Seven things you must know about Baby's skin care

A common worry that bothers all parents is the care of baby's skin. In my new post I try to capture the frequently asked questions on skin and hair care for babies. 

I will start by explaining the skin structure in very simple language and then explore how to take care of baby's skin and hair.

Q 1 – How is the skin of my child different? Does it require some extra effort and then so, Why?

Ans -The skin of an infant is different from adults in many ways which is crucial for understanding the skin care regimen for the parents -

                   

Skin  Structure of Newborn	Implication for skin care
a)           Higher skin surface area to weight ratio (skin surface area of infant is 700 cm2/kg as compared to adult skin which is 250 cm2/kg) .	a) Increased absorption in the blood of topical preparations (applied products)on the skin.
b)           Connection between the upper layers  of skin (epidermis and dermis) is not very strong	b) Blisters can form easily.
c)           The skin barrier is not fully developed	c)More susceptibility to infections and allergic reactions AND Increased water loss from the skin
d)           Smaller  and inactive sweat glands	d)Decreased sweating , more possibility of heat rash or prickly heat
e)           Acidic pH of the skin	e) Any increase of pH can increase bacterial colonization of the skin.

Q2-Doc, which soap should I use for my Baby?

Ans- Most of the soaps contain surfactants ( Read More here) which can have harmful effects on the skin of the newborn-

1. They deplete the lipid part of the skin barrier hence making it weaker
2. Increase the pH of the skin hence increasing the risk of skin infection
3. Denature( destroy) skin proteins further weakening the skin barrier.

Q3- What are the alternative for soap ?

Ans-  Cocoyl isethionate,sodium lauryl sulphate, and betaines are examples of synthetic non soap detergents (syndets ) which retain the normal pH of the skin but can be drying. Such syndets with addd moisturisers like mineral oil , paraffin and glycerince are most suitable. Soap free cleansers should be preferred but in smaller quantities. Soaps which produce more foam are HARMFUL for your baby's skin.

Q4 – When should I start applying soap to my baby?

Ans- Minimal use in first few months.

Immediately after birth, skin pH may be >6.0 which  falls to 4.95 after birth. This protective “acid” mantle protects against pathogens. Any  soap application will raise the skin pH from acid to neutral hence  increasing the total number of bacteria and increased moisture  loss. Regeneration of skin pH takes at least an hour after washing with alkaline soaps.  If at all needed, healthyterm newborns and infants can be washed MINIMALLY  using cleansers of neutral or slightly acidic pH, which have a gentle surfactant, be chemically and physically stable, and should contain an emollient. BOTTOMLINE is MINIMAL use of soaps in the first month of age.

Q5 – How should I wash  my baby's hair?

Ans -  Shampoos should have minimal time of contact with the scalp to avoid irritant dermatitis. The shampoo should be free from fragrance, anti-inflammatory agents and natural products. Most baby shampoos in the market contain anionic surfactant which ensures adequate cleaning. The pH of the shampoo should be close to the a that of tears and should be non-irritating to the baby’s eyes.

Q6- What about the napkin area of my baby?

Ans- The diaper area is probably the most frequently washed area of the baby.

Cleaning the nappy area "Front to back"

1. Regular nappy/diaper change is a must as baby’s stool and urine can macerate the skin of your baby if in prolonged contact.
2. “Baby wipes”- they also should be alcohol and preservative free. Consult your Dermatologist for recommendations.
3.  Always clean the area from front to back with soft cotton cloth or towel.
4. Apply a  Bland moisturiser and a barrier cream containig Zinc Oxide for skin protection if prolonged Diaper wear is required.( Use Dermatologist /Pediatrician recommended Diaper rash creams) 

Q7- What precautions I should take while washing my Baby’s clothes?

Ans-  You should use gentle detergents for washing your baby’s clothes.

1. Avoid  adding antiseptic solutions or cleansers ( e.g Dettol etc.). They are VERY HARSH for your baby’s skin.
2. The detergent should be fragrance free
3. Rinse the detergent thoroughly. (MACHINE WASH IS BETTER THAN HAND WASH)
4. Donot add Fabric Conditioners/Bleaches
5. Prefer cotton and linen waer for your baby
6. Wash any new dress before making your child wear that.

