Golden rules for children’s skin

Acne, atopic dermatitis and sunburn, the most common problems in children: here’s how to deal with them

19/06/2022 – by Maurizio Maria Fossati

Maybe not everyone knows that the skin is an organ. Yes, even the largest organ in the human body and certainly one of the most complex. But what are the diseases that most commonly affect the skin of children and adolescents? To frame the problem, let’s start by saying that they are divided into inflammatory, infectious and tumor diseases. And that tumors fortunately have an almost insignificant incidence in children.

So let’s start with the inflammatory pathologies. “In pediatric age, atopic dermatitis is by far the most common inflammatory disease,” said Diego Tosi, a pediatric dermatologist at Buzzi-ASST Fatebenefratelli Sacco Children’s Hospital. It can occur as early as in the newborn and can continue until puberty and adulthood. Seborrheic dermatitis, which in the newborn is commonly called cot, is also inflammatory. During puberty, acne can occur with an incidence of 1 in 5 young people. Infectious skin diseases, on the other hand, can be of viral (such as warts), bacterial (such as impetigo) and fungal (ie fungal) origin due to contact between children, animals and the soil ”.

The most common pathology of all is undoubtedly atopic dermatitis – emphasizes the specialist – which usually occurs in the first months of life with dry skin, a more sensitive, reactive skin and red, scaly, typically itchy spots. Often the child is the son of parents who suffer from allergies and he may even develop allergies during his lifetime. Atopic dermatitis has preferred sites. In the newborn, it occurs in the face or in the diaper area. In older children, it is localized in the location of the folds, such as the neck, the cavities of the elbows, and the knees. In the larger ones, the lesions are less acute and less inflammatory, but long-lasting. Mild forms of atopic dermatitis can be treated by the pediatrician, while moderate and severe forms require the assessment of a dermatologist.

Due to the altered skin barrier and skin dryness, says Dr. Tosi, the child with atopic dermatitis should avoid all possible irritating factors such as too frequent washing, aggressive cleaning agents, contact with chemicals.
Even clothing can cause irritation: it is better to avoid skin contact with wool, irritating and allergenic non-breathable synthetic fabrics. Treatments for mild atopic dermatitis include emollient creams designed to restore the skin barrier. In the moderate forms cortisone-based ointments are used in cycles, while in the more severe forms there are now systemic therapies with biological drugs, for hospital use, for children over 6 years. Sun, sea and spa treatments have a beneficial effect on these patients.

Acne, on the other hand, stems from an altered activity of the sebaceous gland. It usually occurs, the dermatologist explains, in the period prior to puberty and is associated with a predisposition to the disease (familiarity). It prefers the face and the trunk. The less inflammatory forms manifest comedones, the famous blackheads and whiteheads, which indicate occlusion of the sebaceous glands. Over time, bacterial invasion can occur, forming papules, that is, inflammatory elements that aggravate the situation. Thus, it is possible to reach the pustules containing pus. The most severe forms show the formation of nodules and cysts. Acne, which is a pathology associated with hormonal development, is a long-term disease that in women can be associated with ovarian problems. Contrary to many people’s beliefs, nutrition plays a marginal role in the course of acne, while stress is known to be a debilitating condition.

How is it treated? Moderate forms of acne are treated with topical therapies based on retinol derivatives, which have an exfoliating effect and therefore reduce the effect of blackheads. On the other hand, when there is inflammation, local antiseptics and / or antibiotics are used. In the most severe forms, antibiotics are also taken by mouth. Female gender can also benefit from the progestogen pill.

Babies and early childhood

No sun for the first six months of life. “Direct exposure of the newborn to sunlight should definitely be avoided,” says the advice of Diego Tosi, a specialist in pediatric dermatology. «And these days it is also necessary to avoid going out in the sun during the central hours of the day, ie in the interval 11-15. After 6 months, it is helpful to apply a 50+ sunscreen and use protective clothing and hats. It should also not be forgotten that the use of sunscreen must always be abundant and restored every two hours and after every bath, despite the fact that the products on the market guarantee resistance to water ». In the pediatric age, sunburn should definitely be avoided as they represent a high risk factor for melanoma for adulthood. It is always good to remember that the skin has its own “memory”, and therefore any exposure to the sun increases its natural aging without recovery.

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