Dryness and redness of the skin in a child

In the human body, the skin is one of the most important organs. It performs several functions at once: barrier, excretory, sensitive, thermoregulatory, storage and others. Therefore, parents should carefully monitor the condition of their baby’s skin from early childhood.

Normally, a child’s skin should be clean, smooth, without cracks or inflammation. If there are any changes on it (redness or roughness), parents should immediately pay attention to it. The child’s body signals that something has gone wrong.

If a child has dry skin, it means that the stratum corneum does not contain enough moisture. Its appearance changes - it becomes rough, wrinkled, sometimes even scaly, and loses elasticity. But that's not the worst thing. The danger lies in the fact that microcracks appear in dry skin, through which pathogenic bacteria easily penetrate into deeper layers and become the cause of the development of dermatological diseases.

Why does my baby have dry skin?

Dry skin in a child usually occurs in the first three years of life in the autumn-winter period or early spring. This phenomenon can be observed both on individual parts of the body (arms, legs, face) and on its entire surface. Children's skin is very sensitive to external factors, its protective function is just developing. Therefore, when dry spots or rashes appear on the body, it is important to determine which personal hygiene items can cause irritation to the epidermis, and exclude shampoos, soaps, gels, and washing powders to which the baby may be allergic. If your child has dry skin, you should choose only hypoallergenic hygiene and laundry products, preferably without a strong odor and bright color.

You should not bathe your baby in hot water, as it tends to dry the skin; the optimal temperature for this procedure is 37°C.

Sudden changes in temperature can also cause dry skin in a child. Severe frost and cold winds often cause irritation and redness on the face and hands. Therefore, before going outside, the baby needs to lubricate exposed areas of the body with a special cream.

Heating systems operating in winter dry out the air in apartments, so it is recommended to use special humidifiers during this period.

Dry skin in a child can be an allergic reaction of the body, so you should pay attention to food. Among them may be those that provoke allergies, in particular citrus fruits and chocolate.

Dry skin on a child's feet

Quite often, children have dry skin on their feet. Especially in the summer, it loses moisture to such an extent that it begins to crack and hurt. In this case, it is better to wear open shoes with maximum air access. To avoid dust and dirt getting into the cracks, you need to wear socks. Before going to bed, be sure to wash your baby’s feet with baby soap, wipe them dry and lubricate them with massaging movements with a special softening fortified cream.

Dry skin on a child's feet is highly susceptible to infections, which can lead to complications. The familiar heat rash, diaper dermatitis, and diaper rash spread quickly if not properly cared for, and a pustular rash can even form. To avoid complications, it is necessary to show the child to the doctor as soon as possible and begin treatment.

Treatment of dry skin in children

The epidermis in young children is not yet able to retain moisture in sufficient quantities, so it has to be replenished from the outside. The choice of moisturizer must be taken seriously, since the skin reacts sharply to external irritants. If the child has very dry skin, choose a product together with the pediatrician. Most often, in such cases, doctors recommend external preparations containing urea, in particular Excipial M lotion, as well as an additional course of vitamin A for a period of two months. It is better absorbed if you drop it on a small piece of black bread before eating. In some cases, if the baby’s skin is inflamed, vitamin E, calcium supplements, and fish oil are prescribed. The dose of medication is determined by the doctor.

It is better to bathe your child without foaming detergents at all. Herbal baths are very effective in such cases. You need to mix rose petals and chamomile flowers in equal proportions, pour boiling water over it and let it brew for 15-20 minutes. After this, strain and add to water. The procedure should last at least 10 minutes. A bath with flax oil is also effective (1 tablespoon will be enough).

After bathing, you can give your baby a massage, treating the skin with a cream containing vitamin A.

Dry skin of a child as a sign of the onset of the disease

Sometimes dry skin can indicate the onset of a disease. Therefore, if redness or irritation occurs, parents need to consult a doctor to make an accurate diagnosis, establish the cause and begin treatment. Dry skin in a child, mainly under the age of 1 year, often occurs with atopic dermatitis. Severely itchy, reddened areas are localized on the face, without affecting the nasolabial triangle.

Peeling and scaly formations on the elbows, knees, and cheeks may be signs of ichthyosis, a genetic disease in which the process of keratinization of cells in the body is disrupted.

If a child’s skin is very dry and peeling, most likely it is hypovitaminosis A and PP; treatment in the form of taking the necessary vitamins eliminates unpleasant symptoms.

It should be taken into account that dry skin can be caused by dehydration due to dyspeptic disorders (vomiting, diarrhea) and heavy sweating.

