Your body goes through tremendous changes during pregnancy.
Your belly gets larger and your blood volume increases as your baby grows. You may experience cramping, morning sickness, and all sorts of unfamiliar aches and pains. Your hair and skin may also go through a transformation for the better — or worse. (You’re beautiful all the same.)
If you’ve noticed dark patches of skin on your face, you may have melasma. Here’s more about this condition, why it crops up in pregnancy, and how you can treat it safely.
What is melasma in pregnancy?
Melasma is a skin disorder where the melanocytes (color-producing cells) in your skin produce extra pigment for some reason. In pregnancy, it’s often referred to as chloasma, or the “mask of pregnancy.”
Chloasma is a cosmetic concern. It doesn’t affect your baby in any way or indicate any other pregnancy complications.
People with more pigment in their skin — for example, those of African, North African, Middle Eastern, Latin or Hispanic, Asian, Indian, or Mediterranean descent — are more likely to develop chloasma, as they naturally have more active melanin production.
Overall, between 50 and 70 percent of people will develop some form of melasma during pregnancy.
Symptoms of melasma in pregnancy
The primary symptom of chloasma is the darkening of the skin on the face. You may notice dark patches or splotches on your forehead, cheeks, chin, or around your mouth. These areas may get darker the more you’re exposed to the sun or the further along you are in your pregnancy.
Pain, itchiness, or soreness are not symptoms of melasma. If you experience these signs or develop severe irritation, you may be dealing with another condition. Bring up any additional symptoms you have with your doctor.
A dermatologist can accurately diagnose your condition using a Wood’s lamp, which helps show whether a skin condition is bacterial, fungal, or otherwise concerning.
Causes of melasma in pregnancy
Skin hyperpigmentation during pregnancy is very common. You may notice your nipples/areolas, armpits, or genitals become darker. You may see a line (linea nigra) extending from the pubic area over the belly, or darkening of the skin all over the body.
Changing hormones, particularly the excess of estrogen and progesterone, is the main cause of melasma during pregnancy. Beyond that, the dark patches on the face can be exacerbated by sun exposure, the use of certain skin care products or treatments, and even genetics.
Chloasma may also be worsened by hormonal imbalances that may have been present even before pregnancy.
Whatever the case, your melanocyte-stimulating hormones react to these triggers by making an excess of protective pigments (dark patches) on the skin called melanin.
When melasma may start in pregnancy
Melasma may start at any point in your pregnancy, though it most commonly begins in the second or third trimester.
Again, there are a variety of factors at play when it comes to darkening pigment. Your skin color and type may make this condition more or less noticeable. How much you’re out in the sun or even the time of year when you’re pregnant may also affect when you first notice it.
Does melasma go away after delivery?
The good news is that this hyperpigmentation likely won’t get worse after you deliver your child. That said, it may take time — possibly months — for it to completely fade without any targeted treatment.
Pregnancy-safe treatments
Speak with your doctor about ways to treat your melasma during pregnancy. Your doctor may refer you to a dermatologist for more information.
Some experts don’t recommend treating melasma during pregnancy. One reason is that it may resolve on its own. And some treatment methods may not be safe or effective to use when pregnant.
The best course of treatment may actually be prevention, with the help of a few lifestyle changes.
Seek shade
Since the sun may trigger the development of more pigment, it’s a good idea to stay out of its rays, especially for long periods of time.
Yes, this also applies to tanning beds or any other environment where you would be exposed to UVA and UVB rays. Limit sunbathing and try relaxing under a tree or umbrella instead.
If you’re exercising, try avoiding peak sun hours in your area, generally in the middle of the day. Head out early in the morning or later in the evening when the sun is low.
Wear sunscreen
This doesn’t mean you have to stay indoors when the sun is out, though. Wearing a good pregnancy-safe sunscreen with SPF 30+ is key.
Look for products that contain zinc oxide, titanium dioxide, or other physical blockers (mineral sunscreens) versus those that rely on chemical blockers. Physical blocking sunscreens tend to offer broader protection and may be less irritating to the skin.
