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Healthy Skin

You take your children to regular doctor’s check-ups, physicals and dental appointments, but when was the last time they saw a dermatologist? Healthy skin is just as important as healthy bones, eyes and teeth.

It’s important for kids to get in the habit of caring for their skin. You can help by making sure they use sunscreen and keeping an eye out for these conditions:

  • Birthmarks, moles and warts – Marks on your child’s skin can be any number of things. This section will help you tell the difference.
  • Rashes, eczema and psoriasis – Rashes are common in children, but they could be a sign of a skin condition like eczema or psoriasis.
  • Acne – The plague of many teenagers, acne can be treated effectively to minimize breakouts and embarrassment.

Birthmarks, moles and warts

Birthmarks

Birthmarks are areas of discolored skin that are on a baby’s body at birth or that show up within a few months after delivery. More than 80 percent of babies have some kind of birthmark. Some endure for life, while others fade away over time. Most birthmarks fall into one of two categories: vascular or pigmented.

Vascular birthmarks are caused by blood vessels that have accumulated below the surface of the skin. They range in color from pink to red to bluish, depending on the depth of the blood vessels.

Pigmented birthmarks — usually brown, gray, bluish, or black — result from an abnormal development of pigment cells.

Birthmarks come in a wide range of shapes, sizes, and colors, and they can show up anywhere on the body.

Most birthmarks are harmless. Many go away on their own after a few years. However, each year about 40,000 U.S. children have birthmarks that need medical attention. Potential problems include port-wine stains near the eye and cheek, birthmarks on the lower spine and groups of six or more café au lait spots.

Some of these conditions may require removal. If a birthmark isn’t disfiguring or causing physical problems, your baby’s doctor may suggest that it’s best to leave it alone.

Moles

Moles on a young child’s skin are generally nothing to worry about. It is normal for new moles to appear during childhood and adolescence. Moles will grow as the child grows. Some moles will darken, and others will lighten. These changes are expected in children and are seldom a sign of melanoma — a type of skin cancer that can begin in a mole.

Melanoma is rare in young children and most moles are harmless, but there are a few types that should be examined by a dermatologist just to be sure. Mole types include:

Common : Also referred to as a beauty mark, a common mole is harmless. Most moles that develop on a child’s skin are common moles. If a mole looks different from the others, itches or bleeds, the mole should be examined by a dermatologist.

Congenital : Is when a child is born with a mole. They are considered a type of birthmark. Some look like common moles, while others resemble bruises. When a child has a giant congenital mole, it should be examined by a dermatologist. The risk of developing melanoma is greatest during the first 10 years of life and especially high during the first 5 years.

Dysplastic : Dysplastic moles have one or more of these traits:

  • asymmetrical (if folded in half, the sides would not match)
  • an irregular border
  • more than one color in the mole
  • a diameter that exceeds 6 millimeters (about the diameter of a pencil eraser)

If your child has dysplastic moles, he should have routine skin exams after puberty.

Spitz nevus : A Spitz nevus often is a pink, raised, dome-shaped lesion. It also can contain variable colors such as red, black and brown. The mole may bleed or have an opening that oozes. It resembles melanoma so closely that it is not possible for a dermatologist to look at a Spitz nevus on the skin and tell whether or not it is a melanoma. A dermatologist will be able to determine the difference by examining a bit of the tissue under a microscope.

Molluscum

Molluscum contagiosum is a common skin disease caused by a virus that spreads easily from person to person.

Often the only sign of molluscum is pink or flesh-colored bumps that can appear anywhere on the skin. Most people get about 10 to 20 bumps. If someone has a weakened immune system, many bumps often appear. People who have AIDS can have 100 or more bumps.

People can get molluscum by sharing towels and clothing. Wrestlers and gymnasts may get it from touching infected mats. Skin-to-skin contact also spreads the virus. Whenever you can see the bumps on the skin, molluscum contagiosum is contagious.

Dermatologists often recommend treatment for molluscum contagiosum . Treatment helps to prevent the virus from spreading to other parts of the body, spreading to other people or growing out of control in people with a weakened immune system.

The treatment your dermatologist prescribes will depend on age, health, where the bumps appear and other considerations. For a young child, treatment can have unwanted side effects and may not be best.

