Tuesday 16 November 2010

Looking after your child’s skin

Chat session led by Dr Michèle Sayag, Allergist.

Chat transcription:


Question 1
Internet user : As an expecting mother, I would like to know how parabens can harm my child?
Dr Michèle Sayag: Parabens are a type of preservative that have been used in cosmetics for many years. There is not yet any scientific proof of any toxic effects caused by most of the parabens used. However, by way of precaution, we have chosen not to use any parabens in our new ABCDerm range.

Question 2
Internet user: Do I need to give my children a bath every night? Should I wash their hair every time?
Dr Michèle Sayag: As long as your baby or child doesn’t have dry skin and hasn’t inherited any tendency to develop allergies, it is OK to give him a bath every night. You don’t have to wash his hair every day if he hasn’t gotten sweaty.
However, if he is prone to allergies, bathing him once every other night is enough (in order to protect the delicate skin barrier).

Question 3
Internet user: My son has had eczema since he was little, and although it is much better now his skin is still sensitive. He has lots of dry plaques. What moisturising cream should I use?
Dr Michèle Sayag: Before applying any cream I recommend that you use a cleanser formulated for dry skin, don’t let him spend too long in the bath or use too hot water, and make sure you dry his skin gently but thoroughly by patting with a towel. You should apply a moisturising skin restorative cream twice a day if possible.

Question 4
Internet user: My son has lots of spots on his lip and chin that sometimes look like eczema, especially when he has his dummy. I can’t get rid of them. What should I do, given that he already has dry delicate skin?
Dr Michèle Sayag: You can use a cream specially formulated for irritations around the mouth which will protect the skin from the aggressive action of saliva. However, it is unlikely you will be able to resolve this skin problem completely until you stop using the dummy altogether.

Question 5
Internet user: What is the best sun protection factor for baby skin?
Dr Michèle Sayag: Up to one year old, you are strongly recommended to keep your baby out of the sun. However when exposure cannot be avoided, you should use a product with SPF 50+ that will provide sufficient protection against UVA rays. Up to the age of 3, you should use mineral-based sun creams (not ones with chemical filters).

Question 6
Internet user: I have been using micellar water ever since my daughter was born. She has just turned 7 months. But now that she is teething, she sometimes has a red bottom. Can I still use micellar water?
Dr Michèle Sayag: Yes, micellar water is suitable for using on the bottom, even when it is irritated. Our ABCDerm H2O in fact has an emollient effect.

Question 7
Internet user: What is the best product to use when changing nappies? Wipes, cleansing milk, lotion?
Dr Michèle Sayag: They are all OK, there isn’t one particular product that is more recommended than another for changing. It is up to you to choose which product is best for you and your baby.

Question 8
Internet user: Is it true that using fabric softeners on a baby’s clothes can cause allergies?
Dr Michèle Sayag: Some studies have shown that when the fibres have been softened, clothes cause less irritation which is good for allergy-prone skin. There is no proof that these products cause allergies.
Internet user: So when I see fabric softeners that say they are specifically for babies, it’s more a marketing ploy than an actual benefit of the product?
Internet user: Do I really need to use special washing powder for washing my baby’s clothes?
Dr Michèle Sayag: Since I don’t know what has gone into these fabric softeners and washing powders, it is hard for me to say.

Question 9
Internet user: How can I prevent and treat atopic dermatitis?
Dr Michèle Sayag: Prevention is used for “at-risk” children, namely children with at least one allergy-prone parent. In these cases, for example, we know that it is best to avoid contact with cats during the first few weeks. As regards treatment, outbreaks of eczema should be treated as early as possible with anti-inflammatories. The changes in the skin barrier should be treated every day with an emollient.

Question 10
Internet user: Ever since I was a child I have had regular attacks of impetigo. Is there any risk of me giving it to my baby through contact? Is it hereditary?
Dr Michèle Sayag: Impetigo is a skin infection caused by bacteria (staphylococcus or streptococcus). It is contagious and there is therefore a risk that you could give it to your baby. However, impetigo is not a hereditary condition.
Internet user: Does that mean I am a carrier of staphylococcus or streptococcus?
Dr Michèle Sayag: It is possible. I suggest that you speak to your treating doctor.

Question 11
Internet user: When winter starts my child’s skin gets very dry in the folds between his feet and at the back of his knees and legs. I make sure I moisturise these areas well, but is that enough?
Dr Michèle Sayag: Continue moisturising at least twice a day with an intense moisturising cream (balm).

Question 12
Internet user: When my son gets colic his bottom becomes irritated. Can you tell me what product I should use?
Dr Michèle Sayag: You can use a protective cream in order to prevent any redness before it appears; this will protect the skin from the irritating stools. Once the redness has appeared, you should apply a reparative water paste.