Dress for success
Another option for sun cover is clothing with or without UV protection, such as SPF rash guards or sun protective clothing. Even if it’s hot outside, loose-fitting clothing can be comfortable and protect your skin.
What about the face? Wide-brimmed hats are your best friend. And don’t forget a stylish pair of sunglasses — the bigger the better.
Use gentle skin care products
Face washes, lotions, and serums that irritate your skin may make melasma worse. Slather up with gentle products instead. Look on the label for words like “non-comedogenic,” “sensitive,” “fragrance-free,” or “dermatologist approved” if you get overwhelmed in the beauty aisle.
The same goes for makeup you may use to conceal the dark areas. Look for non-comedogenic or hypoallergenic foundations, concealers, powders, and other products..
Eat well, rest, and try a few supplements
Since melasma may also be the result of hormonal imbalances, you may improve matters by giving yourself some much-needed TLC. Make sure you’re staying hydrated, eating a diet with plenty of fresh fruits and vegetables, and getting enough sleep each night.
Be sure that you’re rounding out your diet by consuming supplemental omega-3 fatty acids. Ask your doctor about any potential vitamin deficiencies. Some studies link melasma to a deficiency in iron and possibly vitamin B12.
Be patient
After pregnancy, you may ask your dermatologist about other treatments if your melasma doesn’t fade on its own. Treatments include topical medications like:
- Hydroquinone
- Tretinoin
- Corticosteroids
Your doctor may also recommend certain acids that lighten the skin, alone or in combination. There are also some procedures — including chemical peels, microdermabrasion, laser treatments, and other light therapies — that may work.
The takeaway
It can be frustrating to deal with changes to your skin during pregnancy. Fortunately, chloasma generally fades within a few months after giving birth.
There are various lifestyle changes you can try to prevent the condition from progressing during pregnancy. Otherwise, speak with your doctor about the options for treatment and the benefits and risks of each. You’ll be glowing again before you know it!
- Avoid Rapid Temperature Changes: Protect your skin from abrupt changes in temperature by wearing gloves, scarves, and hats when outside.
- Moisturize Often: Use a heavier moisturizer like shea butter during winter months, and apply liberally several times a day.
- Use Mild Skincare Products: Switch to natural or unscented skincare products to reduce irritation caused by changing temperatures.
- Get Some Vitamin D: Consider vitamin D supplements, especially during winter when sun exposure is limited. Use sunscreen to avoid sunburn.
- Use a Humidifier: Combat dry air by using a humidifier inside the house to prevent skin from cracking.
- Keep the Skin Dry: Remove wet clothes promptly to avoid worsening eczema in cold and damp conditions.
- Use Prescription Ointments: Consult a doctor for prescribed creams, medications, or ointments to treat eczema.
- Natural Remedies: Explore natural options like sunflower seed oil, coconut oil, acupuncture, massage, vitamin D, and probiotics.
- Wear Layers: Dress in layers to regulate body temperature and choose natural fabrics to avoid irritation.
- Eat Eczema-Friendly Foods: Consider the impact of certain foods on eczema symptoms and consult a doctor if food allergies may be a factor.
Treating Eczema in Children and Babies:
- Cover their skin when going outside with warm clothes, gloves, and a scarf.
- Remove layers when inside to avoid overheating.
- Dress them in soft fabrics like cotton or silk to prevent irritation.
- Apply sunscreen even in winter when exposing their skin to sunlight.
- Moisturize their skin frequently with an oil-based moisturizer suitable for babies or children.
- Encourage them not to scratch, and keep their fingernails short to prevent skin harm.
Staying warm, layering, adding moisture to both skin and air and avoiding irritating products will help manage eczema in winter. Teaching children the importance of staying warm and using layers correctly will also contribute to alleviating eczema symptoms.
What Is Psoriasis?
Psoriasis is a chronic (long-lasting) skin condition. People with psoriasis have a skin rash and, sometimes, joint problems or nail changes.
There’s no cure for psoriasis, but treatment can help most people who have it control its symptoms.