Dry spots on baby's skin

Dry spots on children's bodies often appear, and there is nothing unusual or scary about this, because she is very sensitive. But parents should be concerned if they do not go away for a long time. Firstly, the cause of such spots may be physiological, since in young children the fat glands are not yet fully functioning. Secondly, the condition of the skin is influenced by environmental factors (temperature and water hardness, air humidity, food, soap). At first, to soften the affected areas, you can use a product purchased at the pharmacy, for example, Panthenol. But if dry spots on the child’s skin do not disappear, you should consult a doctor, as they can be symptoms of serious diseases such as atopic dermatitis, eczema, and psoriasis.

Skin ailments are usually difficult to deal with, but a correct diagnosis made in time makes the task easier. If there are signs of a particular skin disease at an early age, it is very important to immediately take action and prevent its progression. Without proper treatment in a medical facility, it can become chronic.

Video from YouTube on the topic of the article:

In some children, parents notice the appearance of dry and rough skin. These changes may not be observed on the entire body, but in certain places: on the face, on the arms and legs, on the head or behind the ears. You need to tell your pediatrician about these changes and find out the reason for their appearance.

In this article, we will consider the reasons for such a phenomenon as rough skin in a child, and also describe the most popular recommendations of pediatricians on this issue.

Causes of dry and rough skin

The causes of dry skin in a baby can be different:

1. The sudden appearance of reddish rashes on the face and roughness may be a manifestation acne in a newborn. This change in the skin is caused by an excess of hormones in the child’s body, and such a rash disappears by about one and a half months of the baby. The skin on your face will be clean and soft again.

2. Rough skin may result from influence of external factors:

1. the influence of dry air and lack of fluid in the body;
2. lack of vitamins;
3. the quality of bathing water and the use of decoctions of some drying herbs (chamomile, oak bark, chamomile, etc.);
4. exposure to frosty air or wind on the skin; in this case, patches of rough skin appear mainly on open areas of the body;
5. Frequent use of shampoo (even high-quality) can contribute to the appearance of dry and rough skin on the head;
6. Excessive use of baby powder can also “dry out” the delicate and easily wounded skin of a baby.

1. Dry skin and roughness may be one of the symptoms of diseases:

1. congenital diabetes mellitus, which is also characterized by increased appetite and thirst, increased blood glucose levels;
2. congenital hypothyroidism (reduced thyroid function): as a result of slow metabolism, the renewal of the surface layer of the skin is disrupted; Dry skin is most pronounced in the area of ​​the elbow and knee joints.

1. Rough skin may also indicate hereditary pathology(manifestations of genetically determined roughness appear before the age of 6 years, more often from 2 to 3 years):

1. about ichthyosis, in which, as a result of gene mutations, the process of keratinization of skin cells is disrupted: first, the skin becomes dry, it becomes covered with white or gray scales, then the rejection of scales is disrupted, and over time the body becomes covered with them like fish scales. In addition to skin manifestations, there are dysfunctions of internal organs and metabolic processes;
2. hyperkeratosis, a disease in which there is increased thickening, keratinization of the surface layer of the skin and a violation of its rejection. These manifestations are most pronounced in the feet, elbows, thighs and scalp. The causes of this pathology are not fully understood. In addition to the hereditary factor, others are also important for the occurrence of hyperkeratosis: dry skin of the child; avitaminosis of vitamins E, A, C; side effects of hormonal drugs; stress; hormonal changes during puberty in adolescents; excessive exposure to ultraviolet rays; diseases of the digestive system; exposure to detergents.

1. Worm infestation may also cause rough skin in children.

1. But most often, pink and rough cheeks and buttocks may be a manifestation atopic dermatitis(the outdated name for this condition is “exudative diathesis”). It can appear as dry, rough patches on different parts of the body. This is a disease of an allergic nature, expressed in the skin's reaction to exposure to various allergens.

The risk of allergies in a child may increase when the mother is treated with hormonal and other medications during pregnancy, when she takes uncontrolled multivitamin complexes, or when the woman smokes during pregnancy and lactation.

Long-term breastfeeding is a good protection for your baby from allergies. The nutrition of a nursing mother is also important, excluding seasonings, smoked foods, fried and fatty foods from her diet.

Hereditary predisposition to allergies is also important, not only on the mother’s side, but also on the father’s side (the presence of allergic diseases such as bronchial asthma, urticaria).

Allergens for a baby can be:

1. food products, including adapted milk formulas or even mother's milk; in older children, allergies are provoked and intensified after eating sweets;
2. clothing made from synthetic fabrics;
3. washing powder and other hygiene products (soap, gel);
4. pet hair;
5. tobacco smoke (passive smoking);
6. aquarium fish and food for them.

