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How to help prevent & treat some baby rashes, cradle cap, dry skin & eczema
Here’s our expert guide to help you avoid and treat some of the more common baby skin problems, so you can help keep your baby’s skin at its softest.
Help with managing your baby's rash
Rashes are very common in babies from as early as a few days old, as their bodies adapt to life outside the cosy womb. Most are harmless and go away on their own. But if your baby also seems unwell, or you’re worried, talk to your GP or pharmacist to find out what might be causing the rash.
Here are some of the more common causes of baby rash – and how to avoid or treat them:
Usually found in neck, armpit and thigh folds, these rashes are known as intertrigo and develop when their skin stays moist and the folds rub together causing friction. To avoid them, the key is careful washing and drying, then gently massaging a suitable emollient into the affected areas to lessen the friction.
"Washing the face and neck before and after feeds helps, too, as does a feeding bib or muslin to catch drips," advises consultant dermatologist Dr Tabi Leslie. "And make sure you get fresh air to the skin after nappy changes and bath time."
If the rash is not getting better, becomes weepy, or is spreading, this could indicate infection, so see your GP.
Appearing around the bottom area only, nappy rash can usually be cleared up by changing your baby’s nappy frequently and letting the skin breathe whenever possible. It may also be useful to use a suitable barrier cream. "Give your baby as much nappy-free time as possible," says Dr Tabi. She also suggests changing your baby as soon as you can – even during the night if they soil their nappy. Poo can cause a painful rash, especially if the skin is broken.
Make sure you thoroughly clean your baby’s bottom. You should stick to water only for the first few weeks, and then can use fragrance and alcohol-free wipes or a suitable mild wash and cotton wool, always wiping from front to back. Rinse with plain water and pat dry, then apply gentle hypoallergenic nappy rash barrier cream (ask your pharmacist to recommend one) just before the new nappy goes on. This will help provide protection as the skin heals.
But check out the type of nappy rash your baby has. "If it’s raised spots, rather than a flat rash, it could need an anti-fungal cream to treat any infection," says Boots pharmacist Angela Chalmers. And, as common as it is, if nappy rash persists for more than three days or is causing significant discomfort, see your GP.
Itchy red heat rash
If your baby is particularly well wrapped up, or the redness appears in areas of the skin that tend to overheat and sweat (usually the neck, nappy area and armpit) it could simply be a heat or sweat rash. Boots pharmacist, Angela Chalmers, says: "The most important thing is to keep the rash area skin dry and make sure you let air get to it. If it continues, or you’re concerned, see your pharmacist or GP, who can check it isn’t something else, such as an allergy."
Rash of red spots
When little ones get a virus, their bodies tend to break out into a patchy red rash, which may be made up of pinkish spots, patches or bumps that should fade if you roll a glass over them, and which disappears as they get better. Chicken pox, for example, is viral but it’s easy to distinguish from other viruses because it usually starts out as individual spots – just one or two on their tummy or back – before erupting all over as single spots. Your pharmacist can advise if your baby needs to see the GP, and can advise a suitable product. For chicken pox, you may want to consider using a cooling gel product to help relieve symptoms. A viral rash may also be accompanied by fever, so speak to your pharmacist for suitable products to help relieve fever.
Could it be meningitis?
A meningitis rash usually starts as small red pinpricks before spreading quickly and turning into red or purple blotches that don’t fade if you press the side of a clear glass firmly against the skin. But the rash does not appear in all cases, so look out for other warning signs, including refusing feeds, not wanting to be picked up, a bulging fontanelle, being floppy or unresponsive or having a stiff body, and having an unusual high-pitched cry. You should get medical advice as soon as possible if you’re concerned, so trust your instincts. Call NHS 111 or your GP surgery for advice if you’re uncertain whether it’s serious, or go to your nearest A&E if you think your child is seriously ill.
Coping with cradle cap
"Scaly scalps are most likely to be caused by cradle cap – which usually clears up on its own when your baby is between six and 12 months," says Boots pharmacist Angela Chalmers. And if you’re tempted to pick, don’t! Consultant dermatologist Tabi Leslie advises: "Leave it alone – picking at it may only make it worse!"
However, to help prevent scaly build-up, Angela also suggests gently massaging in a little baby oil to help soften the scales before using a baby shampoo. Carefully dry their head, then gently brush out any loose scales with a wide-toothed baby brush and comb. You can also buy specially formulated cradle cap shampoos from the pharmacy – ask your pharmacist for advice.
If cradle cap becomes particularly crusty it could be infected, so visit your GP.
How to deal with dry skin
Your baby’s skin is very delicate, and may react to some baby products so look out for those for sensitive skin.If your baby is newborn and their skin is very dry, creams or lotions may cause further problems – seek advice from your midwife or health visitor. Plain water is best for your baby's skin in the first month. As they get older, suitable dry skin emollients and rich baby moisturising creams are great at upping moisture levels and countering hard water. "The right product is key," says Dr Tabi. "Don’t worry if it feels greasy. I even recommend moisturising the face before and after a feed to act as a barrier."
Seasonal dry skin
In summer keep your baby well moisturised, covered up with long sleeves and a hat (even in shade) and with a wind shield on your pram. Babies under six months should always be kept out of direct sunlight. "High-protection sunscreen and weather protection cream are good moisturisers," says Dr Tabi.
Is it eczema?
Areas of dryness or a red, itchy rash appearing on cheeks, behind the ears, or in the creases of the neck, knees and elbows, starting any time after two months, could mean eczema. It’s rare in newborn babies though: "If I see a very young baby with dry skin and a rash, it’s more likely to be a reaction to a product or some form of dermatitis," says Dr Tabi.
A gentle skincare routine and moisturising four times a day with a suitable moisturiser, using downward strokes, are key to helping soothe sore patches and prevent flare-ups. But in the event of a flare-up, or if the eczema has become infected, talk to your pharmacist or GP for advice. Recent evidence has shown that aqueous cream should be avoided, and soap and other bath products can dry or irritate the skin.
Bathtime routine for babies with dry skin
Baths can dry out babies’ skin, especially if the water is hot or you’re not using suitable products. Try to remember to:
Keep baths short and sweet
Baths should be a maximum of 10 minutes and no hotter than 37˚C. And remember that bathing every other day is fine. If your child is older and you bath them every day, use a softening emollient on sensitive skin.
Avoid scented products
"Bubble bath can dry the skin. Products don’t need to lather to be effective!" says Dr Tabi. "If your baby has sensitive skin, use products free from fragrance and other additives like SLS (read the label!) – experiment to find what suits your baby best." Always use a suitable baby product.
Use a suitable gentle wash and a rich moisturising baby lotion. On non-bath days, mix emollient with a little warm water and wipe with a flannel before patting dry.
Rinse and dry skin thoroughly
Damp areas can cause a rash. Pat dry gently, as rubbing can create irritating friction.
Moisturise to the max
Use baby moisturisers after the bath, and slather the nappy area with nappy cream at change time. "It’s not really possible to 'over moisturise' a baby, so do it as often as you can," says Dr Tabi. "Keep a tub of your favourite baby brand by the changing table."
Never leave your baby unattended in the bath.