Signs & Symptoms of Psoriasis
The main symptom of psoriasis (seh-RYE-eh-siss) is red, thickened patches of skin called plaques. These can burn, itch, or feel sore. Often, silvery scales cover the plaques.
Plaques can happen anywhere. In children, they’re most common on the:
- face
- scalp
- areas where skin touches the skin (such as where the arm bends or in the armpit)
- diaper area (in babies)
Other symptoms of psoriasis include:
- dry, cracked skin that may bleed at times
- thick, pitted nails
- arthritis (painful, stiff, swollen joints)
Types of Psoriasis
- Plaque psoriasis: This is the most common type of psoriasis. It causes plaques and silvery scales, usually on the knees, elbows, lower back, and scalp. They can be itchy and painful and may crack and bleed.
- Guttate (GUT-ate) psoriasis: This type often shows up after an illness, especially strep throat. It causes small red spots, usually on the trunk, arms, and legs. Spots also can appear on the face, scalp, and ears.
- Inverse psoriasis: This causes smooth, raw-looking patches of red skin that feel sore. The patches develop in places where skin touches the skin, such as the armpits, buttocks, upper eyelids, groin, and genitals, or under a woman’s breasts.
- Face, scalp, and diaper area psoriasis: These areas of psoriasis rash are more common in children. Diaper area psoriasis can clear up after a child is toilet trained and no longer wears diapers.
Causes of Psoriasis
The exact cause of psoriasis isn’t known. But experts do know that the body’s immune system, which fights germs and diseases, is involved. Overactive immune system cells make skin cells grow faster than the body can shed them, so they pile up as plaques on the skin.
Some genes have been linked to psoriasis. About 40% of people with psoriasis have a family member who has it.
Anyone can get psoriasis and it may begin at any age. It can’t spread from person to person.
Psoriasis Flare-Ups
Symptoms of psoriasis can go away completely, and then suddenly come back. When the symptoms are worse, it’s called an “outbreak” or “flare-up.” Symptoms of psoriasis can be brought on or made worse by:
- infections such as strep throat and colds
- some medicines, such as lithium and beta-blockers
- stress
- skin irritations
- cold weather
- drinking alcohol
- smoking
Diagnosis of Psoriasis
Doctors usually diagnose psoriasis by examining the skin, scalp, and nails. They’ll also ask whether someone else in the family has psoriasis and if the child recently had an illness or started taking a new medicine.
Rarely, doctors might take a skin sample (a biopsy) to check more closely. A biopsy can tell the doctor whether it’s psoriasis or another condition with similar symptoms.
Treatment of Psoriasis
Psoriasis is usually treated by a dermatologist (skin doctor). A rheumatologist (a doctor who treats immune problems) may also help with treatment. Treatments can include:
- ultraviolet (UV) light from the sun or home or office treatments. But in some children, sunlight can make psoriasis worse.
- creams, lotions, ointments, and shampoos such as moisturizers, corticosteroids, vitamin D creams, and shampoos made with salicylic acid or coal tar
- medicines taken by mouth or injected medicines
A doctor might try one therapy and then switch to another, or recommend combining treatments. It’s not always easy to find a therapy that works, and sometimes what works for a time stops helping after a while.
How Can Parents Help?
For some children, psoriasis is just a minor inconvenience. For others, it is a difficult medical condition.
To manage symptoms and make outbreaks less likely, your child should:
- Wash hands well and often and stay away from people who are sick to prevent infections.
- Manage stress through exercise, yoga, or meditation.
- Do not smoke or drink alcohol.
- Keep a healthy weight. People who are overweight tend to have more severe psoriasis symptoms.
Kids and teens with psoriasis may feel uncomfortable with the way their skin looks. Help your child understand that psoriasis is common and treatments can help.
Causes of Warts in Children
Warts are primarily caused by the human papillomavirus (HPV). Different types of warts result from various strains of this virus.
Risk Factors
Children are more prone to warts, especially if they have close contact with someone infected or a weakened immune system.