Dry skin due to allergies can also be local in nature, for example, it appears behind the baby’s ears. When a staphylococcal infection is attached, crusts and weeping with an unpleasant odor may form. True, such manifestations behind the ears can also be associated with errors in caring for the baby, and not with allergies: when regurgitating, vomit flows into the area behind the ear and is not removed from there in time.

Why does an allergy affect the skin?

The bottom line is that an allergy is the body's response to a foreign protein (antigen). In response to a signal that the protein is foreign, an antibody is produced to neutralize it. This creates an antigen-antibody complex that causes an allergic reaction.

It is known that allergies can also be caused by a substance that is not a protein. In this case, this non-protein substance combines with a protein in the blood and such a protein, which is native to a given organism, is already regarded as foreign and antibodies are produced to it.

The immature enzymatic system of the child's body is not able to break down some foods normally, and they become allergens. In another case, the product entered the digestive system “in excess” - this situation occurs when a child is overfed. In this case, there are not enough enzymes, and the product (protein) remains undigested and unbroken.

Foreign protein (or incompletely digested) is absorbed into the blood. These substances can be released from the blood through the kidneys, through the lungs and through the skin (with sweat). The skin reacts to them with the appearance of a rash, redness and itching.

Considering the above, it becomes clear why it is so important not to overfeed the baby or overload his immature digestive system. This statement is confirmed by the fact that in a child during the period of intestinal infection, when diarrhea is noted and the food load is significantly reduced, the manifestations of allergic dermatitis decrease.

Clinical manifestations of atopic dermatitis depend on the age of the child. In infants, it manifests itself mainly in the form of dry skin, flaking on the face, scalp, and diaper rash, even if the child is well cared for. The main symptom is redness, itching, roughness and flaking of the skin on the cheeks and buttocks.
With proper treatment, symptoms are easily relieved. If left untreated, children over one year of age are affected by the deeper layers of the skin, as evidenced by the appearance of blisters and ulcers. Affected areas appear on the trunk and limbs. The child is bothered by severe skin itching. A bacterial or fungal infection may occur with the development of complications.

In children older than one year, atopic dermatitis takes on a protracted course with frequent exacerbations. The process can develop into eczema (dry or weeping). If left untreated, allergic rhinitis and bronchial asthma may join skin manifestations.

Dr. Komarovsky about allergic dermatitis:

Prevention of atopic dermatitis

From the first weeks of a baby’s life, parents should take care of the baby’s health.

1. Breastfeeding plays an important role in preventing allergies. A nursing mother needs to carefully follow a diet, exclude spices, smoked foods, canned food, exotic fruits, chocolate from her diet, and limit the amount of confectionery.
2. Systematically monitor the temperature and humidity in the child’s room - use hygrometers and thermometers. The temperature should be between 18-20°, and the humidity should be at least 60%. If necessary, you should use air humidifiers, and if they are not available, place containers of water in the room or hang a damp towel on the radiator.
3. The baby's underwear should be made from natural fabrics (cotton, linen). For children with allergies, it is better not to buy outerwear made of wool or natural fur.
4. Children's clothes and bedding should only be washed with gentle (“baby”) powders.
5. You should bathe your baby with baby soap no more than once a week. It is better to use purified water for bathing, or at least settled and boiled water.
6. During the day, instead of washing, you can use special hypoallergenic wet wipes.
7. When using disposable diapers several times a day, you should undress the baby and give him air baths.
8. Before going for a walk (20 minutes before), you need to use moisturizers to treat exposed skin.
9. If there is a genetic predisposition to allergies, pets and carpets should be removed from the apartment, and the child should not play with soft toys.
10. Several times a day, wet cleaning of the premises with water without the use of chemicals should be carried out.

Treatment of atopic dermatitis

Treating this disease is not an easy task. It requires the joint efforts of doctors and parents. Treatment is divided into non-pharmacological and medicinal.

Non-drug treatment

Treatment always begins with improving the child’s nutrition. First, you need to identify and eliminate the food allergen. If your baby receives breast milk, you should work with your pediatrician to analyze the mother’s diet and track which product is causing skin manifestations in the baby.

You should also pay attention to the issue of regularity of the mother's bowel movements, since constipation increases the absorption of toxins from the intestines into the mother's blood. These toxins can then enter the baby's body through the milk and cause allergies. To combat constipation, the mother can use lactulose, glycerin suppositories, and increase the consumption of fermented milk products.

