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!!