Identifying Symptoms
Warts are usually painless, except for those on the soles of the feet. Common, plantar, flat, filiform, and periungual warts exhibit distinct characteristics.
Common Types of Warts:
- Common Warts: Rough surface, grayish-yellow or brown, found on fingers, elbows, knees, or face.
- Plantar and Palmar Warts: Soles of feet or palms of hands, potentially forming painful mosaic groups.
- Flat Warts: Small, smooth growths commonly appear on children’s faces.
- Filiform Warts: Small, long growths on eyelids, lips, face, or neck.
- Periungual Warts: Thickened skin around nails, causing painful splits (fissures).
Plantar Warts: A Closer Look
Plantar warts, though non-cancerous, can be painful and resistant to treatment, developing on the soles of the feet.
Diagnosis
Healthcare providers diagnose warts based on appearance. A physical exam, and in some cases, a shave biopsy, may be recommended.
Treatment Options
The approach to treating warts depends on factors such as location, type, and duration. Treatment methods include:
- Topical Irritants: Applying salicylic acid or other medicines.
- Cryotherapy: Freezing the wart with liquid nitrogen.
- Electrocautery: Applying an electrical current to the wart.
- Excision: Cutting out the wart.
- Laser Surgery: Removing the wart with laser surgery.
Complications
Warts can be challenging to treat and may recur, necessitating ongoing attention.
Prevention Tips
Warts are contagious, spreading through skin-to-skin contact or shared personal items. Preventive measures include:
- Avoiding self-spread: Ensure your child doesn’t touch the wart to other body parts.
- Limiting contact: Discourage sharing personal items, such as towels.
- Foot protection: Wear socks or slippers if warts are on the bottom of the feet.
When to Seek Medical Attention
Contact your child’s healthcare provider if warts are painful, disrupt normal activities, or become a source of embarrassment.
The Impact of a Low-Glycemic Diet on Acne
Understanding the Connection
Have you ever wondered if avoiding greasy foods could keep those pesky pimples at bay? Recent research suggests
the answer might lie in your diet, specifically, the glycemic index of your consumed foods.
What is a Low-Glycemic Diet?
High-glycemic foods rapidly raise blood sugar levels. Examples include white bread, potato chips, sugary drinks,
and more. On the contrary, low-glycemic foods, such as fresh vegetables, some fruits, beans, and steel-cut oats,
might be the key to clearer skin.
Research Findings: The Low-Glycemic Diet Effect
- USA Study: 2,258 Patients
In the United States, a study involving 2,258 patients on a low-glycemic diet for weight loss showed a remarkable
reduction in acne. 87% of participants reported having less acne, with 91% stating a decreased need for acne
medication.
- Australia Study: 43 Males
In Australia, a 12-week study with 43 males (15 to 25 years old) revealed that those who adhered to a
low-glycemic diet experienced significantly fewer acne breakouts than those on a normal diet.
- Korea Study: 32 Patients
A 10-week study in Korea involving 32 acne patients (20 to 27 years old) demonstrated a significant reduction in
acne for those following a low-glycemic diet.
- Turkey Study: 86 Patients
In Turkey, 86 patients (50 with acne) kept food logs for 7 days, revealing a correlation between severe acne and
a high-glycemic diet.
The Low-Glycemic Diet Mechanism
Scientists theorize that the reduction in acne may be linked to the elimination of blood sugar spikes, which
cause inflammation and an increase in sebum production—factors contributing to acne.
Milk and Acne: Unveiling the Connection
The Surprising Link
While cow’s milk is low-glycemic, studies suggest a potential link between its consumption and acne breakouts.
USA Studies: Clear Connection
Multiple studies in the USA show a correlation between cow’s milk intake and acne, with some indicating a 44%
higher likelihood of acne in those who consumed 2 or more glasses of skim milk daily.
Global Insights
Studies in Italy and Malaysia further support the link between cow’s milk and acne, emphasizing the need for
more research to understand the underlying mechanisms.
The Mystery of Cow’s Milk and Acne
Hormones and Inflammation
One theory suggests that hormones in milk may cause inflammation, leading to acne. However, further research is
essential to confirm this hypothesis.
