The rash on your baby’s face explained by an expert

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Before I had my baby last year, I had absolutely no idea just how much care goes into keeping baby skin healthy and free of a rash. I knew they had sensitive skin, it’s why I spent a week washing all her newborn clothes in an hypoallergenic laundry detergent. But it wasn’t until I was in the newborn trenches myself that I realised just how much care and vigilance goes into looking after baby skin.

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Dots, rashes and redness appear on a daily basis. We spoke with Associate Professor Gayle Fischer on looking after a rash on baby skin and the treatment of them.

What are the most common types of rash?

“The commonest are atopic eczema, seborrheic dermatitis and psoriasis in the first year of life,” explains Associate Professor Gayle Fischer. “Baby acne usually only happens to boys and is not really a rash: usually just blackheads and a few pimples” Milia are common in newborns but not any later.

Why do these rashes appear?

“Atopic eczema is a common genetic condition that 10-20% of babies have,” explains Associate Professor Gayle Fischer. “The rash appears because of dryness and inflammation.” Psoriasis is also genetic and usually presents itself as red, well defined scaly patches on both cheeks. Milia are actually blocked pores and this happens because very young babies do not sweat freely. “Acne results from inflammation of oil glands on the face reacting to hormones” says Associate Professor Gayle Fischer. “A newborn baby is still affected by mum’s hormones and this may not wear off until they are about 12 months old.”

How do you go about treating these rashes?  

“Eczema and psoriasis are both treated with moisturisers, topical corticosteroids and if infected antibiotics,” says Associate Professor Gayle Fischer. “It is best to avoid soap and use a soap substitute.” When it comes to acne, it’s usually a mild case and doesn’t need treatment but acne creams containing retinoids can be used if it is severe. Milia also doesn’t need treatment.

What ingredients/products should you avoid?

“None of these conditions are caused by fungal infection so avoid anti-fungal creams,” explains  Associate Professor Gayle Fischer. “Never use anything that was not prescribed specifically for your baby. If an antibiotic is needed only use the one prescribed by your doctor.” Avoid perfumed products and soaps as they can be irritating.  

What are the biggest no-nos in treating a facial rash at home?

-Don’t Never use topical corticosteroids any stronger than 1% hydrocortisone unless it was prescribed for your baby.

-Do If the rash is getting worse, stop whatever you are doing and see your doctor.

-Don’t try things that were prescribed for you or anyone else.

-Do Avoid herbal products: they are not necessarily any safer than medical ones and can cause allergic reaction.

-Do Avoid perfumed products.

-Don’t pick or squeeze pimples and pustules.

Should you always see a doctor when a rash appears?

Not necessarily. Apply unperfumed moisturiser and wait. Some rashes can be quite mild and transient. “You can apply 1% hydrocortisone available from the chemist yourself,” explains Associate Professor Gayle Fischer.

How do you work out when you should see a doctor if a rash appears on a baby’s face?

You should see a doctor if the rash is really obvious, is causing distress, itching and getting worse. “If it is just milia in a newborn there is no need to see a doctor,” sayd Associate Professor Gayle Fischer. “This goes away by itself. Mild acne also goes away with no treatment.”

At what stage should you be referred to see a dermatologist?

Associate Professor Gayle Fischer recommends seeing a dermatologist when the treatment given by your GP doesn’t help and the rash is itchy or sore or becomes very red and weepy.

Has your baby suffered from any of these rashes? What treatment did you employ?

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