Ask Dr. Marla: Lotion doesn't help my baby's rough skin

By Dr. Marla Shapiro on July 30, 2012
My baby has some rough skin on her knees and belly. We put lotion on, but it doesn’t help. What could it be?

Answer:

Without seeing the rash it is not really possible to make a diagnosis. It may be as simple as dry skin or perhaps a reaction to a laundry detergent that you are using. It is reasonable to start first with a very good hydrating moisturizer.

One of the most common rashes seen in childhood is eczema, which is a form of what we call an atopic dermatitis. Often there is a family history of this skin condition or other allergies. The rash often feels dry and can present with redness and small bumps in the affected areas. It can also appear on extremities such as knees, elbows, wrists and so on.

While there is no cure for eczema, some babies will outgrow the condition. For others, control is possible. You might notice that the rash appears worse after sitting in the bath and doctors will advise you to limit baths. Frequent moisturizing with a fragrance-free hypoallergenic cream is another good tip.  Often your doctor will prescribe a cream with a steroid in it, but I suggest using it sparingly on the affected areas.

Other rashes can be a so-called contact dermatitis. That means that irritants rubbing against the skin will cause the rash to appear worse. In addition to bubble baths, rough fabrics and saliva from drool can cause a rash to appear. The first step in clearing up the rash is to remove the irritant. Again, your doctor might suggest a mild cortisone cream. It is also possible that the rash you are seeing is due to chafing from crawling.

Psoriasis is less likely to be seen in babies than adults and it generally looks worse than eczema – it’s more red and scaly, while eczema is generally pink and less scaly, although rougher in texture.

Given that your baby’s condition appears to be ongoing, it is less likely being caused by a virus or impetigo, a highly contagious skin infection. Impetigo occurs when a bacteria – typically staphylococcal or streptococcal – enters the skin through a cut or scrape.

Either way, visit your doctor to assess the cause and management of this rough skin.

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Originally published in ParentsCanada magazine, August/September 2012.

By Dr. Marla Shapiro| July 30, 2012

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