Yogurt and Cheese: Safe Choices?
No Evidence of Breakouts
Surprisingly, while cow’s milk may be associated with acne, there’s no evidence suggesting that yogurt or cheese
contributes to increased breakouts.
Taking Action: What You Can Do Now
Assessing Your Diet’s Impact
While more research is needed, dermatologists recommend paying attention to your breakouts and asking critical
questions about potential triggers.
Effective Acne Treatment
Remember, achieving clear skin involves more than dietary changes. Utilizing acne-friendly skincare and
prescribed medications remain crucial for preventing new breakouts.
In one word, ”acne” is a pain! And the worst part is, they make a grand entry on our face when we least want them to.
Causes of acne:
Pores get clogged with dirt and dead skin cells and this leads to acne formation on the surface of the skin. Acne can vary in form and varies from person to person. Whiteheads, blackheads, and pimples are common symptoms of acne.
The factors affecting acne formation can differ depending on factors such as:
- Genetics
- Stress
- Hormones
- Diet
- Air quality
- Water consumption
- Sleep
Each day, people spend thousands on expensive acne treatments while you can treat this condition easily at home by implementing many simple and easy to carry out remedies. However, always consult a doctor and never self-medicate.
To get you started, here are a few!
#1 Lemon Juice
Thanks to its astringent and exfoliating attributes, lemon juice scores many brownie points on the treatment front of acne. Just squeeze a lemon into a bowl and add a few drops of rose water to it. Apply this mixture with a cotton ball on the affected area such as the neck or the face. Not only will this prevent pimples from forming but will also help for glowing skin and reduce the appearance of scars. This is your one sure-shot natural way to keep control of acne and pimples!
#2 Aloe Vera
This cool gel does wonders to your skin! Just cut an aloe shoot in half, scrape the gel out with a spoon, and apply it to the acne. Make this a regular ritual and say goodbye to bacterial infections and acne-causing inflammation. You can also buy Aloe Vera gel for skincare from a herbal store but make sure it does not contain any hidden ingredients. Are you ready for soothing, loveable, baby-like skin!
#3 Chamomile
Chamomile is another treasured ingredient that can be used to keep acne and pimples at bay. You can use this ingredient in two ways – empty the contents of a chamomile tea bag in a blender, add water and blend into a smooth paste. Apply this paste on your face and bid a good long adieu to acne! Alternatively, you can also boil one to two chamomile tea bags in two cups of water. Allow the mixture to cool and apply on your blemishes to have the same positive effect on your skin. Include this step in your skincare routine.
#4 Echinacea
Known to speed up the healing process, Echinacea also helps in controlling acne, pimples, and other skin infections. You can either use Echinacea tea as a regular face wash or apply a few drops of the tea on the affected areas with a soft cloth or cotton.
#5 Toothpaste
Your humble toothpaste can also come in very handy in treating acne and removing the scars formed by them. Just apply a little toothpaste on the problem areas and see the size of the pimples reducing in a few days’ time.
#6 Honey
This powerhouse of nutrients is also a good natural contender in the treatment of acne and pimples. Apply a healthy serving of honey directly to the acne and allow it to dry. In an hour or so wash off! The stickiness of honey helps in removing excess dirt from the pores of the skin.
#7 Mint
Mint helps to de-clog the pores and helps to keep a check on bacterial infections. To help maintain an acne clear face, mix about two tablespoons of finely chopped fresh mint and two tablespoons of yoghurt and oatmeal. Whisk to a smooth paste and apply to your face. Leave it to dry for ten minutes and then rinse off with cool water.
What are epidermoid cysts?
Epidermoid cysts are typically harmless, slow-growing bumps under the skin. They often appear on areas with more hair such as the scalp, face, trunk, upper back, or groin area. These cysts can range in size from ½ inch to several inches across. Some may have an enlarged pore in the center of them. They are the most common type of skin (cutaneous) cyst.