When artificially feeding a child, it is advisable to switch to soy formula to exclude an allergy to cow's milk protein. Such mixtures include “Bona-soy”, “Tuteli-soy”, “Frisosoy”. If there is no improvement, the baby is transferred to mixtures based on hydrolysates of cow's milk proteins (Alfare, Nutramigen).

If dermatitis develops after the introduction of complementary foods, the baby should be returned to his usual diet for 2 weeks. Then start complementary feeding again, strictly following the rules for its introduction: introduce each new product, starting with the minimum dose, for 3 weeks. In this way, food allergens can be identified.

If the child is older than one year, you should keep a daily log of all the products the child receives and a description of the condition of the skin. The most allergenic foods (fish, eggs, cheeses, chicken, citrus fruits, strawberries, etc.) should be excluded, and then give the child only one product at a time for 2-3 days and monitor skin reactions.

Sweets are absolutely contraindicated for such children: they increase fermentation in the intestines, and at the same time the absorption of allergens increases. Consuming jelly, honey, and sweet drinks will make things worse. For children with allergies, products containing stabilizers, preservatives, emulsifiers and flavor enhancers are prohibited. It should be remembered that imported exotic fruits are also treated with preservatives to increase their shelf life.

It is very important to ensure that the child has enough fluids and regular bowel movements. The safest remedy for constipation in infants is Lactulose. You can also use Normaze, Duphalac. These drugs are not addictive.

It is very important that the child does not overeat. A formula-fed baby should make a very small hole in the nipple on the bottle with the formula so that he eats his portion in 15 minutes and gets a feeling of fullness, and does not swallow it in 5 minutes, requiring more nutrition. You can also reduce the dose of the dry mixture before diluting it. It is better to discuss this issue with your pediatrician.

When you reach the age for the first complementary feeding, it is better to start with vegetable puree from one type of vegetable. The most low-allergenic vegetables are cauliflower and zucchini.

When regulating a child’s nutrition, the adverse effects of the environment should also be eliminated. The air in the children's room should always be fresh, cool and humidified. Only under such conditions can sweating and dry skin in a child with dermatitis be prevented.

Family members should only smoke outside the apartment. The baby's contact with smoking family members should be kept to a minimum, given the release of harmful substances in the exhaled air of a smoker.

Wet cleaning of the room, elimination of “dust accumulations” (carpets, soft toys, velvet curtains, etc.), and exclusion of contact with pets will help achieve success in treatment. We must also remember to regularly wash toys with hot water.

All children's clothes (underwear and bed linen) must be made of cotton or linen. After washing children's clothes with hypoallergenic phosphate-free powder, they should be rinsed at least 3 times in clean water. In especially severe cases, the last rinse is also carried out with boiled water. The child's dishes should be washed without using detergents.

You should dress your child for a walk according to the weather. Do not wrap your baby up to avoid excessive sweating. Staying in the fresh air should be daily at any time of the year and in any weather - at least 3 hours a day. In winter, you must not forget to treat your baby’s face with rich baby cream before going for a walk.

With atopic dermatitis, skin care is very important not only during the acute stage of the process, but also during the period of remission. The child should be bathed daily in filtered or at least settled (to remove chlorine) water. You can add herbal decoctions (nettle, yarrow, burdock root) to the water, excluding the use of herbs with a drying effect.

When bathing, do not use a washcloth, and use baby soap and neutral shampoo only once a week. After bathing, the skin should be carefully dried with a soft towel and immediately lubricated with baby cream, moisturizing milk or moisturizing lotion.

Lubrication should be carried out throughout the body, and not just in the affected areas. Preparations containing urea (Excipial M lotions) moisturize the skin well. Bepanten ointment has proven itself well as a skin care product. It has not only a moisturizing effect, but also a soothing itching and healing effect.

It is necessary to wash your child's face and perineum frequently. You can use wet hypoallergenic wipes produced by well-known companies.

It is also important to maintain a daily routine, sufficient duration of daytime and night sleep, and a normal psychological climate in the family.

Drug treatment

Drug treatment of atopic dermatitis is carried out only as prescribed by a doctor!

Sorbents (Smecta, Enterosgel, Sorbogel) can be used to remove toxic substances from the body. If the child is breastfed, the child’s mother also takes the drug.

If rough spots cause itching and anxiety in the baby, then Fenistil ointment can be used to treat them.

Creams or ointments containing glucocorticosteroids are used as prescribed by an allergist. For deep lesions, ointments are used, and for superficial lesions, creams are used. These hormonal medications must be strictly dosed. You cannot change the dose and duration of use on your own. Cancellation of the drug should only be gradual, over a few days.

