About Diaper Rash & Cradle Cap

Diaper rash is one of the most common skin problems (affects up to 60% of all babies ) and is most frequent between the ages of 6 and 12 months which correspond to the time when a baby begins to eat a variety of foods and is most often caused by diaper chafing or wetness.
Diaper friction makes the very thin skin of babies even more sensitive. When diapers are soiled, their occlusive effect causes humidity and softening of the skin leading to potential germ proliferation. Other causes of diaper rash include over-washing, a change in diet, teething, diarrhea and infectious illnesses.

In most cases this condition can be resolved by applying dermo-cosmetic products to the affected area before having to meet medical treatment.

Cradle cap is characterized by small flakes of skin, whitish to yellowish in color that can appear on baby’s scalp and face. Cradle cap is quite common (2 in 3 babies are affected) and not a serious condition. It is due to an excessively greasy scalp caused by the transfer of hormones from the mother to baby at the end of pregnancy.

Because they are often located on top of the anterior fontanel, it is difficult to remove them during a daily cleansing routine. Mustela® has found a solution to this problem in Stelaker® purifying scalp cream.

In the past decade, much has been discovered about eczema-prone skin. For eczema to occur, a patient must have atopic gene(s) plus environmental stimulation. This combination leads to biochemical aberrations, IgE dysregulation, and loss of balance of the immune response.

Common environmental factors are dry surroundings, changes in weather, Staphylococcus aureus, and itchy clothing. Less common antigenic stimuli include house dust mites, certain foods, aeroallergens, and psychosomatic factors. Atopic Dermatitis is the type of eczema most commonly seen in pediatric practice and the morphology and distribution of AD is divided by age.

Infantile phase (0-2 years) The average age of symptom onset is about 3 months. Red papulovesicles appear, followed by oozing and crust formation. The skin is very dry. The child wiggles constantly in an effort to scratch. For this reason, bald spots are noted over the occiput, or erosions are noted on the chin. Once the child is old enough to coordinate movement, the child scratches constantly, leading to scratch marks and often to secondary infection with S aureus. The distribution is usually generalized to the trunk, arms, and legs.

Childhood phase (2-12 years) As eczema comes and goes, it takes many different forms. Acute sites have excoriations, redness, papules, and bleeding. Chronic sites have lichenification, characteristic skin thickening with infiltrated red plaques, accentuated skin folds, and post inflammatory hyperpigmentation. Once the child is 18-24 months old, the distribution of eczema shifts to the wrists and ankles and the face becomes less irritated. These children continue to have dry skin, hyperlinearity of palms and soles, pityriasis alba, infraorbital folds, and keratosis pilaris.

Source: Tor Shwayder, MD Director, Pediatric Dermatology, Henry Ford Hospital, Detroit Mich. July 15, 2007, Modern Medicine.

Sensitive skin is defined as skin which reacts very easily to various external and internal stimuli that are usually well tolerated. This excessive reaction is apparently linked to an imparied skin barrier and lowering of the skin tolerance threshold. This hyper-reactivity results in stinging, tightness, burning and sometimes pruritis. It can also be associated with temporary redness. (1,2,3)

All newborns and babies have delicate, immature skin, but approximately 45% have sensitive skin. In addition, 60% of pregnant women consider that they have sensitive skin and my pass this condition on to their child.(4)

There are several problems which probably cause sensitive skin in newborns, babies and children. The state of sensitive to intolerant skin could be related to the immature barrier function, vulnerable skin (fewer corneodesmosomes hence greater vulnerability to environmental factors) and an increase in Transepidermal Water Loss (TEWL). There is often a family history of sensitive skin. (1,2,3)

Several triggering factors have been identified:

• Climatic factors: heat, cold, wind, sun, etc.
• Physical factors: pressure applied to the skin or scratching
• Emotional factors: anger, stress
• Environmental factors: detergents, soaps, hard water, etc.

Source:
(1) O. De Lacharrière. Peaux sensibles, peaux réactives. Encycl Méd Chir (Éditions Médicales dt scientifiques Elsevier SAS, Paris). Cosmétologie et Dermatologie Esthétique 2002 ; 50-220-A-10 : 4p.
(2) L. Misery et al. Peaux sensibles en France : approche épidémiologique. Ann Dermatol Venereol 2005 ; 132 : 425-9
(3) C. Lafforgue, J. Thiroux, S. Béchaux. Cosmétiques et peaux sensibles, réactives. Nouv dermatol. 2006 ; 25(6) : 430-4
(4) Dr. Clarence De Belilovsky dermatologist, Paris, France