Question 13
Internet user: Why is talc no longer recommended for baby skin?
Dr Michèle Sayag: Because of its occlusive effects which increase the amount of water in the surface of the skin (which therefore intensifies the permeability of the skin).

Question 14
Internet user: I suffer from allergies (eczema, shingles). Will my daughter therefore be more prone to developing these skin problems?
Dr Michèle Sayag: Shingles is not an allergy but a viral infection.
However, if you suffer from atopic allergic reactions, your daughter is more likely than average to suffer atopic dermatitis.

Question 15
Internet user: Is my son’s skin more sensitive when he is teething? I have noticed he gets more spots and small blemishes than usual.
Dr Michèle Sayag: There have been no scientific studies into this problem. However, we have indeed seen that babies have skin problems when they are teething, in particular on the bottom, but we do not know the exact cause.

Question 16
Internet user: What are the skin symptoms of an allergy to cow's milk protein?
Dr Michèle Sayag: A cow’s milk protein allergy can cause skin symptoms, but it can cause other symptoms too (digestive symptoms). There are two possible types of skin reaction: an immediate reaction in the form of acute urticaria (red, swollen and itchy skin) and a delayed reaction in the form of eczema (red itchy plaques that may weep).

Question 17
Internet user: My son is in the first year of primary school (age 7) and he has very thin skin that is prone to irritation. Can you please tell me a product that he would enjoy applying and that would protect him from the cold and air pollution?
Dr Michèle Sayag: I recommend first using a cleanser designed for delicate skin (soap-free). Then, if the irritation occurs on the face and particularly around the mouth, use a specially-formulated protective cream. Otherwise, applying a moisturising cream every day can help since it reinforces the skin barrier.

Question 18
Internet user: I have noticed that my two-month old daughter often gets weepy skin behind the ears. What product can I apply behind her ears to treat this problem?
Dr Michèle Sayag: First, use a suitable cleanser (soap-free), then make sure you dry the area very gently but very thoroughly by patting with a towel. Then apply a drying and healing lotion such as Cicabio Lotion.

Question 19
Internet user: I am expecting and I want to prepare a “toiletry pack” for my baby. I would therefore like to know what product I should buy to avoid small white spots on my baby’s face?
Dr Michèle Sayag: These “small white spots” can be caused by many things (newborn baby acne, heat spots etc.). It is therefore hard for me to recommend anything at the moment, but I wouldn’t worry because he may not even have these problems.

Question 20
Internet user: Should I moisturise my baby’s skin after a bath? Is a cold cream soap enough?
Dr Michèle Sayag: If your baby has dry skin, you should apply a moisturising cream after a bath, or every so often put baby oil in the bath. Even if your child doesn’t have dry skin, applying a moisturising cream after a bath can create a special time for you to bond with your baby.

Question 21
Internet user: My baby has spots that look like acne (red, inflamed and pussy). What product can I use?
Dr Michèle Sayag: I recommend you check with your paediatrician that it actually is acne. In most cases, newborn baby acne disappears spontaneously after a few weeks. If necessary, your paediatrician will advise you on the best treatment.

Question 22
Internet user: Do you recommend using skin milks or creams for young children who do not have any skin problems?
Dr Michèle Sayag: Applying moisturising cream can be beneficial even for normal skin, in particular during winter (when the dry cold weather can affect the skin).

Question 23
Internet user: I am asthmatic and would like to know if my 3-month old daughter is at any risk of skin problems because of my condition?
Dr Michèle Sayag: If you have allergic asthma (triggered for example by house dust mites, pollens, cat hair etc.) then you are “allergy prone” and your daughter has more chances of developing atopic dermatitis than a child whose mother doesn’t have allergies.

Question 24
Internet user: My baby is three months old. From what age can I start using skin cream?
Dr Michèle Sayag: If he has dry skin you can use a moisturiser from the first few weeks, but choose a cream suitable for his age (under 36 months).

Question 25
Internet user: What is the difference between atopy and eczema?
Dr Michèle Sayag: Atopy means you are prone to allergies that can manifest themselves as skin problems (atopic eczema, still called atopic dermatitis), respiratory problems (allergic asthma), in the ear nose and throat (allergic rhinitis) or in the eyes (allergic conjunctivitis).

Question 26
Internet user: Is a baby’s skin more delicate than that of an adult?
Dr Michèle Sayag: In the absence of any food allergies confirmed by a specialist by a series of tests (in particular food exclusion/reintroduction tests), you should never avoid giving food to an allergy-prone child. However, you should wait longer before introducing allergy-prone children to new foods. In particular, you should not give eggs, fish, exotic fruit (other than bananas) or celery during the first year.

Question 27
Internet user: Can the water I use to wash my child aggravate his allergies?
Dr Michèle Sayag: Hard water aggravates dry skin and therefore affects the skin barrier which allows allergens from the environment to penetrate the skin and trigger outbreaks of eczema.

