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Suggest Remedy For Acne On Cheeks And Chin Of 6 Week Old Baby
Question: My six week old daughter had a case of baby acne on her face which turned into dry scale-like flaky skin. After flaking off, it left light patches almost completely covering both her cheeks and chin. She was diagnosed with atopic dermatitis by pediatrician,but dermatologist said any allergy on face they call atopic, they said dont worry its common for babies its kind of adaptation to new world,Do the symptoms sound like Atopic Dermatitis? But if its really allergy, what reason can be, she s on breastfeeding, can it be allergy on food what am eating? Should I follow diet for that?and am Russian n her father s XXXXXXX , but she s pure White, can it be because of XXXXXXX climate?doctors prescribed me desonide cream its kind of steroids, am afraid to put, i m giving for her Cetaphil moisturizer, now she s 6 weeks for 3 days her face much better, in family there s no history of any allergy or asthma, so how to understand thah its atopic dermatitis, how to understand that its an allergy, n which product I should avoid from ma food, am so much worry because doctors here don't explain anything properly, I ve read about atopic dermatitis that it can stay till 4 years, am so afraid
Brief Answer:
Allergies can be investigated to confirm diagnosis
Detailed Answer:
Hello,
Thank you for asking at HCM.
I went through your daughter's history and would like to make suggestions for your daughter as follows:
1. First of all, I would agree that it is dermatitis, whatever the cause may be.
From history, it sounds like atopic dermatitis as atopic dermatitis can present at this age involving face. I would like to know amount of itching or irritability she has while having skin lesions, itching more suggests atopic dermatitis.
2. To come more close to diagnosis, I usually suggest my such patients serum total IgE test which is elevated in atopic dermatitis.
3. Please note that all atopic dermatitis are not due to food allergies. Only moderate to severe atopic dermatitic are due to food allergies, common foods being animal milk, egg, peanut, tree nuts, fish, shell fish, wheat, etc. Allergy testing for each specific food is available.
Yes, if a breast feeding baby's atopic dermatitis is due to food allergy, it is usually from food particles that are passed from mother to baby via breast milk. So treatment includes restriction of that particular food by mother.
4. However, please note that above mentioned 8 foods are responsible for 90% of the allergies and many of them are nutritive and part of daily diet - milk, wheat, egg, etc. So it is not advisable to restrict any particular food without confirmation as it can have nutritional consequences for both mother and baby.
5. Treatment of atopic dermatitis (and most of other dermatitis) is usually topical corticosteroids. I usually prescribe my infants hydrocortisone cream which is the lowest potency steroid preparation. So it causes minimum side effects.
6. Of course, all the possible measures should be followed to ensure minimum possible used of topical corticosteroids.
One of such measures is regular use of moisturizer (as you are already doing), especially immediately after sponging/bathing. It will retain moisture within the skin and improve dermatitis regularly.
Another measure is avoidance of allergen and skin irritants. Allergens can be food allergens and air-borne allergens, which can be tested in laboratory by blood tests. Common skin irritants are extremes of temperatures, woolen/rough clothes/bedsheets (cotton is usually best cloth for dermatitis), irritant cosmetics/creams/soaps etc, etc.
With above measures you can minimize use of topical corticosteroids.
7. Yes, I would agree that most of the atopic dermatitis improve with age.
8. I usually also prescribe my atopic dermatitis patients probiotics and vitamin D which may help improve immunity and atopic dermatitis.
9. It is very appreciable that you are breast feeding the baby, which is most effective strategy for prevention of allergies. Please try to breastfeed her exclusively (nothing other than breast feeding) up to at least 4-6 months of age, if possible, which is important for immune system.
So please do not worry too much. Atopics dermatitis is reasonably common disorder and not very much severe disorder in most of the cases.
Hope above suggestions will be helpful to you.
Should you have any further query, please feel free to ask on follow-up.
Wish your daughter the best of the health ahead.
Thank you & Regards,
Dr Parin N Parmar
Allergies can be investigated to confirm diagnosis
Detailed Answer:
Hello,
Thank you for asking at HCM.
I went through your daughter's history and would like to make suggestions for your daughter as follows:
1. First of all, I would agree that it is dermatitis, whatever the cause may be.
From history, it sounds like atopic dermatitis as atopic dermatitis can present at this age involving face. I would like to know amount of itching or irritability she has while having skin lesions, itching more suggests atopic dermatitis.
2. To come more close to diagnosis, I usually suggest my such patients serum total IgE test which is elevated in atopic dermatitis.