Epidermoid cysts are sometimes called epidermal cysts. They are also called sebaceous cysts. But a sebaceous cyst is different from an epidermoid cyst. They are also less common. True sebaceous cysts start in the sebaceous gland. This is an oil gland in the skin that produces (secretes) an oily substance called sebum. Sebum lubricates the skin to help keep it healthy.
Epidermoid cysts can remain stable. Or they may steadily grow. Sometimes they will become inflamed, red, painful, or suddenly break open (rupture). This poses a risk for infection.
What causes epidermoid cysts?
Your skin has several layers. The thin, protective outer layer of skin is called the epidermis. The cells that make up the outermost layer slowly shed and are replaced as newer cells move to the skin’s surface.
Most epidermoid cysts are caused when skin (epidermal) cells move under the skin surface, or are covered over by it instead of shedding. These cells continue to multiply, like skin does normally. They then form a wall around themselves (cyst) and secrete normal skin fluids (keratin). This is a thick, yellow substance that may drain from the cyst. This may be developmental. But it often happens because of an injury to the skin.
Epidermoid cysts are often found around hair follicles. These follicles are like cysts, but they have openings. Normal lubricating oils for your hair are sent out through these openings. A cyst occurs when an opening becomes blocked or the site inflamed. This often occurs when there is damage to the hair follicles by a scrape or wound.
What are the symptoms of epidermoid cysts?
- Feeling a lump just beneath the skin
- It may be painful
- The cyst may smell bad
- The cyst may become inflamed or red
- The cyst may leak fluid or thick material
The symptoms of epidermoid cysts may look like other skin conditions. Always talk with your healthcare provider for a diagnosis.
How are epidermoid cysts diagnosed?
A healthcare provider can often diagnose an epidermoid cyst by examining the cyst. A tissue sample (scraping dead skin) can be taken and looked at under a microscope.
How are epidermoid cysts treated?
Epidermoid cysts often go away without any treatment. If the cyst drains on its own, it may return. Most cysts don’t cause problems or need treatment. But if a cyst is a concern to you for any reason, see your healthcare provider. Epidermoid cysts can be treated by simple surgery (excision) with removal of the cyst and cyst wall.
What are possible complications of epidermoid cysts?
Epidermoid cysts may go away on their own. The cysts are often not painful, unless they become inflamed or infected. An epidermoid cyst that is inflamed can be injected with steroids. This can reduce inflammation and the cyst may not need to be drained.
But infected cysts may need to be cut and drained. To do this, your provider makes a hole in the top and removes what is inside. Large cysts can come back after this procedure and may have to be surgically removed (excised). If a cyst becomes swollen, tender, large, or infected, treatment may include antibiotics and then surgery.
Can epidermoid cysts be prevented?
There is no known way to prevent epidermoid cysts. But you can prevent possible infection and scarring if you don’t squeeze, pop, stick a needle in it, or cut it open. This often leads to an infection and scarring. If it gets severely inflamed or infected, you should get medical care.
When should I call my healthcare provider?
Call your healthcare provider right away if any of these occur:
- Swelling, redness, or pain
- Pus coming from the cyst
Key points about epidermoid cysts
- Epidermoid cysts are typically harmless, slow-growing bumps under the skin.
- They often appear on areas with more hair such as the scalp, face, trunk, upper back, or groin area.
- Epidermoid cysts often go away without any treatment. If the cyst drains on its own, it may return.
- Most cysts don’t cause problems or need treatment. They are often not painful, unless they become inflamed or infected.
- If a cyst is a concern to you for any reason, see your healthcare provider. It can be removed through simple surgery.
Next steps
Tips to help you get the most from a visit to your healthcare provider:
- Know the reason for your visit and what you want to happen.
- Before your visit, write down questions you want answered.
- Bring someone with you to help you ask questions and remember what your provider tells you.
- At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
- Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
- Ask if your condition can be treated in other ways.
- Know why a test or procedure is recommended and what the results could mean.
- Know what to expect if you do not take the medicine or have the test or procedure.