Question 28
Internet user: Is a baby’s skin the same as an adult’s skin?
Dr Michèle Sayag: A baby’s skin is no more delicate than an adult’s skin. In a baby born to term, his skin has the same properties as that of an adult. However, the difference is that babies have a much higher skin surface area to weight ratio. Therefore, any product you apply is potentially more toxic than in an adult, and so it is important to carefully choose which ingredients you are going to apply to your baby’s skin.

Question 29
Internet user: How long should a bath take and is it possible to use bath bubbles without damaging the skin?
Dr Michèle Sayag: If your baby has normal skin he can stay in the bath as long as the water is warm enough to prevent him catching cold. Bath bubbles can be a source of irritation. However, you can use a soap-free foaming cleansing product without any problems.

Question 30
Internet user: How are organic products good for the skin? Should I choose organic products for my child’s skin?
Dr Michèle Sayag: Organic cosmetics are subject to the same standards as other cosmetics and in particular they must use ingredients approved by regulations. For dermatologists, products that do not contain synthetic ingredients - such as organic cosmetics - are no more effective. As regards safety, they are actually more suspicious because they know the allergic potential of certain natural ingredients.

Question 31
Internet user: Should we avoid using perfumed products for children?
Dr Michèle Sayag: Of all the ingredients in cosmetic products, perfumes are the one most likely to cause an allergy, however children who do not have atopic dermatitis or allergy-prone parents can use perfumed products.

Question 32
Internet user: My two-year old son has atopic eczema. What is a good skincare and cleansing regime for him?
Dr Michèle Sayag: 1) Use a suitable cleansing product: soap-free cleanser, a short bath or shower in warm water; 2) local anti-inflammatory treatment for the eczema (usually a dermal corticosteroid) prescribed by a paediatric specialist or dermatologist, essential for avoiding any aggravation to your child’s condition and which should be applied in a sufficient quantity and for a sufficient amount of time, according to your doctor’s advice; 3) Apply an emollient over the whole body (other than the eczema plaques) at least once a day, and definitely continue applying every day even after the plaques have cleared up in order to prevent any relapse.

Question 33
Internet user: My son who will soon be one month old has peeling skin on his face. What product should I use?
Dr Michèle Sayag: You should apply a moisturising face cream specially designed for babies under 36 months. If the dry skin persists, consult your paediatrician.

Question 34
Internet user: With the arrival of the cold weather, what cream should I use for my child’s face and what should I do to prevent cracked lips?
Dr Michèle Sayag: A baby’s skin is no more delicate than an adult’s skin. In a baby born to term, his skin has the same properties as that of an adult. However, the difference is that babies have a much higher skin surface area to weight ratio. Therefore, any product you apply is potentially more toxic than in an adult, and so it is important to carefully choose which ingredients you are going to apply to your baby’s skin.

Question 35
Internet user: For six weeks my daughter’s skin, which is very sensitive, has become almost rough to touch, but we haven't changed our soap. What can we do?
Dr Michèle Sayag: The arrival of the (dry) cold weather and turning on your central heating (which is often insufficiently humidified) can explain this recent dryness. During this period you should use a soap-free cleanser and a good moisturiser (a cold cream or, if that isn’t enough, a product designed for dry atopic skin).

Question 36
Internet user: Now that my child is eating a wider variety of food, what food should we be most careful of in order to avoid allergic reactions?
Dr Michèle Sayag: No fruit juice for the first few months. Introduce vegetables after 5-6 months and then introduce fruit 2 weeks later, but avoid kiwis and exotic fruits (other than bananas). You should not give fish before six months or egg whites before nine months.

Question 37
Internet user: My daughter is currently teething and has a red bottom. I am using a paraben-free cream because she is allergic to parabens, but it isn’t working very well. What can I use?
Dr Michèle Sayag: You can change product and use a water paste, alternating with a soothing restorative cream, such as Cicabio crème.

Question 38
Internet user: My son first developed eczema when he was three months old, when I weaned him. Since then he has constantly had eczema. I would like to know how to treat it and what product to use?
Dr Michèle Sayag: It is very important to treat eczema plaques immediately and effectively with local anti-inflammatories (dermal corticosteroids) that can be prescribed by your paediatrician or dermatologist. When correctly used these products should reduce the inflammation in about a fortnight, but you must also moisturise the whole body every day without fail in order to avoid any relapse. Do not also forget the cleansing advice that I gave above (Question 32). If that isn’t enough, your dermatologist can check if the problem is caused by any environmental factors, allergens (dust mites, cat hair, food etc.) or irritants (cleansers etc.).

_{This transcription does not necessarily contain all the conversations that took place during the Chat session.}