There are many skin conditons that affect children’s skin, and it is important to stay informed and up-to-date in order to understand the myriad of treatment options available. Skin conditions such as eczema, acne, psoriasis, and infantile hemangiomas are among the most common skin conditions treated by pediatric dermatologists, yet many healthcare professionals do not understand the symptoms and treatment options available.

ACNE

Acne is a common skin condition that affects people of all ages. Often associated with teenagers, acne typically develops due to hormonal changes that occur during puberty. When hormone stimulation encourages oil gland enlargement, oil production increases, leading to bacterial overgrowth. This, in combination with blocked pores, leads to inflammation and comedone formation, visible as acne. Whiteheads and blackheads, closed and open comedones respectively, are common types of mild acne. Increased inflammation with deeper skin involvement leads to nodules of moderate to severe acne.

It is important to establish a daily skin care routine, in order to minimize the condition and support any medications used to treat the acne. For example, washing the face twice daily with a mild soap labeled for sensitive skin can promote healthy skin and lessen pimple formation. It is also advised to avoid over-scrubbing and using washcloths as part of the routine, as these can cause irritation. If the acne is not improving and over-the-counter products are not working, the client may need to consider prescription medication.

ECZEMA

Atopic dermatitis, also known as eczema, is another common skin condition typically seen in children and teenagers. Eczema is a chronic skin disorder in which the skin appears inflamed, red, itchy, and dry. Clients with eczema usually suffer from an impaired skin barrier, which keeps the skin from retaining water. This causes the skin to lose moisture, making the skin more inclined to irritation and hypersensitivity. While the symptoms may vary between clients, eczema is often found among younger children.

Eczema can be found anywhere on the body and appears as dry, red, scaly, or leathery patches of skin. During early infancy, eczema can develop as a rash on the cheeks and around the mouth. In infants, it is worsened by drooling, as excess saliva causes the skin barrier around the mouth to weaken and intensify the rash. While there is no cure for eczema, a consistent skin care routine can greatly improve symptoms for even the most severe cases. A sample routine involves choosing the right type of skin care product that will work well with the child’s skin. Choose products that are labeled fragrance-free instead of hypoallergenic – these are often less irritating. Select thicker moisturizers, such as petroleum jelly and ointment-based products, rather than thin lotions, as these are more effective at locking in moisture. By sticking to a gentle skin care routine, parents can improve their baby’s skin health and improve the symptoms of eczema.

PSORIASIS

This is a common skin disorder that is often mistaken for eczema. Psoriasis can present at any age, and the symptoms vary from person to person, depending where on the body it appears. There are many different types of psoriasis – plaque psoriasis and guttate psoriasis are the most common in children – however, it usually appears as thick, dry, red, scaly patches that may have no symptoms, may be itchy, and can sometimes burn.

Psoriasis develops when skin cells pile up on top of each other instead of shedding as dead skin. The skin condition can run in families; thus, there is an underlying genetic link for psoriasis. However, a combination of environmental factors can also play a role in the disease, and minor skin injuries such as cuts, scrapes, and infections can trigger psoriasis or make it worse. Up to half of children with psoriasis will have a flareup two to six weeks after illnesses such as ear infections, strep throat, or a common cold.

Treatment depends on the type and severity of each case, as well as the area of skin affected. Psoriasis on the face of a 10-year old will likely be treated differently than psoriasis on the leg of a 30-year old. A child’s pediatrician can advise on the best course of basic treatment, which would include a range of topical creams, shampoos, and ointments. If this regimen falls short of preventing or managing the client’s symptoms, consider consulting with a pediatric dermatologist, who can recommend a myriad of additional treatment options, such as ultraviolet light therapy or systematic medications.

HEMANGIOMAS

Infantile hemangiomas are a benign collection of extra blood vessels in the skin. They are often nicknamed strawberry marks. Infantile hemangiomas follow a fairly predictable course. First appearing as bright, red marks on the skin in the first few weeks of infancy, they rapidly grow until the child is six months of age. As the baby gets older, the hemangiomas slowly begin to become less red, greyer, and softer, until they eventually disappear. The vast majority of cases will have significantly improved once a child is 10 years of age. Most hemangiomas typically resolve on their own and do not require treatment. However, in the rare case of complications, pediatric dermatologists will decide whether to treat the hemangioma based on the age of the patient, size and location of the hemangioma, how rapidly it is growing, and whether it is likely to cause any problems.

If a child’s skin is not doing well despite following good skin care recommendations and using over-the-counter medications from a primary care doctor, the parents should ask about a referral to a pediatric dermatologist. Pediatric dermatologists are trained to treat common and rare skin conditions using a variety of additional methods.

Dawn Davis, MD, is the immediate past president of the Society for Pediatric Dermatology. She is an associate professor of dermatology and pediatrics at Mayo Clinic Rochester and the founder of the Pediatric Dermatology Fellowship, currently serving as the Division Chair of Clinical Dermatology.  A native of Kansas City, Missouri, she graduated from the University of Missouri Honors College with a degree in biology, followed by a medical doctorate with honors from the University of Missouri School of Medicine. Dawn is board-certified in pediatric dermatology, dermatology, and pediatrics.