Acne, Eczema, & Bathing Infants: An Interview With A Pediatric Dermatologist
Rashes, bites, blemishes, abrasions, hives, blisters, chafing, bumps, burns.
There are so many ways that our kids can be inflicted. Even beyond an ED doc, a dermatologist is the clinician we’d most appreciate having by our side for our kid’s medical surprises.
So, I reached out to renowned pediatric dermatologist, Dr. Sheilagh Maguiness MD, FAAD, to help answer some common questions and bust some myths.
From addressing common misconceptions about eczema to providing strategies for managing acne in teens, Dr. Maguiness offers invaluable insights into nurturing healthy skin from infancy through adolescence. She emphasizes the significance of gentle cleansers, fragrance-free products, and sun protection measures tailored to children's unique needs, advocating for a holistic approach to skincare that prioritizes both safety and efficacy.
5 Questions For A Pediatric Dermatologist
1. How often should we be bathing infants? Can you discuss the minimum and maximum amount of times you recommend and what products to use or avoid?
Infant bathing practices vary widely! There are no clinical randomized trials that tell us exactly how often is best, but pediatric dermatologists typically agree on best practices when it comes to newborn skin care and bathing. We usually recommend frequent immersion/tub bathing daily to every other day, as long as you apply a moisturizer head to toe right after bathing to seal in all that water. You don’t need soap every time, even plain water will still clean your baby! Make sure to get the face and scalp wet during the bath and apply a fragrance-free moisturizer head to toe right after bathing to help seal in the water. I find that regular bathing of the face and scalp is important for preventing cradle cap and baby acne.
When it comes to baby care products, I recommend keeping things simple. Choose products that are gentle, fragrance-free free and hypoallergenic. I also recommend avoiding essential oils and excessive amounts of botanical ingredients which can irritate the babies’ thinner skin barrier or even lead to potential absorption through the skin. Having an all-purpose ointment to moisturize, act as a skin protectant, diaper barrier and just all around hero when it comes to babycare is essential, and you simply can’t beat the incredible power of plain petroleum jelly!
2. How does this change when it comes to bathing toddlers? When should you introduce shampoo or conditioner and which chemicals should you avoid?
Honestly, toddler skin is still maturing. I typically recommend sticking to a gentle cleanser for bathing, the same one used during infancy is fine. There is no need to make big changes until later in childhood. A fragrance-free shampoo and conditioner is fine to add in at this stage, I also really like detangling sprays for managing toddler hair
3. What are the misconceptions and mistakes parents make when it comes to eczema?
One very common misconception I want people to understand is that eczema is not primarily caused by an allergy to a food or environmental trigger. Eczema is caused by genetic skin barrier defects that lead to excessive water loss through the skin. This causes an impaired skin barrier where dryness, itch, inflammation, and bacterial infection/colonization propagate the condition. Supporting your child when they are itchy with a lukewarm bath and the application of a bland moisturizer is a great first step. During flares or episodes of significant itching, the addition of a wet wrap/damp pajama wrap can be a very helpful way to turn around a flare.
Another common myth is that frequent bathing might make eczema worse and dry out the skin. Studies have shown that daily bathing (or even twice daily!) when followed by a bland, hypoallergenic, fragrance-free moisturizer is actually helpful for your skin barrier and helps prevent eczema flares.
I also want families to know that dilute bleach baths (yes - you read that correctly) can be helpful in reducing bacteria on the skin and calming down a flare. Check with your doctor to see if this could be helpful for your child. In essence, a diluted bleach bath is the same as jumping in a swimming pool with chlorinated water, and safe to get the whole body and face wet as well. Bleach baths can also be a very helpful tool for families to help deal with mild skin infections or eczema flares.
4. I had an uphill battle with acne as a teen and probably checked all of the boxes on what not to do. What are specific strategies that teens can use to minimize acne?
Teens should be aware that though diet is not a strong contributor, there are still some foods that are linked to worsening acne. Specifically, high glycemic index foods have been shown to worsen acne severity, including things like skin milk. Certain supplements can also be a problem, for example whey powder. So a healthy diet rich in low glycemic index foods is best for your skin if you struggle with acne.
Good hygiene habits are important for tweens and teens! Washing your face (preferably twice a day) with a gentle cleanser is a great first step in caring for your complexion. If your teen has an active lifestyle, send him with tools to care for their skin on the go (the wipe out wipes from Stryke Club are a great option!).
For mild acne, like whiteheads and blackheads, adding in a cleanser that fights bacteria is helpful, for example one containing sodium hypochlorite or benzoyl peroxide. At this stage, a topical retinoid is also a great thing to add in, as it can treat and prevent acne breakouts - try adapalene gel in a very thin layer nightly if the acne is more significant. Finally, if acne is becoming more severe and inflammatory, or if you see early scarring, it’s time to see your doctor.
5. What do parents get wrong about sun protection for kids?
A lot of parents forget to see the whole picture when it comes to sun protection. They focus on the sunscreen and not on the larger goals - they forget that sun protection is a lot more than just relying on application of a sunscreen. I like to start the conversation with reminding everyone that in infancy sun avoidance is important - protective clothing, seeking shaded areas, wearing broad brimmed hats, are all integral to protecting an infant from the harmful effects of UV rays. Protective clothing is so convenient, and much easier to put on and keep on your wiggly toddler than covering them with creams.
When you do choose a sunscreen for exposed ares, in children under two I recommend sticking only to the mineral sunscreen ingredients, these include zinc oxide and titanium dioxide. These are very safe for children ages 6 months and up and typically provide excellent UVA and UVB protection. Just like other products, I really like fragrance free and hypoallergenic options. Always skip a spray sunscreen as these more commonly use chemical sunscreen ingredients, provide uneven coverage and are not safe for children to inhale.
To learn more about Dr. Sheilagh, check out:
Instagram: @dr.sheilagh.m
Tiktok: @drsheilagh
Her company, www.strykeclub.com, which sge launched with three other moms during the pandemic. It's a skincare brand with products she formulated especially for teen and tween boys!
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