A healthy skin protects us from several diseases.
Adequate sleep, exposure to morning sunlight for about 10
minutes, a daily bath, clean clothes, breastfeeding for smaller
children and a healthy diet for an older child that includes
coconut water, fresh fruits, leafy and raw vegetables, avoidance
of unnecessary drugs and a happy state of mind, all help in keeping the skin healthy.
Basic Care Of Your Child’s Skin
The skin basically consists of two layers. The outer
layer is called the epidermis, and the inner layer is the dermis.
In general, smaller children tend to have drier skin as
compared to older ones. So it is not advisable to use too much
soap on a child’s skin. Expensive soap is not required. Any
unscented bath soap may be used 2 to 3 times a week.
Infections of the face and buttocks are more common in young children. These areas should
be washed more frequently. No talcum powder or special baby powder is advisable, they
irritate the nostrils and lungs, and
tend to cake in the skin folds. Baby creams and oils are also
unnecessary. If the skin is too dry, coconut oil or a refined cooking
oil may be tested on a small area of the skin. If it does not
give rise to a rash, use it on the rest of the body. If the child
develops a rash, try some other inexpensive oil.
Acne
Acne or pimples is a disease of adolescence. It is due
to hormonal changes at this age resulting in more oily secretions. Although a healthy diet and a clean skin are
desirable for all children, do not nag a child having
acne about personal hygiene and food all the time. There is no
evidence that fried foods or chocolates are the cause of acne.
However, if you explain to the child the basic cause of acne, he
is more likely to listen to your advice about avoiding junk food
as far as possible. Just share information about acne with your
child as a friend.
SYMPTOMS: Acne affects the face and upper chest or back.
MANAGEMENT: Washing the face once in the morning and once at night with an ordinary
bath soap is enough. Instruct the child not to keep touching the pimples and
not to squeeze them. He will listen, especially if you explain
that pinching the pimples can lead to permanent scarring.
Regarding medication, it is better to take the advice of
your doctor or a skin specialist and to avoid indiscriminate
use of over-the-counter medicines. Treatment should be
continued as per your doctor’s advice. Most cases improve within
a month or two, but the condition can recur. Fortunately,
most cases improve with age.
Albinism
SYMPTOMS: Children with this inherited condition have white hair, white skin, blue eyes
(blue iris) and diminished eyesight. However, they can manage to read
and write. They also have photophobia (intolerance to bright light). The condition is not too uncommon — occurring
in 1 out of 20,000 people. A person with albinism who
marries a healthy unrelated person can have a child without
albinism. Most individuals can lead a satisfying life. Severe
cases can develop blindness and skin cancer later in life.
TREATMENT: No treatment for this condition is available.
Boils
SYMPTOMS: A boil is caused by the collection of pus
under the skin and may show up as a painful pimple or as a
red, hot and tender swelling under the skin called an abscess.
TREATMENT: The basic treatment is drainage of pus. Give hot water fomentation to the area every 3 to 4 hours
(place a thick layer of sterile gauze pieces — available at a
chemist — over the swelling. Pour warm water over it. Let the wet
gauze remain in place for about 15 minutes. Then remove the
wet pieces and dress with dry gauze and bandage). This may
be needed for a few days. When the head of the boil opens
and starts discharging pus, continue the hot compress till
all the pus comes out.
As with acne, do not squeeze the boil to take out the
pus. Let it come out on its own with the help of moist heat.
If you do not notice any relief within 3 to 4 days, consult
your doctor. At times, the pus may need to be drained out with the
help of a cut. Your doctor may have to dress the wound and
prescribe some antibiotic to be taken orally.
Diaper Rash (Nappy Rash)
This rash, confined to the nappy area, is commonly seen
in newborn babies and in older infants with frequent loose motions. It is seen less commonly in breastfed babies.
It is more common with babies who are put into disposable diapers. A naked baby does not get diaper
rash.
SYMPTOMS: Typically, we neglect to change the diaper soon after it is wet or soiled, and
the prolonged
contact of the skin with urine or stools leads to redness over the
lower part of the abdomen, groin, the genital area and the
buttocks. This is more likely to happen with a disposable diaper.
Sometimes, the moisture in the area can attract a fungus. Fungal
infection leads to redness over the area mentioned above, except the buttocks.
PREVENTION: To prevent diaper rash, use cotton diapers instead of disposable ones. Even
when you are travelling, use a cotton diaper and cover it up with a plastic cover.
