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Part 4: Keeping Your Child Healthy  >  The A-Z of Childhood Illnesses  >  Skin Conditions

SKIN CONDITIONS

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.


Eczema

See Allergies.


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.


Urticaria
See Allergies.


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.




7 March, 2016

 
Part 4
The A-Z of Childhood Illnesses

Abdominal Pain
Abrasions or Scratches
Acute Glomerulonephritis
Acute Nephritis
Acute Watery Diarrhoea
Addictions
Adenoids
AIDS
Allergies
Anaemia
Anorexia (Poor Appetite)
Asthma
ADHD
Autism
Backache
Bed-Wetting (Enuresis)
Birth Deformities
Bites and Stings
Bleeding
Bone, Joint and Muscle Injuries
Bowlegs and Knock-Knees
Breathlessness
Bronchiolitis
Burns
Calcium Deficiency
Cancer
Cardiac Pulmonary Resuscitation
Cerebral Palsy (CP)
Chickenpox
Choking
Circumcision
Cleft Lip and Palate
Common Cold
Congenital Heart Disease
Constipation
Convulsions or Fits or Seizures
Cough
Croup
Crying
Cuts
Dengue Fever
Diabetes Mellitus
Diarrhoea, Dysentery ...
Diphtheria
Down's Syndrome
Earache, Ear Infections ...
Electric Shock
Encephalitis
Eye Problems
Fears
Foot Problems
German Measles (Rubella)
Glands in the Neck ...
Headache
Head Injury
Hepatitis
Hydrocephalus
Hypertension
Hypospadias
Influenza (Flu)
Jaundice
Joint Disorders
Kala-Azar
Leptospirosis
Limp and Pain in the Legs
Malaria
Malnutrition (Undernutrition)
Measles
Meningitis
Meningomyelocele
Menstrual Problems
Mental Retardation (MR)
Mouth To Mouth Breathing
Mumps
Nephrotic Syndrome
Nose-Related Problems
Obesity
Pneumonia
Poisoning
Poliomyelitis
Premature Baby
Prolapse of the Rectum
Rabies
Rheumatic Fever
Rheumatoid Arthritis
Rickets
Short Child
Skin Conditions
Sleep and Sleep Problems
Sore Throat (Pharyngitis)
Splinters
Stammering
Stridor (Noisy Breathing)
Teething and Care of Teeth
Tetanus (Lock Jaw)
Thrush
Thumb-Sucking
Tics
Torticollis
Tracheoesophageal Fistula
Tropical Eosinophilia
Tuberculosis (TB)
Typhoid
Umbilical Problems
Undescended Testis
Urinary Infection
Vaginal Discharge
Vomiting
Wheezing
Whooping Cough (Pertusis)



Part 4
Keeping Your Child Healthy
Choosing A Paediatrician
Proper Use of Medicines
Home Remedies
A First Aid Kit
The A-Z of Childhood Illnesses
Psychological Concerns
Managing A Hospital Stay
Emergencies
Prayer And Your Child's Health
The Role of Nature Cure
Homoeopathy
Ayurveda and Child Care
Congenital Heart Disease FAQ
 
Guide to Child Care
Home
Introduction
1 Pregnancy, Childbirth ...
2 The Growing Years
3 Feeding Infants, ...
4 Keeping Your Child Healthy
5 Keeping Your Child Happy
About Dr. R. K. Anand
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