Skin care tips for mother and baby

Dermatology Nursing, Feb, 2006 by Diana Gorgos

New mothers are often concerned about skin changes experienced during and after pregnancy, but also the health of their child's skin. What do you do if your child suddenly develops what looks like a case of teenage acne, or a rash on her scalp? Speaking at the American Academy of Dermatology 2005 Convention, dermatologist Andrea Lynn Cambio, MD, discussed skin care concerns during and after pregnancy, the most common skin conditions of infants, and how to protect a newborn's skin as the seasons change.

Many women experience the glow of pregnancy; a time when their skin takes on a rosy complexion due to the increased volume of circulating blood and they notice fewer fine lines and wrinkles in part from increased water retention and weight gain which can plump out the face. However, the joy of this benefit may be short-lived as they also may begin to experience some unique changes to their skin.

Dr. Cambio explains, "Psychosocial stressors, such as hormonal changes, sleep deprivation, dietary changes and the new responsibility of caring for a baby, can have a significant effect on a mother's skin. Hormones pass from the mother to child that also can affect the baby's skin, leading to several common conditions that can be resolved by consulting a dermatologist."

Dark patches on the face could be melasma, also known as the mask of pregnancy. This benign condition is attributed to an overproduction of melanin, a natural substance in the body that gives color to the hair, skin, and eyes. Treatment options include topical prescriptions for hydroquinone, retinoids, azeleic acid, or hydroxyacids. A combination of these products may be used to enhance efficacy. No treatment of melasma is complete without the daily, year-round use of a broad-spectrum sunscreen with SPF of 15 or higher to prevent the further darkening of the skin.

One of the most pressing skin concerns for women during and after pregnancy is how to treat stretch marks. These red or purple bands on the abdomen and sometimes on the breasts and thighs develop in more than 90% of women during the 6th and 7th months of pregnancy and result from the pulling and stretching forces in the underlying layers of skin. With time, the redness fades and the bands become lighter than the surrounding skin. However, many women still find the appearance of stretch marks to be distressing.

"Unfortunately, there are no over-the-counter treatments to 'cure' stretch marks, but a moisturizer of any type may help improve their appearance and control itching, which is very common," remarked Dr. Cambio. "Women also may use a sunless tanning product which can help hide stretch marks. If a woman would like to do more than cover or fade the marks, there are many successful treatment options available from a dermatologist, such as a prescription tretinoin cream or laser treatments."

Another skin condition faced by pregnant women is itchy, red skin, especially on the palms of the hands and soles of the feet. The best solution for this condition is to avoid long, hot showers and switch to a fragrance-free non-soap cleanser. An over-the-counter mentholated or oatmeal-based moisturizer stored in the refrigerator can provide added relief.

Many women report a healthy, thick head of hair during pregnancy that then begins to fall out following childbirth. Called telogen effluvium, there is no treatment for this temporary "shedding" of the hair. During pregnancy, along with the hair on their head, many women also report excessive hair growth on the face or chest. Dr. Cambio recommends that to remove this hair, women try tweezing, waxing, threading, or shaving. Laser hair removal, which provides long-lasting results and is safe and effective for both pregnant and nursing mothers, is also an option.

An infant's skin is sensitive and can experience numerous changes and conditions in the first few weeks of life. Parents may be concerned by their baby's less-than-perfect skin, but a dermatology practitioner can evaluate and determine which conditions will resolve themselves and which may need additional treatment. Recurrent diaper rash is the most common skin condition for which new parents seek health care advice. This condition is caused by persistent wet, soiled diapers, and the use of unnecessary baby products, such as powders, creams, lotions, and oils. "When a baby has diaper rash, parents should remember to change diapers frequently, use a warm, wet washcloth instead of pre-moistened baby wipes on the bottom, and apply a barrier cream with zinc oxide to the affected area," Dr. Cambio noted. "Also, keeping the area open to the air as long as possible before putting a clean diaper on can help prevent the condition."

Atopic dermatitis or eczema, also is a common condition found in newborns and young children. This itchy, oozing, crusting rash occurs mainly on the face and scalp, but patches can appear anywhere. "This condition also can be confused with cradle cap, a common, red, scaly rash most commonly seen on the scalp, sides of the nose, eyebrows, eyelids, and the skin behind the ears," Dr. Cambio said. "Eczema treatment can include the use of an over-the-counter or prescription topical, steroid-free antihistamine, while cradle cap usually clears without treatment by 8 to 12 months."