- If you have a follow-up appointment, write down the date, time
Birthmarks are marks on the skin that a baby can develop before birth or soon after. Birthmarks can be flat or raised, have regular or irregular borders, and have different shades of coloring from brown, tan, black, or pale blue to pink, red, or purple.
What Causes Birthmarks?
Doctors don’t know what causes most birthmarks. They can’t be prevented and they’re not caused by anything done or not done during pregnancy. Most aren’t related to trauma to the skin during childbirth. Some kinds may run in families, but a genetic cause hasn’t been found.
What Are the Types of Birthmarks?
There are two main types of birthmarks, which have different causes:
Vascular Birthmarks
The most common vascular (blood vessel) birthmarks are macular stains, hemangiomas, and port-wine stains:
- Macular stains. Also called salmon patches, angel kisses, or stork bites, these faint red marks are the most common type of vascular birthmark. Macular (MA-kyuh-ler) stains typically are on the forehead or eyelids; the back of the neck; or on the nose, upper lip, or back of the head. They may be more noticeable when the baby cries. Most often they fade on their own by the time a child is 1 to 2 years old, although some last into adulthood.
- Hemangiomas. Hemangiomas are superficial when they’re on the surface of the skin (“strawberry marks”), deep when found below the skin’s surface, and compound when they affect both layers. A hemangioma (hee-man-jee-OH-muh) can be slightly raised and bright red, and usually won’t be visible until a few days or weeks after a baby is born. Deep hemangiomas might look bluish because they involve blood vessels in deeper layers of the skin.
Pigmented Birthmarks
The most common pigmented birthmarks are café-au-lait spots, Mongolian spots, and moles:
- Café-au-lait spots. These very common spots are the color of coffee with milk, which explains the name. They can be anywhere on the body and sometimes increase in number as a child gets older. One alone is not a problem. But call your doctor if your child has 6 or more spots that are larger than a pencil eraser (for a younger child), or larger than a dime (for an older child). Having many café-au-lait spots can be a sign of neurofibromatosis (a genetic disorder that causes abnormal cell growth of nerve tissues).
- Mongolian spots. These flat, bluish-gray patches are often found on the lower back or buttocks. They are most common on darker skin, such as on children of Asian, American Indian, African, Hispanic, and Southern European descent. They usually fade — often completely — by school age without treatment.
How Are Birthmarks Treated?
Macular stains usually fade away on their own. Ones at the back of the neck may last longer, but are not very noticeable. Most other vascular birthmarks can be treated.
Port-wine stains and some hemangiomas can be disfiguring and upsetting for children. Small hemangiomas in less visible locations usually don’t need treatment, as most shrink back into themselves by the time a child is 10. Doctors can treat larger or more visible hemangiomas with medicine put directly into the hemangioma, given into a vein (with an IV), or taken by mouth (oral).
When Should I Call the Doctor?
A doctor should check a birthmark when it first appears to see what type it is, and to decide what monitoring or treatment it needs, if any.
Call the doctor if a birthmark ever bleeds, hurts, itches, or gets infected. Like any injury where there is bleeding, clean the wound with soap and water and, using a gauze bandage, place firm pressure on the area until the bleeding stops. If the bleeding doesn’t stop, call the doctor.
What Else Should I Know?
It can be a shock at first to see a birthmark on your newborn. If the birthmark is clearly visible, people might ask questions or stare, which can feel rude. It helps to have a simple explanation ready to handle this. Most people mean no harm, but it’s also OK to let them know if they’ve gone too far.
Even at a young age, kids watch how their parents respond to such situations. This is where they learn how to cope with others’ reactions. Talking simply and openly about a birthmark with kids makes them more likely to accept one as just another part of themselves, like hair color. Practice simple answers they can use if asked about it, like “It’s just a birthmark. I was born with it.” It’s also helps kids emotionally to be around supportive family and friends who treat them normally.
A skin lesion is a general term used for the different types of bumps, spots, moles, or other growths that may appear on the skin. Most skin lesions are harmless, but sometimes they can be a sign of skin cancer or other health problems.