3. Please note that all atopic dermatitis are not due to food allergies. Only moderate to severe atopic dermatitic are due to food allergies, common foods being animal milk, egg, peanut, tree nuts, fish, shell fish, wheat, etc. Allergy testing for each specific food is available.
Yes, if a breast feeding baby's atopic dermatitis is due to food allergy, it is usually from food particles that are passed from mother to baby via breast milk. So treatment includes restriction of that particular food by mother.
4. However, please note that above mentioned 8 foods are responsible for 90% of the allergies and many of them are nutritive and part of daily diet - milk, wheat, egg, etc. So it is not advisable to restrict any particular food without confirmation as it can have nutritional consequences for both mother and baby.
5. Treatment of atopic dermatitis (and most of other dermatitis) is usually topical corticosteroids. I usually prescribe my infants hydrocortisone cream which is the lowest potency steroid preparation. So it causes minimum side effects.
6. Of course, all the possible measures should be followed to ensure minimum possible used of topical corticosteroids.
One of such measures is regular use of moisturizer (as you are already doing), especially immediately after sponging/bathing. It will retain moisture within the skin and improve dermatitis regularly.
Another measure is avoidance of allergen and skin irritants. Allergens can be food allergens and air-borne allergens, which can be tested in laboratory by blood tests. Common skin irritants are extremes of temperatures, woolen/rough clothes/bedsheets (cotton is usually best cloth for dermatitis), irritant cosmetics/creams/soaps etc, etc.
With above measures you can minimize use of topical corticosteroids.
7. Yes, I would agree that most of the atopic dermatitis improve with age.
8. I usually also prescribe my atopic dermatitis patients probiotics and vitamin D which may help improve immunity and atopic dermatitis.
9. It is very appreciable that you are breast feeding the baby, which is most effective strategy for prevention of allergies. Please try to breastfeed her exclusively (nothing other than breast feeding) up to at least 4-6 months of age, if possible, which is important for immune system.
So please do not worry too much. Atopics dermatitis is reasonably common disorder and not very much severe disorder in most of the cases.
Hope above suggestions will be helpful to you.
Should you have any further query, please feel free to ask on follow-up.
Wish your daughter the best of the health ahead.
Thank you & Regards,
Dr Parin N Parmar
Above answer was peer-reviewed by :
Dr. Ashwin Bhandari
Thank you so much, it makes more clear picture...But I think she didn't get any itching, it not seems like that, this 3 days actually am using moisturizer for her and for this 3 days redness s gone, rashes r gone, she s almost clear only small yellow patches r there ,if it ll go now, after sometimes it ll come back???and which probiotics I can give to her? Am giving her vitamin D3 drops, in fact your answer was first full answer what I ve heard in XXXXXXX now
Brief Answer:
Continue moisturizers, do not worry too much at present
Detailed Answer:
Hello,
Thank you for your follow-up and appreciation.
Usually, atopic dermatitis children have intense itching. So if she is improved with only with moisturizer, I would suggest you to continue moisturizer application and avoidance of irritants until the skin becomes normal. Moisturizer application will also help improve her skin.
Atopic dermatitis does tend to come back after discontinuation. Regarding other dermatitis, they may come back or may not.
In other types of dermatitis also, moisturizer will help.
I usually prescribe Lactobacillus rhamnosus GG probiotic for atopic dermatitis. Please note that it is not useful for other dermatitis. Also, it is available with other strains of probiotics (may not be available singly).
It is good that you are giving vitamin D drops.
Hope above suggestions will be helpful to you.
Should you have any further query, please feel free to ask on follow-up.
Wish your daughter the best of the health ahead.
Thank you & Regards,
Dr Parin N Parmar
Continue moisturizers, do not worry too much at present
Detailed Answer:
Hello,
Thank you for your follow-up and appreciation.
Usually, atopic dermatitis children have intense itching. So if she is improved with only with moisturizer, I would suggest you to continue moisturizer application and avoidance of irritants until the skin becomes normal. Moisturizer application will also help improve her skin.
Atopic dermatitis does tend to come back after discontinuation. Regarding other dermatitis, they may come back or may not.
In other types of dermatitis also, moisturizer will help.
I usually prescribe Lactobacillus rhamnosus GG probiotic for atopic dermatitis. Please note that it is not useful for other dermatitis. Also, it is available with other strains of probiotics (may not be available singly).
It is good that you are giving vitamin D drops.
Hope above suggestions will be helpful to you.
Should you have any further query, please feel free to ask on follow-up.
Wish your daughter the best of the health ahead.
Thank you & Regards,
Dr Parin N Parmar
Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation
Above answer was peer-reviewed by :
Dr. Yogesh D
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