the skin unless there are areas on the feet that are cracked.

NEONATAL/INFANT/BABY ACNE

This rash appears as pink pimples on the face and sometimes the scalp. Thought to be the result of maternal hormones that stimulate the oil glands. It most commonly occurs during the fourth or fifth week of life. It sometimes gets worse before it gets better, and can last for a few weeks. Treatment is usually not necessary. Neonatal acne is not the same acne that older children and adults get.

MILIA

These are tiny white pimples usually found on the nose, but they can also be found on the face. These pimples ar edue to clogged oil glands and will resolve without treatment.

SALMON PATCHES

These areas are also called ”stork bites” if located at the back of the neck, or “angel kisses” if located between the eyebrows. They are believed to be a collection of blood vessels that usually fade after several weeks or months. Approximately fifty percent of the stork bites at the back of the neck persist for life and generally are not a problem, because hair covers the area.

MONGOLIAN SPOTS

These flat, gray-blue spots are very common on any part of the body of dark-skinned infants. They appear very similar to a bruise. The most common area is on the buttocks. By school age, they usually fade away.

CRADLE CAP (Seborrhea Capitus)

Thick, greasy yellow crusts on the scalp are characteristic of cradle cap, which presents around 1-2 months of age. In addition to these scaly areas on the scalp, occasionally a red, irritating rash may be present on the face, behind the ears and on the neck. To remove these crusts, olive oil on the scalp to soften the crusts, plus brushing with a soft brush and shampooing can help. Prescription medication and shampoo is sometimes needed to treat seborrhea.

Rashes associated with other symptoms such as fever, poor feeding, lethargy, or appear to contain white o ryellow fluid need to be evaluated by a provider.

Tips on Skin Care Products for Newborns

When choosing skin care products for your newborn, look for mild skin cleansers and moisturizers that have a good safety/tolerance profile and have been shown to be safe for infants. The first ingredient listed on the product label should be water. They also should not cause eye irritation.

Products advertised as being natural are not always better. Fragrance-free products can sometimes contain other chemicals used to mask the scent. These chemicals may cause skin irritation. Skin cleansers and moisturizers that have the seal of acceptance from the National Eczema Association are generally good products to use on newborn skin.

Terri Bailey, a Kids Plus Provider since 2011, is a Certified Registered Nurse Practitioner.