I have tried to touch the most commonly asked questions about Baby Cleansing. Please feel free for comments/queries and spread this message across for Better skin care for our children which they truly deserve and desire. This will be followed by How to tackle dry skin in children. Happy Reading!!! Stay skin healthy and skin wiser!!

Dr Divya Sharma is a practicing dermatologist at Bangalore. The data shared in this blog is her personal opinion based on her knowledge and experience. The author is not responsible for any adverse event that arises out of following blog opinion

How do I choose a cleanser for my face? A simple guide to understand cleansers

Cleansing is one of the most common and essential regime followed worldwide. It is not only required for purpose of maintaining hygiene but it also plays a significant role in neurosensory and musculoskeletal development of children. We often wonder which cleanser should I choose for myself. in this blog post. I will try to explain the principles of cleansing which should be kept in mind, next time you think of the ideal choice of cleanser for your skin based on your skin type.

Q- How do cleansers work? 
Ans- The cleansers are surface active substances that lower the surface tension on the skin and remove dirt, sebum, microbes and dead skin cells in an emulsified form. At the microscopic level, cleansers are made up of a chain of hydrocarbons. One end of this hydrocarbon chain attaches to grease and oils on your skin while the other end of the chain bonds with water. When you rinse with water, the soap and any attached impurities wash away. 

Q – What are the various types of cleansers available? 
Ans - They include soaps, superfatted soaps, beauty bars, dermatological bars, liquid cleansers, antibacterial washes and foaming solutions. 

Q – What is wrong with applying just any other soap available? Is soap harmful to apply on the face? 
Ans-Soap is a combination of fats and oils (of animal or vegetable origin) and salt. It is the simplest anionic surfactant, forming soap salts in water that emulsify whatever is on the skin surface while increasing the pH of the skin. Applying just any cleanser may result in swelling of the upper layers of skin and loss of natural moisturizers and water leaving the skin dry and the barrier compromised. 

Q- How do I choose the best cleanser for myself? 
Ans- In my previous blog post I had put up a simple quiz which will allow you to understand your skin type (here). Based on your skin type you can follow this simple check-list and also the ingredients that I mention in the answers below to choose your cleanser

Q- What about "Beauty Bars"?

Ans- They are similar to the normal soaps but fragrance and few moisturisers are added to enhance their cosmetic appeal. But the efficacy to prevent dry skin is unknown and hence not recommended.

Q- How are the soaps prescribed by doctor different from the regular soap bars?

Ans-  These soaps contain weak organic acids to lower the ph of the skin and have moisturisers like glycerin , lanolin, Vitamin E and Natural lipids like Squalene. Colloidal oatmeal containing soaps are much more beneficial.

Q- What about so many Liquid cleansers or face washes?

Ans-  Liquid cleansers are composed of non ionic or amphoteric surfactanta with very high rinsibility factor. Their ph is similar to skin and hence they are less drying. One study demonstrated that, following hand cleansing, a liquid cleanser removed 85% of bacteria while a bar soap was able to remove only 65%.

Q – Is a face wash better than a soap if I have pimples or acne?

Ans – Research has shown that use of an acidic liquid cleanser or face wash  led to a reduction in inflammatory ( pus filled) acne lesions and the number of bacteria Propionibacterium acnes (P. acnes) on the skin aiding in faster resolution of pimples while maintaining  smoothness of texture.

Q- Which type of cleanser  is recommended for people with sensitive skin?

Ans- There are certain general recommendations I would like to make when it comes to choosing the right product for sensitive skin. Choose a cleanser with

Non – Ionic surfactants (like polysorbate).

Silicone surfactants ( e.g. Dimethicone) which can penetrate follicles or crevices and hence bring debris to the surface. ( Always check this component in products claiming to be ” DEEP CLEANSERS”).

It should contain moisturisers and humectants ( they prevent water loss when bathing).

Last but not the least , It should have a high rinsibility factor so that it does not leave any skin residue.

Q – What do you recommend for my face if I have conditions like ‘Rosacea’ or ‘Cosmetic Intolerance’?

