How to Treat Common Skin Disorders in Children
What adult over a certain age wouldn’t like to have the dewy, wrinkle-free complexion of a child?
But skin is not just for looks. The largest organ of the human body, skin serves as a protective barrier between the body and the world, while also regulating body temperature, absorbing vitamin D and providing the sense of touch.
Children’s skin is not merely a younger, prettier version than that of their parents’. Children sometimes get certain skin conditions more commonly than adults – such as infections. Moreover, the ratio of their skin surface area to the rest of their body weight is larger, and so some medications used to treat skin issues could potentially be more toxic to a child than to an adult due to increased absorption.
Other than eczema, infections are some of the most common skin conditions affecting children. As I tell the parents of my young patients, much of the reason their kids are so prone to these infections is just that they are kids being kids. They can get them from rolling around on a mat in gym class, running around without shoes, picking their noses, sharing brushes, hats and combs – and especially from not washing their hands. It’s not something the parent did wrong!
Luckily, most skin infections in children are easily treated. Here are five of the most common skin conditions I see in children, and what you can do about them.
Eczema (atopic dermatitis)
is the most common skin problem I treat. Actually, it isn’t an infection per se, but I included it on this list because eczema compromises the skin’s normal protective barrier and often leads to infections. Eczema is a chronic condition with remissions and flare-ups in which the skin becomes red, flaky and severely itchy. After some time, the skin can become thick and hard – almost lizard-like. Sometimes skin with eczema has bumps that weep. Eczema is itchy, so kids scratch and cause cuts in their skin, leaving it open to invasion by microbes. That’s why eczema is known as “the itch that rashes.”
Nobody knows for sure what causes eczema. Often it’s hereditary, and flare-ups can be triggered by environmental factors such as the weather or an allergen, like grass or food, but the trigger is not the cause. Eczema usually starts before the age of one, and fortunately kids typically grow out of it by school age.
While there is no cure for eczema, you can control it. My mantra to parents: “Moisturize, moisturize, moisturize.” What you use is not as important as using something, and preferably a moisturizer that is thick without a lot of fragrance. The goal is to create a barrier with the moisturizer (and clothing), so that the child cannot scratch open the skin.
For uncontrollable flare-ups, providers can prescribe an anti-inflammatory steroid cream to be used periodically. A home remedy that can help prevent bacteria from flaring chronic eczema is a bleach bath, which kills bacteria on the skin and reduces itching and redness. Use one-fourth of a cup of bleach for every gallon of water, once or twice a week under the direction of your dermatologist.
Warts (verruca vulgaris):
Warts are the unattractive but harmless manifestations of an HPV virus (not the same strain that causes cervical cancer). They’re the most common viral skin infection in the kids I see in my office. Warts can be spread by picking or touching – either touching someone else’s warts, or touching something the virus came in contact with, such as a shared towel.
Warts don’t necessarily have to be treated, and more than half of them will go away in a couple of years or less. But in certain situations, such as if the warts are all over a child’s face, infected or itchy, then treatment may be needed. Treatment consists of methods to remove the thick wart skin or boost the skin’s immune system to combat the wart. Unfortunately, there is no anti-wart cream or pill to make them go away quickly and never return. Depending on a wart’s location, a physician can scrape it off, freeze it off with liquid nitrogen, prescribe a vitamin A acne cream that will help peel the skin where it lives or prescribe a cream to boost the skin’s immune system to fight the wart.
You can also try over-the-counter salicylic acid pads, which peel warts off in a couple of months or less. I recommend these pads over the spray guns that are sold over the counter. The freezing agent in the guns is not the same as liquid nitrogen and does not work as well.
Molluscum is another viral skin infection very similar to warts. It is caused by the Molluscum virus and results in small pink or fleshy-colored crusty bumps. Molluscum contagiosum is also spread by direct contact with the virus through touching or picking. It is especially common in children who have eczema. Molluscum goes away more quickly than warts, typically in less than one year. The treatments for Molluscum are similar to those for warts.
Despite the name, ringworm is not caused by a worm. It is actually a fungal infection in the skin, and can be found in the hands, feet, body or scalp. The resulting rash has a ring-like shape. It is red, scaly and itchy. On the scalp there are often dandruff-like flakes. It can be spread by touching someone who has it or through the sharing of combs or hats, by not washing hands or by walking around barefoot (particularly by not wearing footwear around a swimming pool).
Ringworm on the body is usually treatable through topical over-the-counter and prescription anti-fungal creams. If you suspect your child has ringworm that has not improved with over-the-counter anti-fungal creams, contact your pediatrician or dermatologist; it’s important to treat it to prevent spread and scarring.
Ringworm of the scalp (also called Tinea capitis) requires an oral medication prescribed by a doctor and anti-fungal shampoo. The oral medication and shampoo should be administered for several weeks or for a couple of months. Tinea can lead to hair loss if not treated, so be sure to check with your pediatrician if you think your child might have it.
This infection, caused by streptococcus or staphylococcus bacteria, results in sores that ooze pus and become encrusted, often resembling a honeycomb. The sores or blisters, often around the mouth or nose, frequently begin as small blisters, and although they are not painful, they might itch.
Impetigo is easily spread by direct contact with other kids or babies who have it, by sharing sheets or other items contaminated with these bacteria and by not washing hands. Any time the skin is broken – by a cut, scrape or insect bite – it’s easier to get impetigo.
Impetigo is treated with antibiotics, either an ointment or an oral medication for worse cases. If you suspect your child has picked up this infection, contact your pediatrician or dermatologist. Left untreated, impetigo can get deeper into tissue and could potentially spread to bones, joints and blood, requiring hospitalization and IV antibiotics.
For more information on these skin infections and other childhood skin problems, visit the Society for Pediatric Dermatology website.
Originally published: 10-01-17