Treatments that a dermatologist can perform in the office to treat molluscum contagiosum include:

  • Cryosurgery : The dermatologist freezes the bumps with liquid nitrogen.
  • Curettage : The dermatologist may use a small tool called a curette to scrape the bumps from the skin.
  • Laser surgery : A dermatologist uses a laser to target and destroy the bumps. This can be an effective treatment for people who have a weakened immune system.
  • Topical (applied to the skin) therapy : Your dermatologist can apply various acids and blistering solutions to destroy the bumps. These work by destroying the top layers of the skin.

Medicines your dermatologist may prescribe for use at home include Imiquimod, a strong medicine that is applied to the bumps and helps the immune system fight the virus, and retinoid or antiviral medicine applied to the skin.

Warts

Children and teens are more prone to getting a wart virus than adults. In children, warts often go away without treatment. A dermatologist should treat warts that hurt, bother the child, or quickly multiply.

Viruses called human papillomavirus (HPV) cause warts. It is easier to catch a virus that causes warts when you have a cut or scrape on your skin. This explains why so many children get warts.

There are a few different types of warts. The type is determined by where it grows on the body and what it looks like.

Common warts grow most often on the fingers, around the nails and on the backs of the hands. They are more common where skin was broken, such as from biting fingernails or picking at hangnails. Most often they feel like rough bumps and can have black dots that look like seeds.

Foot (or plantar) warts grow most often on the soles (plantar surface) of the feet. They can grow in clusters and often are flat or grow inward because walking creates pressure.

Flat warts can occur anywhere, but children usually get them on the face. They are smaller and smoother than other warts and tend to grow in large numbers — 20 to 100 at a time.

Filiform warts look like long threads or thin fingers that stick out. They often grow on the face around the mouth, eyes and nose. They also often grow quickly.

While most warts are harmless, you should see a dermatologist if your child’s warts don’t go away, if they hurt, or if there are a lot of them. A dermatologist may use one of the following treatments:

  • Cantharidin : A dermatologist may treat a wart in the office by “painting” it with cantharidin. Cantharidin causes a blister to form under the wart. In a week or so, you can return to the office and the dermatologist will clip away the dead wart.
  • Cryotherapy : For common warts in older children, cryotherapy (freezing) is the most common treatment. This treatment is not too painful. It can cause dark spots in people who have dark skin. It is common to need repeat treatments.
  • Electrosurgery and curettage : Electrosurgery (burning) is a good treatment for common warts, filiform warts and foot warts. Curettage involves scraping off (curetting) the wart with a sharp knife or small, spoon-shaped tool. These two procedures often are used together. The dermatologist may remove the wart by scraping it off before or after electrosurgery.
  • Excision : The doctor may cut out the wart (excision).

Source: American Academy of Dermatology


Rashes, eczema and psoriasis

Rashes

Rashes are generally caused by skin irritation, which can have many causes. A rash is generally a minor problem that may go away with home treatment. In some cases a rash does not go away or the skin may become so irritated that medical care is needed.

Diaper rash, cradle cap and a host of other conditions are common in newborns. If you suspect that your child has more than a simple skin irritation, it is best to see a doctor.

Though uncommon, some childhood rashes have serious or even life-threatening causes. Many rashes can look the same, making it difficult to know the exact diagnosis. Whenever you have a concern, see your doctor immediately.

Eczema

Eczema is a common skin disease in children. Children often get it during their first year of life. Dry and scaly patches often appear on the scalp, forehead and cheeks. Eczema is often itchy and can be so intense the child can’t sleep.

When eczema begins in infants, you’ll see a rash that appears suddenly and makes the skin dry, scaly and itchy. The skin can bubble up, then ooze and weep fluid. Babies rarely get eczema in the diaper area because the skin there stays too moist.

In children ages 2 until puberty, eczema usually starts as a rash that begins in the creases of elbows or knees. Other common places for the rash to appear are the neck, wrists, ankles and/or crease between the buttocks and legs. You’ll also see itchy, scaly patches where the rash appeared.

Eczema can be a long-lasting condition, but treatment and good skin care can alleviate much of the discomfort.

A treatment plan often includes medicine, skin care and lifestyle changes. Skin care and lifestyle changes can help prevent flare-ups.

