Infant Eczema (Atopic Dermatitis)
Atopic Dermatitis is a common and itchy skin disease that typically starts in early life. It may affect as many as 17% of all children and usually begin in the first year of life. Symptoms of Atopic dermatitis include intense itching and red and scaly lesions or patches. Most children grow out of the skin eruption but sometimes they do not and sometimes eczema begins in adulthood. We have learned more about the cause of eczema and it is felt that there is a defect in the barrier of the skin in most patients with eczema. The barrier dysfunction in the skin is due to a defect in a protein product called fillagrin. The recommended treatment of atopic dermatitis is to hydrate the skin. This is the most important treatment. Bathing in a warm water bath 20-30 minutes once or twice a day followed by immediate application of a greasy moisturizer (like Cetaphil Cream, Vanicream or CeraVE Cream). We recommend avoiding soaps that overly dry out the skin like Ivory or Dial.
Diaper rash is basically an irritant contact dermatitis on the buttock. It is due to the wetting and drying of the skin. Initially it is a red scaly rash that looks like a burn. But secondary skin infections may occur on the skin as it is broken down. Yeast infection may occur here as well as a bacterial infection. If pustules develop it is likely that some type of infection has occurred. Changing diapers regularly is one way to help prevent a diaper rash. Using disposable diapers is LESS LIKELY to cause diaper rash. Cloth diapers tend to hold in the water and sometimes macerate and irritate the skin. We recommend AVOID using baby wipes as these have many chemicals in them that are known to cause an allergic contact dermatitis. In place of baby wipes we recommend Cetaphil Gentle Skin Cleanser (which is a soapless cleanser) used on a cotton ball or a very soft gentle cloth.
Molluscum are an infectious small flesh colored papule or growth that occurs on the skin most commonly in children. Molluscum is caused by a virus similar but not the same as the wart virus. Most molluscum bumps resolve or go away without any treatment. Molluscum is infectious and these bumps may be passed from one child to another, specifically in a swimming pool or in the bath rub. Molluscum does not cause any other health problems, though some children scratch the molluscum and they may become secondary infected. In addition treating warts may also lead to secondary infection. When an individual wants to attempt to treat molluscum a variety of methods such as freezing and cantherone (beetle juice) may be used.
Warts are caused by a superficial viral infection on the skin. Warts are caused by a different virus than the virus that causes molluscum. Warts are caused by the human papillomavirus (HPV). There are many strains to this virus and the strains that typically cause warts on the hands and feet are completely harmless. Unfortunately the wart virus is much harder to clear from the skin. The average life of a wart is up to 9 years. Half of all warts will clear on their own, though in the first 1-2 years. Treating warts may be challenging. Treatment options include cryotherapy ( freezing), cantherone, laser treatment, duct tape, oral tagamet as well as injections with candida.
Acne is an inflammatory skin disease that typically involves the skin on the face but may involve the chest and back as well. Acne is a “multifactorial” disease implying that there are many causes which include hormone changes, overgrowth of the hair follicles (which are on the skin on the face, chest and back), overgrowth of skin bacteria and increase oil gland section. Acne typically flares in puberty but many individuals have acne that persists into adulthood. The treatment for acne should be individualized. There are many options from treating with topical antibiotics or creams (like Tretinoin or Retin A), oral antibiotics (low dose and high dose such as Doxycyline), oral medications that have effects on the hormonal component of acne (Spiranolactone) as well as laser and photodynamic therapy acne treatments.