In this case, both the dose of the ointment and the concentration of the drug may decrease. To reduce the concentration, the ointment is mixed in a certain proportion (prescribed by the doctor) with baby cream. Gradually increase the portion of cream in the mixture and reduce the amount of ointment.

Hormonal ointments give a quick effect, spots of roughness and redness disappear. But these drugs do not act on the cause of the disease, and if it is not eliminated, changes in the skin will reappear in the same or other areas.

Hormonal ointments (creams) are usually combined with the use of Exipal M lotions, which helps reduce the duration of treatment with hormonal drugs, and, therefore, reduces the risk of side effects from the use of steroids.

Lotions have not only a moisturizing effect, but also an anti-inflammatory effect, equivalent to the effect of hydrocortisone ointment. In mild stages of dermatitis, lotions can have a positive effect without hormonal agents.

There are two forms of Excipial M lotions: Lipolotion and Hydrolotion. Excipial M Hydrolotion is used to moisturize the skin of children during the period of remission of dermatitis. The effect of the drug begins 5 minutes after application. It can be used from birth. A Excipial M Lipolosion should be prescribed during exacerbations of dermatitis. The lipids and urea it contains protect the skin from fluid loss, and the moisturizing effect lasts for about 14 hours. It is approved for use from 6 months of age.

The lotion is applied to the baby's skin three times: in the morning, immediately after bathing and before bedtime. When the process worsens, the lotion is applied the required number of times to ensure constant skin hydration. Regular use of lotions reduces the frequency of relapses.

In severe forms of the disease, calcium supplements (Glycerophosphate, Calcium Gluconate) and antihistamines (Tavegil, Suprastin, Diazolin, Cetrin, Zyrtec) are additionally prescribed. But keep in mind that a side effect of these drugs may be dry skin. Therefore, antihistamines are used for persistent itching. Phenobarbital, which has a hypnotic and sedative effect, is sometimes prescribed at night.

Summary for parents

The appearance of rough, dry skin in a child should not be taken lightly. This should be regarded as an alarming signal from the child’s body. Most often, these “non-serious” manifestations are symptoms of atopic dermatitis. This disease can lead to neuropsychiatric disorders in early childhood and the development of severe allergic disease in the future.

Dermatitis should be treated immediately after it is identified. It is with high-quality treatment in the first year of life that a child can be completely cured. Therefore, it is necessary to overcome both everyday and financial problems that arise when treating a baby.

There are no unimportant components in the treatment. All components of therapy - from proper nutrition, daily routine and baby skin care to drug treatment - are the key to a successful result. Only thanks to the efforts of the parents, in this case, the child will no longer be allergic, and he will not be at risk of developing eczema or bronchial asthma.

Which doctor should I contact?

If your child's skin changes, you should first contact your pediatrician. After excluding external causes (poor nutrition or skin care), the child is referred for consultation to specialists: a dermatologist, an allergist, and, if necessary, an endocrinologist.

Dr. Komarovsky on how to find the cause of allergies:

It's hard not to be alarmed when baby's delicate skin suddenly becomes rough and rough. What happened, why did the skin become rough and is it dangerous? Should I go to the doctor or try to cope on my own?

In general, situations when you have to figure out why a child has rough skin can be divided into several fundamentally different groups:

When it's not a disease

Dry, rough skin in a child can appear either as a result of illness or simply under the influence of external factors: cold, wind, friction.

Friction

For example, the skin on a child's elbows may become rough, wrinkled and dark simply because they are often leaned on while lying down watching TV or playing with gadgets. The same rough brown or pinkish dry, rough patches may appear on the top of the foot if the child has a habit of sitting with one leg tucked under him, which constantly rubs against the upholstery of the chair.

Something similar can happen to the skin of the legs, or less often, it can appear on the hips if you wear woolen pants directly on the body. In this case, the rough red spots look like goose bumps. Actually, this is what it is, irritation appears due to the impact of coarse wool on children’s skin, which has become sensitive in the cold (however, similar problems also occur in adults).

Cold, wind

Children aged 7–10 years who begin to walk independently may develop pimples on their hands: the result of exposure to cold, moisture and wind (most often when walking in wet mittens or without mittens at all). Small rough bumps appear on the skin, it turns red and peels.

All these cases do not require medical intervention. It is enough to change the child’s habits so that the skin does not get injured again and again, and lubricate the areas of peeling with a rich, nourishing cream.

1. This could be domestic hand cream with vitamin F, blue Nivea, Vaseline.
2. One of the folk remedies is goose fat.
3. It is not recommended to use oils in their pure form: any oil effectively moisturizes only after peeling, when keratinized particles of the epidermis have been removed. It is not worth scrubbing already irritated sensitive skin, so as not to further injure it.

