110 - Skin Care

This episode is all about skincare. Dr. Carole Keim MD walks you through the ways newborn skin is different from all other babies’ skin and goes into detail on birthmarks, jaundice, baby acne, eczema, cradle cap, and diaper rash. She explains why newborn skin is prone to dryness and peeling, what milia is and how it will go away on its own, the causes and helps for jaundice, and shares much useful advice.

One of the first things to know about newborn skin is that because they’ve basically been in a bath for nine months, their skin will be dry and peely as it adjusts to the outside world. Have you heard of stork bites, angel kisses, Mongolian spots, or port wine stains? These are all types of birthmarks that Dr. Keim explains in detail. She also details how hemoglobin from extra red blood cells converts to bilirubin in the body, and bilirubin causes the yellowish tint we know as jaundice. Dr. Keim tells exactly what to look for and what to do for your baby.

Covered in this episode:

• Newborn skin
• Newborn rash
• Pustular Melanosis / normal rash
• Milia
• Birthmarks
• Hemangioma
• Jaundice
• Baby acne
• Seborrhoeic dermatitis / cradle cap
• Eczema
• Diaper rash

Newborn skin / newborn rash 0:33

• Dry and peely is normal
• Newborn rash looks a little like chickenpox: red spots all over
• Newborn rash is not itchy or painful and happens usually within first 3 days of life
• No lotion or product required - only a greasy emolient if dry and cracking at wrists or ankles

Pustular Melanosis / normal rash 1:51

• Tends to happen in babies with darker skin tone
• Looks like newborn rash but tiny blisters are smaller - tiny pustules with yellowish fluid inside
• When they pop they leave behind a little freckle
• Freckles go away on their own
• Should go away in a week - if persists beyond week, talk to doctor

Milia 2:44

• Looks like pimples on nose, upper cheeks, forehead
• Is not pimples but is tiny white, pinpoint size, dots
• Do not pick or squeeze, could hurt baby or scar if you do
• It’s essentially skin cells trapped under the skin that form tiny white bumps - almost like clogged pores but not quite
• Will go away on its own and is not dangerous

Birthmarks 3:24

• Present either at birth or a few days or weeks after birth - normal
• Salmon patches - also called stork bites or angel kisses - can show up anywhere on body and usually fade within the first year of life
• Sometimes scalp and back of head salmon patches never fade
• Sometimes when babies cry, especially with patches on forehead or eyelids, they’ll get redder and brighter - this is normal
• Mongolian spots - also called slate grey nevus or dermal melanocytosis - are light blue grey in color, almost like bruises
• They show up frequently from birth in low back area but can really be anywhere
• They tend to fade within the first five years of life
• More common in babies with darker skin tone, normal, and kids outgrow them
• Port wine stains - dark red, flat area of skin - usually on face or upper body, but not always
• Not dangerous but sometimes associated with other conditions
• If your baby has a port wine stain your doctor may want to do a genetic workout but many times it’s nothing
• Treatment is not necessary for port wine stains but some families opt for it for cosmetic reasons

Hemangioma / infantile hemangioma 6:00

• Similar looking to port wine stains but are raised and lumpy
• Are a collection of blood vessels
• If you press on it, it may go lighter colored or white then turn back to red
• Tend to grow quickly - within first 6 months of life - then start to involute or crumble within themselves and shrink back down
• Typically by age four there might be a bit of color left, might not, might be different texture to skin area or might not
• Hemangiomas are often not treated but depending on location may require treatment - hemangioma on eyelid or near airway (“beard distribution” area) could overlay vital structures and cause baby to not see out of affected eye or close airway
• Doctor can check for internal hemangioma with ultrasound
• Treatment may be beta blocker or laser therapy - consult doctor

Jaundice 8:16

• Yellowish color of skin and eyes and is common among babies
• Reason: babies are born with extra red blood cells, some maternal red blood cells release hemoglobin when broken down which converts to bilirubin
• Bilirubin is what causes the yellow color of skin and eyes: jaundice
• Bilirubin can be checked for with tests via light and special device (transcutaneous bilirubin) or blood test (serum bilirubin)
• Phototherapy is brig...