The infancy period is a time when we closely observe every inch of our child's skin, and any changes - spots, redness, peeling - can cause great concern. Is it right? How can we distinguish between harmless, temporary ailments and signals that require attention? At the Healthy LUUdzika Club, we hosted an outstanding specialist - prof. dr hab. n. med. Andrzej Kaszuba, a valued dermatologist with many years of experience, author of publications and national consultant. We talked with the Professor about the specifics of delicate newborn skin and the most common problems, such as heat rash, cradle cap or infant acne, explaining their causes and suggesting how to properly care for the baby's skin.

Why is baby's skin so special?

The first thing we need to understand is that the skin of a newborn and infant is significantly different from that of an adult. As Professor Kaszuba emphasizes, its full maturation is a process that takes years.

"Skin [...] matures (...) often this maturation of the epidermis, dermis and even subcutaneous tissue lasts until the third, fourth or even fifth year of life," the expert explains. What does this mean in practice?

• A thinner protective barrier: The epidermis is thinner, and its stratum corneum - the main shield against external factors - is less developed. This makes the skin more permeable and susceptible to irritation. "This genetic sensitivity is important because some children may have more sensitive skin, others less sensitive, but generally this skin sensitivity at this age (...) is very high."
• Immature glands: The sweat and sebaceous glands are only just learning to function properly. This can lead to them becoming blocked more easily (heat rash) or producing too much sebum (cradle cap).
• Increased sensitivity: A baby's skin is more reactive to external factors: temperature, humidity, cosmetics, detergents and clothing materials.

The most common skin problems in newborns and infants: a guide for parents

Although every change on a baby's skin is cause for concern, many of them are temporary and harmless. Prof. Kaszuba discusses the most common ones:

1. Miliaria: Small blisters or spots, often appearing in the folds, on the neck, back or chest. "Most often, it is caused by (...) overheating of the child," says the professor. They result from blockage of immature sweat glands. They can be white (Miliaria crystallina - superficial, like "dewdrops") or red, more inflammatory (Miliaria rubra - deeper). They usually disappear on their own after the skin is aired and overheating is avoided.
2. Neonatal acne: Small pimples and blackheads, mainly on the face (cheeks, nose, forehead). "It is associated [...] with transferred hormones from the mother," the expert explains. This is a temporary condition that usually disappears on its own within a few weeks or months and does not require special treatment, only gentle hygiene. It is worth distinguishing it from infant acne, which can appear later (after the 3rd month) and can be more severe.
3. Cradle cap (seborrheic dermatitis of the scalp): Yellowish, greasy scales that form a "crust" on the scalp, sometimes also on the eyebrows. It is the result of overproduction of sebum by immature glands, often under the influence of the mother's hormones. It is usually not dangerous. It requires regular greasing (e.g. with olive oil, special preparations), gentle combing with a soft brush after softening the scales and washing with a mild shampoo. "Cradle cap can accompany a child from the third week, fourth week of life," adds prof. Kaszuba.

Atopic Dermatitis (AD) – early signals and the role of genetics

You should be particularly vigilant when your skin is noticeably dry, as it may be the first symptom of a tendency towards atopy. "Dry skin (...) is based on atopy, i.e. atopic skin, which is characterized by defects in the structure of some epidermal proteins, especially filaggrin," explains the professor.

AD is a chronic disease with a genetic basis, but its symptoms (dryness, intense itching, inflammatory changes – redness, lumps, erosions) are often provoked by environmental factors. Prof. Kaszuba draws attention to the growing incidence of atopic diseases, calling them the "epidemic of the 21st century." "The increase in atopic diseases (...) is enormous. 30% of the population has an atopic basis for their problems," he says. Persistent cradle cap, especially if accompanied by dry skin in other places (e.g. on the cheeks, in the creases of the elbows or knees), should prompt medical consultation.

Infant skin care: key principles

How to care for such delicate skin? Prof. Kaszuba advises:

• Gentle washing: Baths do not have to be daily. Washing too often, especially with traditional soaps, disrupts the natural protective barrier. Daily washing of the folds and intimate areas is enough, and bathing the whole body every 2-3 days, using mild syndets or emollients for washing (soap-free preparations with a pH similar to the skin).
• Avoiding overheating: This is the basis for preventing heat rash. Let's adjust the child's clothing to the temperature, choose natural, breathable fabrics.
• Moisturizing and lubricating (when needed): Healthy newborn skin often does not require additional cosmetics. However, if it is dry, prone to irritation or atopic, regular use of emollients is necessary - preparations that moisturize, lubricate and rebuild the skin barrier.
• Sun protection: Infant skin is very sensitive to UV radiation. Avoid direct exposure to the sun and use appropriate clothing and mineral filters designed for the youngest.
• A prudent diet (for atopy): In children at risk of atopic dermatitis, it is worth introducing new foods carefully and observing skin reactions. Prof. Kaszuba mentions the potential effect of a diet that stimulates the release of histamine (e.g. citrus fruits, chocolate, some cheeses) on the exacerbation of symptoms.

When is a visit to a dermatologist necessary?

Although many changes are physiological, a medical consultation is indicated when:

• Skin changes are severe, long-lasting or cause great concern.
• The skin is very dry, cracking, flaking.
• There is severe itching, the child scratches to the point of bleeding.
• Inflammatory, oozing changes appear, suspected bacterial infection (suppuration).
• Parents have doubts about the diagnosis or care.

"If the mother notices any symptoms on the skin (...), she should come to the doctor and the doctor will outline (...) the scope of treatment" - advises prof. Kaszuba.

An appeal to parents: observation, calmness and sensible care

Dear parents, the skin of your little one is exceptionally delicate and is only just learning to function in a new environment. Observe it carefully, but do not panic. Remember the basic rules of care: avoiding overheating, washing gently and moisturizing when necessary. Do not experiment excessively with cosmetics. And if something worries you, do not hesitate to consult a pediatrician or a pediatric dermatologist. Your calmness and sensible approach are the best support for the healthy skin of your little one.

The article was based on a conversation with prof. dr hab. n. med. Andrzej Kaszuba, a dermatology specialist, conducted as part of the Healthy Kids CLUUb.