In a newborn and a child up to one year old

In the first two weeks of life, dry, rough skin, fine peeling on the baby’s stomach and sides may be normal: this happens in about a third of babies. After removing the vernix, the skin becomes more sensitive to external influences and dry air in the room (especially in winter, when central heating is on) reduces the amount of moisture in the skin. No special measures are needed here: it is enough to bathe the baby regularly (provided that the umbilical wound has healed) and after bathing, lubricate the skin with baby oil or milk.

The skin of a healthy baby can dry out and peel if:

1. too dry air in the house,
2. excessive use of baby powder,
3. bathing too often with soap or foam,
4. adding string, chamomile, oak bark to the bath.

All this is quite easy to detect and eliminate.

Diaper dermatitis

Rough skin on the butt of an infant can become a manifestation of diaper dermatitis, when the skin begins to swell due to excess moisture or is injured by the diaper. In this case, in addition to peeling on the skin, red swollen areas appear that appear denser and seem to rise above the surface. The redness does not have clear outlines, gradually fades away, and is often covered with small papules (tubercles), which can spread beyond the area of ​​redness. When the process begins to fade, the redness disappears, but peeling and sometimes rough skin remains. Diaper dermatitis is always limited to the diaper area, the spots are uneven, and “drips” around the elastic bands are often visible.

This situation can hardly be called a variant of the norm, but there is no reason to panic. If you take measures in a timely manner, preventing infection from occurring, you can cope with the problem without a doctor. The diaper must be changed at least once every 2 hours. The baby's skin should be kept clean; when changing a diaper, any remaining urine should be removed with wet wipes. Areas of inflammation are treated with zinc powder or zinc ointment. If the problem is limited to mild redness and peeling, you can use creams with a healing effect (Bepanten).

If, with regular care and timely diaper changes, the situation does not change within 5 days, you need to consult a doctor.

When rough skin is a disease

1. Hives
2. Atopic dermatitis
3. Eczema
4. Psoriasis

Other diseases that can cause dry and flaky skin include:

1. follicular hyperkeratosis (goose bumps);
2. congenital thyroid deficiency (hypothyroidism);
3. congenital diabetes mellitus;
4. a rare hereditary disease – ichthyosis;

And also some body conditions:

1. lack of vitamins;
2. helminthic infestation.

Allergic diseases

Allergy is one of the main problems of our time: according to WHO, a third of the population of developed countries already suffers from one or another of its manifestations, and in the future the number of such patients will increase. Proponents of the hygienic theory of allergies believe: the problem is that we live in a too clean, almost sterile world, and the immune system, due to the lack of real “enemies,” attacks the proteins of its own body.

Allergic reactions and diseases associated with excessive allergic readiness of the body often manifest themselves on the skin.

Hives

In appearance, this reaction is similar to traces of a nettle burn; the skin becomes rough, bumpy, swells, sometimes blisters appear (and sometimes the matter is limited to swelling). The rashes are itchy and may be painful to the touch. The skin and mucous membranes are affected, the rash can spread throughout the body, on the back and abdomen, or be located only in certain areas (for example, with increased sensitivity to ultraviolet radiation, solar urticaria appears only on open areas of the body).

Hives can be triggered by food allergens (honey, citrus fruits), medications, insect bites, even cold and sun.

What distinguishes urticaria from skin diseases is the rapid appearance of many elements, while in skin diseases the rash begins with 1 - 2 elements and spreads over some time. Also, unlike skin diseases, rashes with hives last 1–2 hours, after which they disappear. The danger of this condition is that swelling of the mucous membrane can spread to the tissues of the larynx and impair breathing - this is called Quincke's edema. This condition requires immediate medical attention.

To treat urticaria, it is necessary to eliminate the allergen and take an antiallergic drug (loratadine, fexofenadine, cetrin). For food allergies, sorbents (Smecta, Polysorb, Enterosgel, Filtrum) are recommended; they will bind some of the allergens, preventing them from entering the blood. Fenistil can be used topically.

Atopic dermatitis

This is one of the most common causes of rough skin in a child. According to WHO, up to 15% of the world's population suffers from atopic dermatitis. Girls get sick more often than boys. The disease has a hereditary predisposition: if one of the parents has any allergies, the probability that the baby will develop atopic dermatitis is 20%; if both are allergic, the probability of the disease increases to 60%.

In essence, atopic dermatitis is an immune-dependent inflammation of the skin, during which the formation of the normal stratum corneum and lipid composition of the skin are disrupted. Speaking in Russian, due to inflammation caused by an allergic reaction, the skin produces too little fat and too many dead horn cells, which normally should protect it from external influences, but in atopic dermatitis, accumulating in excessive quantities, making the skin dry and rough.