Ans – Apart from the above said points , One should go for a cleanser which is fragrance and parabens free. Parabens and formaldehyde donors (e.g., diazolidinyl urea, Quaternium-15, DMDM hydantoin) are the major classes of preservatives which can trigger or worsen eczema in such patients

Let me know how choosing a cleanser works with you. And like always stay skin healthy and skin wiser!!

Know your skin type by Dr. Divya Sharma

Sunscreen while driving: love your skin when you are behind the wheel

Most of us spend a considerable part of our daily lives in travel or driving. According to some recent surveys , this constitutes the largest percentage of total time spent outdoors. This period spent inside vehicle poses the highest risk for intense sun exposure. " Most of us take this plea that we hardly walk in sun to the car park or bus stop which is just few meters and I am in the car or bus only ...Still why do I need to apply sunscreen ?"

Q Why to apply sunscreen when inside the car/bus , " The windows are closed "?

Ans Windshields are made up of laminated glass which blocks upto 90% of UV Rays but sadly the side and rear windows allow them uninhibited. Shoulder , arms and hand closest to the side window receive the highest sun exposure and are always more vulnerable.

In a study published in the Journal of American Academy of Dermatology researchers found that people who had spent most time driving car each week were more likely to develop skin cancers on the side exposed to more sunlight while driving!

Q- Is tinted glass or Films protective?

Ans Clear glass transmits 62%of UVA while dark tinted only 11.4% . UV absorbing films are even better only allowing 0.4% of harmful radiation. Imagine with the latest traffic rules of removing any sort of films how much our sun exposure has multiplied.

Q Okay then I will keep a sunscreen in my car always?

Ans No, never leave your sunscreen in a hot car. On a hot summer day when your car is parked outside, the heat may weaken its potency. Always treat your sunscreen the way you treat a prescription medication- keep it away from extreme heat. Most preservatives in sunscreens are designed and tested in a range of temperatures close to room temperature.

Q Aha..so sunscreen on and i am all protected?

Ans Well almost, one vital area of your face is still uncovered and exposed. Yes you are right its your eyes. Here your sunglasses will protect. A pair of shades goes a long way to protect your eyes. Use a good pair which mentions the UV protection index. It should atleast provide 95% UVB protection and 60% UVA protection.

Keep your skin safe and enjoy your driving with a sun safe skin!..Stay skin healthy and skin wiser!

Dr Divya Sharma is a practicing dermatologist at Bangalore. The data shared in this blog is her personal opinion based on her knowledge and experience. The author is not responsible for any adverse event that arises out of following blog opinion

Razor Bumps : Five facts you always wanted to know - Pseudofolliculitis Barbae

Pseudofolliculitis Barbae also  known as Razor bumps is one of the commonest skin condition seen in my clinical practice.  It is a commonly distressing skin condition in men with multiple myths about the condition and treatments. In this blog I try to dispel them and would love if some of you can share your experience with it.

# 1: What are 'Razor Bumps'?
Ans- The rash consisting of red raised lesions and sometimes small pus filled papules or small bumpy lesions in the beard area of the face is known as Pseudofolliculitis Barbae (PFB). It can also present in other shaved areas like pubic region and underarms.

# 2- What is the cause of PFB or Razor Bump?
Ans- When the hair is shaved too close to the skin, it develops a sharp tip that grows and curves downward and re -enters the upper layer of the skin.

# 3-Why only  few people get it and what are the causative factors?
Ans- Few factors which cause and hence can be prevented are-

• Stretching the skin before shaving causes the sharp edged hair to retract underneath skin.
• Use of a double edged razor encourages penetration , The first blade serves to pull the hair out of the follicle while the second blade cuts it and allows for retraction.
• Improper shaving technique -Shaving against the direction of hair growth.
• Dry Shaving

#4- What can I do to prevent them from coming again? How Do I Shave?Ans - 

• Washing the beard with warm water and an antibacterial soap for several minutes in circular motion
• Avoid very close shave ( as popularized by advertisements these days) especially twin or triple -blade razors. Single blade razors  are the best for such patients.
• Leave the shaving product for atleast 2 to 3 minutes. The harder the beard, the longer it takes to soften the hairs.
• Shave in the direction of hair growth , with short strokes and without using the other hand to tense the skin.
• After shaving, rinse the beard area well and dry with a clean towel slowly massaging the beard area in a circular area.
• Rinse the blades after every use and change them frequently as well.
• Electric razors as there is a protective gap between the blade and the comb hence preventing close shave. Use them at the medium (not the close) shave position.
• Shave only when necessary to allow more time for the skin and beard to recover between shaves.
• To prevent the area from darkening , the patient should avoid shaving products containing alcohol and apply a sunscreen after shaving.