A dermatologist will create a treatment plan tailored to your child’s needs. Medicine and other therapies will be prescribed as needed to:

  • Control itching
  • Reduce skin inflammation (redness and swelling)
  • Clear infection
  • Loosen and remove scaly lesions
  • Reduce new lesions from forming

Psoriasis

Psoriasis is a long-lasting disease that develops when a person’s immune system sends faulty signals that tell skin cells to grow too quickly. New skin cells form in days rather than weeks. The body doesn’t shed these excess skin cells. The skin cells pile up on the surface of the skin, causing patches of psoriasis to appear. It is not contagious.

Psoriasis can begin at any age, but most people get psoriasis between ages 15 and 30. Infants and young children are more likely to get inverse psoriasis and guttate psoriasis.

Types of psoriasis include:

  • Plaque : Causes thick patches of skin that are covered with silvery-white scale.
  • Guttate : Causes small spots that can show up all over the skin.
  • Pustular : Causes pus-filled bumps that usually appear on the foot or hand.
  • Inverse : Develops in areas where skin touches skin, such as the armpit.
  • Erythrodermic : Can cause the skin to look like it is badly burned.

Treatment can reduce signs and symptoms of psoriasis. Some people see their skin completely clear.

Thanks to ongoing research, there are many treatments for psoriasis. It is important to work with a dermatologist to find treatment that works for you and fits your lifestyle. Every treatment has benefits, drawbacks, and possible side effects.

  • Topical (applied to the skin) – Mild to moderate psoriasis. Some effective products include Cutar Emulsion and Tarsum shampoo.
  • Phototherapy (light, usually ultraviolet, applied to the skin) – Moderate to severe psoriasis
  • Systemic (taken orally or by injection or infusion) – Moderate, severe or disabling psoriasis

Discussing your child’s treatment options with a dermatologist will help determine which is right for you.

Source: American Academy of Dermatology


Acne

Your teen may feel like the only one at school with bad acne, but that’s not the case. Acne is the most common skin problem in the United States –about 40 to 50 million Americans have it at any one time. The condition can lead to low self-esteem, but the good news is that most acne can be treated effectively.

Cause

Acne appears when a pore begins to get clogged with dead skin cells. Normally, dead skin cells rise to surface of the pore, and the body sheds the cells. When the body starts to make a lot of sebum, oil that keeps our skin from drying out, the dead skin cells can stick together inside the pore. Instead of rising to the surface, the cells become trapped inside the pore.

Sometimes bacteria that live on our skin also get inside the clogged pore. With loads of bacteria inside, the pore becomes inflamed (red and swollen). If the inflammation goes deep into the skin, an acne cyst or nodule appears.

Treatment Options

At-home treatment: Many people can treat mild acne with products that you can buy without a prescription. A product containing benzoyl peroxide or salicylic acid often clears the skin over time, but not overnight. At-home treatment requires 4-8 weeks to see improvement. Once acne clears, treatment must continue to prevent breakouts.

For more severe acne, an over-the-counter product may not work. Dermatologists offer the following types of treatment:

Acne treatment that you apply to the skin : Most acne treatments are applied to the skin. There are many topical acne treatments. Some topicals help kill the bacteria. Others work on reducing the oil. The topical medicine may contain a retinoid, prescription-strength benzoyl peroxide, antibiotic or even salicylic acid. Vanoxide is an example of an effective topical treatment. Your dermatologist will determine what you need.

Acne treatment that works throughout the body : Medicine that works throughout the body may be necessary for red, swollen types of acne. This type of treatment is usually necessary to treat acne cysts and nodules. A dermatologist may prescribe one or more of these:

  • Antibiotics (helps to kill bacteria and reduce inflammation)
  • Birth control pills and other medicine that works on hormones
  • Isotretinoin (the only treatment that works on all causes of acne)

Procedures that treat acne : Dermatologists may treat acne with a procedure that can be performed during an office visit. These treatments include:

  • Lasers and other light therapies: These devices reduce the bacteria that lead to acne.
  • Chemical peels: Dermatologists use chemical peels to treat two types of acne — blackheads and papules.
  • Acne removal: Your dermatologist may perform a procedure called “drainage and extraction” to remove a large acne cyst. This procedure helps when the cyst does not respond to medicine. It also helps ease the pain and the chance that the cyst will leave a scar.

Source: American Academy of Dermatology

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