Try to change the diaper as soon as it is wet. Clean the soiled
diaper area with plain water and dry it. Make sure that no
moisture is left in the groin or in the creases of the skin.
Some babies get up if the diaper is changed during the night, but they do not get the rash
even if the diaper
is not changed.
A few more words about disposable diapers: Of late, the quality of disposable diapers has
improved, resulting in
less incidence of nappy rash with their use. However, some
other problems with disposable diapers are being brought to
light. Doctors at the University of Keil in Germany report that plastic-lined nappies cause heat to build up around the
testes, possibly hampering their development at a vital stage in
a child’s growth. The highest temperatures were found
among the youngest babies. Dr. N. G. Wagle, former chairman of the Consumer Guidance Society of India, comments that
disposable diapers are reported to have over 5 times the levels of
tetrachlorodibenzodioxin, a potent toxin, as
compared to cloth diapers. He also points out that a
full-grown tree is cut to make just 500 diapers.
TREATMENT: If your baby develops diaper rash, expose the skin to air as often as possible,
especially for
some time after he has passed urine and/or stool. This is often
enough to solve the problem. If the rash persists, a
preparation containing zinc and castor oil may be used for local application. Your chemist can make it or any readymade
preparation can be used 3 times a day. Take the baby to
the doctor if the rash persists. He may have to treat it
with an antifungal preparation.
In severe diaper rash, do not excessively cleanse or
wipe the affected area. Washing with plain water, followed by
cool compresses of a mixture of half milk and half water,
then an application of a zinc cream over a light application of
mild steroid and antifungal cream seems to work best. The
diaper should be changed every hour through the hours you are awake.
Impetigo
SYMPTOMS: Impetigo, like boils, is also due to a
bacterial infection of the skin that presents as blisters which
burst open and form sticky yellowish crusts. They are
infectious and can spread to other parts of the body, but are
usually confined to the skin around the mouth and the buttocks, though they may be passed on to other close contacts.
TREATMENT: A local antibiotic cream is all that is
needed in mild cases. At times, your doctor may have to
prescribe an antibiotic to be given orally. The child’s clothes
should be changed frequently.
Leprosy
While it is true that leprosy is more common in certain
areas and in the poor socio-economic groups, it can affect a
child from any background. However, most cases of suspected leprosy are simply white patches of no significance and
need no treatment. Some of these are due to a fungal
infection that can be treated easily with local applications.
DIAGNOSIS: An early diagnosis of leprosy makes all the difference to its treatment. That is
why our discussion
here is limited to the diagnosis of an early case, with loss of
sensation over the affected part.
If you see a light-coloured patch on the skin that looks different from the surrounding area, test it for loss of
sensation with cotton. First, touch the normal-looking area with the child’s eyes open. Then touch the doubtful
area. After that, ask him to close his eyes and let him point
to the area you touched. If he cannot feel anything over the lightcoloured
area, repeat the test with a pin. Do not prick hard. If in doubt, see your doctor.
TREATMENT: Do not be unduly upset if it turns out to be leprosy; we now have very effective
drugs for the
disease. A history of close contact with a case of leprosy is
helpful to make a diagnosis, though leprosy may be present even in
the absence of such a history.
Patches of leprosy should be differentiated from
ringworm and vitiligo discussed here. A very common type of white
spot is noticed in children who play a lot in the sun, mostly
on the cheeks of children with darker skin, but also elsewhere
on the body. They tend to come and go, and disappear after a
couple of months. No treatment except patience is of any help. Some believe that such white spots may be associated with
worms; there is no harm in giving your child treatment for the
same. Incidentally, it may be mentioned that such patches (and
also white lines on the nails) are not due to calcium or
other deficiencies.
Lice
Children often bring lice home from school or get them
from a maid or any other person at home. Please do not blame
your dog, if you have one; pets do not transmit this
parasite.
SYMPTOMS: Lice cause severe itching and irritability. Eggs of the louse, the parasite that
initiates the
itching, are seen sticking to the hair like grains of salt.
MANAGEMENT: Your doctor will prescribe a local application, which is quite effective. It is
important
to treat all members of the family, who have even the slightest
itching. After a few days of treatment, the hair should be combed
with a fine-toothed comb to remove all nits. All clothes,
combs or brushes that come in contact with the hair should be
washed clean with hot water.
Bacterial infection of the scalp may result following scratching, which may also need to be
treated. Small
pea-sized glands at the back of the neck are often due to lice.
