From 27 to 29 September 2013, Rise and Shine Expo, an informative expo to raise happy and healthy children was held in Singapore. There were more than 100 seminars, workshops and trial classes held and one of the seminars by dermatologist Dr Lynn Chiam was on ‘All about Children’s Skin’, a topic I’m very passionate about.
Dr Lynn Chiam of Children & Adult Skin Hair Laser Clinic is a consultant dermatologist who subspecializes in paediatric skin conditions at Mount Elizabeth Novena Specialist Medical Centre, Singapore. She was formerly the head of paediatric dermatology at National Skin Centre, Singapore before leaving for private practice. She has vast experience in childhood atopic dermatitis and childhood birthmarks. She has previously shared her expertise in this blog on Teen Eczema and Facial Eczema.
Common Skin Conditions
Eczema is one of the most common skin conditions, affecting 20% of children. It can be inherited, and also associated with allergic conditions such as allergic rhinitis. Typically, eczema appears before the age of 7, as a red and itch rash at joints, face (for young children), body and requires treatment. Apart from good skin care routine (relating to shower, moisturizing), topical corticosteroids, antibiotics, antihistamines or wet dressings may be prescribed by the doctor.
Eczema is also affected by the environment, such as environmental triggers (house dust mite, pollen and dander) or irritants that include heat/sweat, rough textiles and low humidity. Allergy testing can be conducted, such as skin prick test, to find out potential allergens for the child. House dust mite is the most common environmental allergen and these dust mites cannot be fully eliminated from the home. Sunning mattress, washing bedding in 60 deg C for an hour and weekly cleaning can reduce the level of house dust mites. Dust mites thrive in humid environment, so humidity can be lowered but care to be taken not to have the bedroom too dry or moisture can be stripped from the skin.
Food allergy on the other hand is not as common in eczema, affecting 5% of children and 1% of adults. The common foods that trigger eczema are egg, milk, crustacean seafood and wheat.
Other Childhood Skin Infections
Warts – Warts are caused by virus, and spread by contact with another infected person. Warts can spread from one part of the body to another, and recur as the virus is hidden deep in skin. Warts can be left alone or treated with cream, freezing with liquid nitrogen, laser or electrocautery.
Molluscum contagiosum – Molluscum contagiosum is caused by the molluscum contagiosum virus (MCV), a member of the poxvirus family. This virus thrives in warm, humid climates and in areas where people live very close together. The virus can be caught in swimming pool and similar to warts, the growths can be left alone or frozen.
Cold sores – Cold sores are caused by the herpes simplex virus (HSV type 1), and can cause cold sores around the mouth. Cold sores can be spread from person to person, and signs that accompany cold sores include fever, poor feeding and irritability. This usually resolved in 1-2 weeks.
Hand Foot Mouth Disease (HFMD) – HFMD is due to the enterovirus, and can incubate for 3-5 days, commonly occurring in children younger than 5 year old. It is accompanied by fever, poor appetite, a vague feeling of being unwell (malaise) and sore throat. There is no specific treatment for it and usually resolve within a week.
Urticaria (Chronic Hives) – Hives are formed in response to histamine released from specialized cells along the skin’s blood vessels. This could be due to allergic reactions, insect stings, sunlight or medication but most of the time, the cause cannot be identified in chronic hives.
Various Skin Marks (Birthmarks – Haemangiomas, Port Wine Stains, Brown Spots and White Spots) – Various skin marks are present in children, some like port wine stain is present at birth while others like haemangiomas present in about 2-3 weeks of age. The appearance of these spots differ, and generally can be treated by laser.
Milia – Milia are tiny white bumps, common in newborns and appear as cream-coloured papules. It is caused by dead skin that is trapped near the baby’s skin surface. When the surface of the bump wears away, the dead skin is sloughed off and the bump disappears.
Pimples – Pimples (whiteheads, blackheads or inflamed red spots), or infantile acne, can also be present in up to 20% of infants and related to blockage, inflammation and breaking of pores from over-production of oil. To prevent scarring, treatment is required. Also for adults having acne, avoid cosmetics, look for powder foundation rather than liquid foundation, and contrary to common belief, chocolate, nuts and oily food does not cause acne.
Next week, I will be posting on the last segment of Dr Lynn’s talk on other skin conditions and grateful to Dr Lynn Chiam for reviewing the above on her talk at Rise and Shine Expo.