#5 -What are the treatment options?Ans - 

• Prevention is the best cure and easiest too.
• It is advisable to stop shaving for some time (around 4 weeks) as the hair above the skin acts as a lever and pulls the ingrown hair itself.
• Warm water compresses should be applied for 10 to 20 minutes everyday followed by application of topical hydrocortisone 1% cream.
• Topical antibiotics , Benzoyl peroxide and AHA agents can be helpful.
• Lasers like long pulsed Nd :YAG , Alexandrite and Diode laser is most effective treatment and in terms of patient satisfaction.
• Consult your dermatologist before considering any treatment option.

These precautions should help you contain razor bumps and give you a smooth bump free skin. Follow this advice and stay skin healthy and skin wiser!

Dr Divya Sharma is a practicing dermatologist at Bangalore. The data shared in this blog is her personal opinion based on her knowledge and experience. The author is not responsible for any adverse event that arises out of following blog opinion

Hair conditioners explained: Which conditioner is best for my hair?

Now that you are aware regarding the shampoos and their components. I will give an overview of the components of a Hair conditioners. This would help you pick the best conditioners suited for your hair. 

Let us first understand, how Hair conditioners work? 

Our Hair is composed of Keratin which is made up of negatively charged amino acids. Hair conditioners have this positively charged molecules which don't get rinsed completely with the hair wash. On drying the hair are left with a very thin coating which prevents frizzing of the hair and also makes it easier to comb.

Okay, so which conditioning agents  are best suited for my hair?

Conditioners are recommended for dry , damaged or treated hair.

The various components that you must watch out while buying a conditioner are:

1.   Moisturizers for hair like – Glycerine , Dimethicone , Simethicone, Polyvinylpyrrolidone , Propylene glycol
2.   Stearalkonim chloride and benzalkonium chloride – Both are antimicrobial, prevent frizzing of the hair too!
3.   Hydrolyzed animal protein- penetrates the hair and strengthen its structure through polymer cross linking. It is the most effective agent for treating split ends.
4.   Essential fatty acids – are also natural moisturizing elements.
5.   Sequestrants – EDTA help in rinsing off with hard water

Hope you choose your shampoo and conditioner wisely from now on...take good care of your skin and hair...stay skin healthy and skin wiser!!

Dr Divya Sharma is a practicing dermatologist at Bangalore. The data shared in this blog is her personal opinion based on her knowledge and experience. The author is not responsible for any adverse event that arises out of following blog opinion

Choose your Shampoo as per your hair type

In the previous post I explained the key components of a shampoo. Now that you know what are the different components of shampoo label, you should try to figure out a shampoo which is most suited for your hair type. In this post I explained the different components you should watch out for depending on your hair type when you purchase shampoo. 

Normal Hair – Chose any shampoo with Lauryl Sulfate derivatives as they require good cleansing  and minimal conditioning.

Oily-Hair  – Excellent cleansing and minimal conditioning properties. Lauryl sulfate or sulfosuccinate surfactants work best . Ph of the shampoo should be between ph 5-6 and should not be too acidic or alkaline. These shampoos should be avoided by people with dry hair.

Dry Hair – mild cleansing and good conditioning  is required. This type of hair should not be washed daily . Try to rinse it little more to prevent a build up of conditioning agents.

Damaged Hair Cuticle magnified image

Damaged – Hair shampoos – Avoid excessive washing , hot combs and styling methods. Hydrolyzed animal or soy protein works best for hair repair.

In my next post I will how to choose your hair conditioners. Till then take good care of your hair and skin..stay skin healthy and skin wiser!!

Dr Divya Sharma is a practicing dermatologist at Bangalore. The data shared in this blog is her personal opinion based on her knowledge and experience. The author is not responsible for any adverse event that arises out of following blog opinion