I see a lot of parents in
my practice who are anxious and worried about the recurring dry skin of their
children or Atopic Dermatitis. This not only is a cause of concern but can be a
distressing condition for the children as well. In this blog post on pediatric
dermatology, We shall discuss the causes and care required for alleviating the
discomfort associated with this under recognized but important skin condition
affecting children. I would be glad to answer your queries and comments.
Q – What is the cause of
dry skin of my child?
Ans – Our skin has a
‘brick and mortar’ arrangement where the skin cells are the bricks and they are
fused with each other by “Natural Moisturizing Factors’ (NMF). NMF is made up
of free fatty acids and Ceramides. It is believed that deficiency in this NMF
leads to ‘Dry Skin condition’ or “Atopic Dermatitis”. Atopic dermatitis simply
can be put as ‘an itch that rashes’. It includes a tendency to have allergies
at places where body is in contact with the external environment like allergic rhinitis,
hay fever and eczemas.
Q – What are the risk factors
for atopic dermatitis?
Ans- A positive family
history of similar dry skin, asthma, hay fever or eczema can predispose the
children to this condition. It is more found in urban areas than rural. It is
largely believed that a cleaner environment and healthier diets to pregnant
mothers exposes the child in utero to very few infections. As a result of which
their immunity is hyperactive and shifts to a tendency for allergies. (HYGIENE
HYPOTHESIS”).
Q – What can I do to
alleviate my child’s discomfort?
Ans – There are a basic
set of precautions and special care that I advise my patients to reduce the
frequency and severity of dry skin in children.
a)
SHORT
Bathing time – reduce the shower time to less than five minutes.
b)
SOAP
USAGE – Minimal application of soap to the entire body and choose a moisturizer containing soap. (For further reading read my blog on this link ).
c)
LUKEWARM
water – instead of very hot water. Water and soap further dry and reduce the
lipid layer of ski , hence they aggravate the condition.
d) MOISTURIZE with a recommended moisturizer within three minutes of bath after gently
patting the skin dry. Don’t handle skin in a rough manner at all.
e)
CONTACT
with woolen garments, fur and dust should be minimized.
f)
COTTON
or LINEN garments should touch your child’s skin.
g) MINIMIZE things which catch dust like carpets and soft toys around your child.
h)
PREFER
vacuum cleaning at least once a month.
Q- Which moisturizer should I use for
my child‘s skin?
Ans- Moisturizer is the lifeline to
prevent this condition as they seal the fissures and improve the disturbed
barrier function. They are of different types-
a)
Emollients
- They are naturally found in palm and coconut oil. They replenish the natural moisturizing factors. Shea cocoa butter containing products belong to this
category.
b)
Occlusives-
They serve to seal the gaps between skin cells and make skin ‘slippery’. They
are greasy, messy and have allergic potential.
Petroleum jelly is an ideal example. I would rank them lower in my
choice of moisturizers.
Q- What is an ideal moisturizer?
Ans -
Patients who are confused by media hype often ask this question. The
ideal moisturizer should be:
·
·
Q – Which type of
moisturizer do you recommend?
Ans
– The following is a quick guide for choosing a moisturizer
1)Moisturizers designed for the face are typically non-greasy, non-comedogenic
emollients, with an emphasis on skin feel and aesthetics with maximal skin
benefits.
2) Silicone derivatives in particular are
targeted for consumers with oily skin. Kaolin and Talc containing compounds are
good for oily skin.
3) Moisturisers marketed as anti ageing
should include sun protectants, alpha hydroxy acids (e.g., glycolic acid), and
retinol and its derivatives.
4)Prefer lotions for day time use while
creams are thicker and should be applied at night.
5)Emollients containing moisturisers
like shea butter , squalene should
be preferred for very dry skin over body and hands. Avoid them on face as they
can trigger ‘acne’ or ‘pimples’.
Q- Which oil should I use for my child?
Ans – Coconut oil has been shown to
improve the skin barrier which is deficient in atopic children. Olive oil and
other oils are harmful than helpful for skin.It has been proven by studies that
the barrier function is best restored with the coconut oil. Coconut milk is
equally desirable.
Atopic Dermatitis tends to improve with age. It should not cause unnecessary anxiety and concern. There are simple and effective treatments available which can remit or at-least maintain results. Consult your dermatologist today for daily skin care regimen.
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