Symptoms

The manifestations of atopic dermatitis depend on age. The disease usually appears at 1 year of age. In children (children aged 1–2 years), active inflammation predominates. Red, rough spots appear on the skin, covered with small nodules (papules) and small blisters that burst. forming weeping ulcers (erosions). Such rashes are located on the cheeks of a one-year-old child, less often on the forehead and chin, and on the hands.

As the child grows, the nature of the rashes and their prevalence change. Usually, after two years, the rough spots on a child’s skin become less bright, stop getting wet, and begin to peel off. And the skin itself becomes rough, its pattern intensifies and the lesions look wrinkled and may crack. The rash spreads to the neck and shoulders, elbow fossae, shins, popliteal fossae, gluteal folds, hands and feet. All these places actively itch, the child scratches them and can become infected. Then purulent crusts appear and the temperature rises.

Changes on the face are also possible: the eyelids darken, peel, and become wrinkled. Due to constant scratching, nails become smooth, shiny, and their edges wear down.

Usually the disease occurs as a series of exacerbations and remissions. Exacerbations occur more often in the cold season and are provoked not only by allergens, but also by stress and colds.

Treatment

Treatment of atopic dermatitis is complex and often unsuccessful. First of all, it is necessary minimize contact with allergens.

1. A special diet is prescribed for this

Eggs, chocolate, citrus fruits, strawberries, factory juices, semi-finished products, and smoked meats are excluded from the diet. Sometimes this is not enough and you have to specifically identify foods that the child cannot tolerate, for example, cow's milk.

Let us dwell in more detail on nutrition for atopic dermatitis, because in children it is food allergens that most often provoke the disease. If the disease appeared before the introduction of complementary foods, the mother will have to take care of her diet, excluding the products mentioned above. An allergy can also occur to formula milk, then the problem should be discussed with a pediatrician who will help you choose a hypoallergenic product (alas, not a single hypoallergenic product actually guarantees the absence of a reaction.

If one or both parents are allergic, the baby is predisposed to atopic dermatitis. In this case, complementary foods should be introduced especially carefully: do not try to diversify tastes by adding one product once a week. Yes, the process will go slower, but it will be possible to track the baby’s reaction.

If the moment has already been missed, and at some stage of introducing complementary foods rashes appear, you will have to start all over again. For two weeks, the baby returns to exclusively breastfeeding. Then complementary feeding begins with minimal doses of one new product, gradually increasing the amount over two weeks. Only if it is well tolerated, the next one is added.

In older children, for whom mother's milk is no longer a necessity, but an addition to nutrition, it is necessary to use other schemes. First, almost everything is excluded from the diet. Only rice or buckwheat in water without oil or salt is allowed. Usually this stage is very difficult to survive: both the child and, especially, the grandmothers are indignant, trying to shove something “tasty” into their hands and accusing the young mother of abusing the child. Try to find an ally in the family who will take the fire.

After a week of such a strict diet, one new product is added. Further, new products are allowed every three days. Everything eaten and drunk during the day is carefully recorded in a food diary. Pay attention to hidden allergens: for example, eggs are often added to homemade cutlets.

1. A change of scenery

If you have a baby at home with atopic dermatitis, you will have to change the environment. You need to remove carpets, drapes and other “dust containers” that harbor dust mites from your apartment. If there are feather pillows and duvets left in the house, you will have to remove them too. Check the bathroom for fungus: it often starts in hard-to-reach places, tile cracks. The fungus will also have to be removed regularly. Cleaning the house will have to be done every day: washing the floors can be replaced with a vacuum cleaner with a HEPA filter that does not allow small particles to pass through. A regular vacuum cleaner, on the contrary, only disperses allergens into the air. If finances allow, an air washer can be a good help, as it will maintain the desired level of humidity (which will have a beneficial effect on the skin of not only the baby, but also the mother), while simultaneously clearing the air of dust.

It is better to bathe your baby without soap and foam. You should not add potassium permanganate to the water - after the umbilical wound heals, the baby does not need sterility, and manganese dries out the skin. Herbs are also not useful - they themselves can become a powerful allergen. After bathing, you can lubricate your baby’s skin with special creams – emollients. Such creams are produced by many pharmaceutical cosmetics manufacturers. They can be used several times a day.

Drug therapy works in two main ways.

External therapy

Ointments with anti-inflammatory and antiallergic effects are used.