Once enlarged, they may take long to disappear. No treatment
is required for these.
Molluscum Contagiosum
This is a contagious skin disease caused by a viral
infection, which can spread from one part of the body to another.
SYMPTOMS: It presents as firm, pearly, skin-coloured swellings of 1 to 5 mm in size. The
centre of the
swelling appears depressed, from which a cheesy material can be expressed.
The disease can get better on its own, but
may persist for months or even years.
TREATMENT: The swellings can be tackled by removing the cheesy material with a needle or
by curettage. They
can recur. In order to destroy the swellings, all those
having the disease in the family should be treated. Recently, cimetidine,
a drug given by mouth (40 mg. per kg. body weight per
day for 2 months) has been found helpful in this condition.
Ringworm And A Few Other Fungal Skin Infections
Ringworm is
a fungal infection that presents as small, somewhat raised rings on the skin
with a pale centre.
Itching may be present, but is not marked. It can spread from
one child to another. Generally, local treatment and
personal hygiene is all that is required. In rare cases, your
doctor may prescribe a medicine to be taken orally, especially if
the nails are also affected. The patches differ from leprosy
because of the surrounding ring and no loss of sensation. The nails appear discoloured and thickened.
Tinea versicolor presents
as dark brown or whitish spots on the upper part of the chest and back. They are also
surrounded by a border that is rather irregular and not
so well raised as in ringworm. A local application twice a day
for about a month clears it completely. It may come back again
when the treatment needs to be repeated.
Candida infection
(which also causes a common fungal infection of the mouth called thrush)
may affect the
groin, armpits and neck. It presents as moist red areas of
skin, and responds well if the affected parts are kept dry, and
are given exposure to air and an antifungal treatment.
Scabies
SYMPTOMS: If more than one member of the family has itching all over the body — more
marked on the wrist, between the fingers and on the penis and scrotum — you
are probably dealing with scabies. The child may even get it
from a close friend.
MANAGEMENT: Preparations for local application containing benzyl benzoate or gamma
benzene hexachloride are quite effective.
In older children, the medicine may be applied all over
the body below the neck, especially between the fingers and
toes, and on the groin. Bathing should be avoided for 24 hours
after applying the medicine.
Smaller infants may also have the disease above the neck and so the medicine in 1:1 dilution
with coconut oil
should also be applied to the face and head. The treatment
should be repeated after a week.
PREVENTION: Besides personal hygiene, all members of the family having even the slightest
itching should be
treated. The disease can spread through clothes and linen, which should be
boiled and dried in the sun before use.
Sunburn
Fair-skinned children are more vulnerable to sunburn.
SYMPTOMS: Sunburn presents as intense redness of the skin over the chest and back
following exposure to sun.
An older child may even complain of pain and a burning
sensation in those parts that were exposed for a prolonged period
to sunlight. The skin may peel off after a day or two.
TREATMENT: Recovery takes place within a few days without any specific treatment.
Frequent baths with
baking soda added to the water help.
Some lotions, recommended for application before going out in the sun, contain drugs that
may not be safe for
children. The best precaution is to ensure that children do not
stay in the sun for too long.
Vitiligo
Vitiligo is the loss of skin colour, resulting in almost
pure white patches. Any part of the body can be affected, but
they are more common on the hands and face, especially around the lips and eyelids. The sensation on the skin is
normal.
MANAGEMENT: If in doubt, consult your doctor. He will rule out the diagnosis of leprosy and
instruct you to
avoid prolonged exposure of the white patches to the sun. If
this is not possible, cover the parts or apply any ointment
containing zinc oxide. Otherwise, the skin may develop blisters. No specific treatment is available. Your doctor may
prescribe some local application combined with exposure to
sunlight or ultraviolet light. At times, an oral medicine is also
prescribed. Some patches may recover spontaneously. But generally, more areas of skin keep getting involved.
Parents must meet the school authorities with a
certificate from a doctor that the disease is not infectious. They
should not pass on their anxiety to the child and thus avoid
secondary emotional problems in an otherwise healthy child.
Warts
SYMPTOMS: Caused by a virus, warts present as rather
hard yellow, brown or black swellings on the hands and toes.
They can also occur on other parts of the body.
TREATMENT: Though many cases are cured spontaneously, it may take years for this to
happen. It
is better to treat them early with the advice of your
doctor. Surgery is sometimes needed. Warts tend to recur, but
will respond again to the treatment.