1. Doctors often prescribe ointments with hormones (for example, methylprednisolone acetate) - there is no need to be afraid of them, these drugs are indicated in clinical recommendations as first-line therapy. Modern ointments with glucocorticoids are safe for a short course (no more than a month). But the dosage must be strictly observed. A strip of cream covering the end phalanx of the index finger is enough to spread over the area of ​​two adult palms. If the area of ​​the rash is smaller, accordingly, you need to take minimal amounts of the product. Do not mix hormonal ointments with petroleum jelly or baby cream - this will reduce the concentration of the active substance and the effectiveness of the drug.
2. As an alternative to hormonal ointments, you can recommend the drugs pimecrolimus (Elidel), approved from the age of three months, or tacrolimus (Protopic), permitted from the age of two. For frequent exacerbations, pimecrolimus or tacrolimus can be used for prophylaxis, applied twice a week - according to this regimen, they are allowed to be used for a year or more.
3. Lesions in the hair are treated with shampoos containing zinc pyrithione.
4. Tar as a folk remedy for treating atopic dermatitis is effective, but has a carcinogenic effect.

General therapy or systemic antiallergic drugs

Loratadine (Claritin), ebastine (Kestin), cetirizine (Zyrtec). They reduce itching, especially at night, and swelling of the skin.

Children over three years old with extensive skin manifestations benefit from ultraviolet radiation: if it is not possible to sunbathe, you can use special devices in the physiotherapy rooms of clinics.

If atopic dermatitis appears at 1 year of life, there is a 60% chance that it will disappear over time. In general, the later the disease occurs, the more likely it is to last into adolescence and adulthood.

Eczema

Another hereditary disease caused by an inadequate immune response. Often combined with problems of the gastrointestinal tract and biliary tract.

The area of ​​skin becomes red and swollen, and small blisters appear on it and burst. leaving behind pinpoint weeping ulcers (erosions), which doctors call eczematous wells. Then crusts appear on them. As it dissolves, new elements appear nearby, so you can simultaneously see different manifestations - redness, blisters, erosions, crusts, peeling. The boundaries of the lesions are unclear.

The rashes are symmetrical, the child has rough skin on the arms, legs, and face. Damaged areas alternate with clear skin, looking like an “archipelago of islands.” After the inflammation subsides, dense, darkened (or, conversely, pale) areas with rough, thick skin and an enhanced pattern remain, which gradually return to normal.

When the scalp is affected, seborrheic eczema occurs: yellowish or gray flaky and itchy crusts, yellowish-pink, swollen spots appear in the hair, behind the ears and on the neck, covered with greasy yellow flaky scales.

In children, the first signs of eczema usually appear between 3 and 6 months. Its manifestations are very similar to those of atopic dermatitis, the treatment is also similar: exclude all possible allergens, including food, ointments with glucocorticoids, oral antiallergic drugs, emollients several times a day to maintain the water-fat balance of the skin.

Psoriasis

Another disease in which skin changes are caused by an inadequate immune response. But unlike previous diseases, with psoriasis the trigger is infection: the disease often appears after chickenpox, tonsillitis, intestinal infections, or fungal infection. Most often this occurs between the ages of 4 and 8 years. The second peak incidence is adolescence.

If in adults psoriasis is rough, dry red scaly plaques, then in children it is most often red swollen spots, very reminiscent of diaper rash, but, unlike diaper rash, scaly. Such spots appear in the folds of the skin, on the genitals, face, and head. The plaques itch and flake off profusely. especially when combing, they often merge. About a third of children's nails change: indentations and transverse stripes appear in them. In adolescence, the elbows are often affected: groups of plaques with clearly defined boundaries gather around them, the skin is rough and red.

Just like atopic dermatitis or eczema, psoriasis gets worse. then goes into remission. The skin may clear completely, or a few “standby” plaques may remain. The duration of remission ranges from several weeks to tens of years.

Treatment of psoriasis begins with local therapy, the purpose of which is to remove peeling. To do this, use ointments based on salicylic acid, which soften the horny scales. The ointment is applied at night, washed off in the morning and the plaques are lubricated with ointments containing corticosteroids.

In severe cases, retinoids are prescribed orally - drugs based on active forms of vitamin A. But this is really a therapy for extreme conditions, which requires mandatory medical supervision.

Ultraviolet radiation helps well: it is useful for such children to sunbathe, and in winter to use artificial sources of ultraviolet radiation.

In the same way as with atopic dermatitis, a hypoallergenic diet is prescribed.

The manifestations of many skin diseases are very similar; it is difficult for a non-specialist to distinguish different types of rash from the descriptions. There is no need to try to diagnose and prescribe treatment on your own - there are dermatologists for that.