Depending on what type of lesion your child has, your doctor may cut out all or a small area of the skin tissue and send it to a lab to be looked at under a microscope. This is called a biopsy. A biopsy may be done to figure out what the lesion is or to make sure it is not skin cancer.
Follow-up care is a key part of your child’s treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line (811 in most provinces and territories) if your child is having problems. It’s also a good idea to know your child’s test results and keep a list of the medicines your child takes.
How can you care for your child at home?
If your doctor told you how to care for your child’s wound, follow your doctor’s instructions. If you did not get instructions, follow this general advice:
- Keep the wound bandaged and dry for the first day.
- After the first day, wash around the wound with clean water 2 times a day. Don’t use hydrogen peroxide or alcohol, which can slow healing.
- You may cover the wound with a thin layer of petroleum jelly, such as Vaseline, and a non-stick bandage.
- Apply more petroleum jelly and replace the bandage as needed.
- If your child has stitches, you may get other instructions. Your child will have to return to have the stitches removed.
- If a scab forms, do not pull it off. Let it fall off on its own. Wounds heal faster if no scab forms. Washing the area every day and using the petroleum jelly will help keep a scab from forming.
- If the wound bleeds, put direct pressure on it with a clean cloth until the bleeding stops.
- If your child is not taking a prescription pain medicine, ask your doctor if your child can take an over-the-counter medicine.
- Do not give your child two or more pain medicines at the same time unless the doctor told you to. Many pain medicines have acetaminophen, which is Tylenol. Too much acetaminophen (Tylenol) can be harmful.
- If your child had a growth “frozen” with liquid nitrogen, he or she may get a blister. Do not break it. Let it dry up on its own. It is common for the blister to fill with blood. You do not need to do anything about this, but if it becomes too painful, call your doctor or nurse advice line.
- Protect your child’s skin from the sun.
When should you call for help?
Call your doctor or nurse advice line now or seek immediate medical care if:
- Your child has signs of infection, such as:
- Increased pain, swelling, warmth, or redness.
- Red streaks leading from the wound.
- Pus draining from the wound.
- A fever.
- Watch closely for changes in your child’s health, and be sure to contact your doctor or nurse advice line if:
- The wound is changing, bleeding, or getting irritated.
- Your child does not get better after 2 weeks of home care.
Diagnosis
Diagnosing hyperhidrosis may start with your health care provider asking about your medical history and symptoms. You may also need a physical exam or tests to further evaluate the cause of your symptoms.
Lab tests
Your health care provider may recommend blood, urine or other lab tests to see if your sweating is caused by another medical condition, such as an overactive thyroid (hyperthyroidism) or low blood sugar (hypoglycemia).
Sweat tests
Or you may need a test that pinpoints the areas of sweating and evaluates how severe your condition is. Two such tests are an iodine-starch test and a sweat test.
Treatment
Treating hyperhidrosis may start with treating the condition causing it. If a cause isn’t found, treatment focuses on controlling heavy sweating. If new self-care habits don’t improve your symptoms, your health care provider may suggest one or more of the following treatments. Even if your sweating improves after treatment, it may recur.
Medications
- Prescription antiperspirant. Your health care provider may prescribe an antiperspirant with aluminum chloride (Drysol, Xerac AC). Apply it to dry skin before going to bed. Then wash the product off when you get up, taking care to not get any in your eyes. Once you start seeing results from using it daily for a few days, you can scale back to once or twice a week to maintain the effect.This product can cause skin and eye irritation. Talk with your health care provider about ways to reduce side effects.
- Prescription creams and wipes. Prescription creams that contain glycopyrrolate may help hyperhidrosis that affects the face and head. Wipes soaked in glycopyrronium tosylate (Qbrexza) may ease symptoms of the hands, feet and underarms. Possible side effects of these products include mild skin irritation and dry mouth.
- Nerve-blocking medications. Some pills (oral medications) block the nerves that trigger sweat glands. This can reduce sweating in some people. Possible side effects include dry mouth, blurred vision, and bladder problems.
- Antidepressants. Some medications used for depression can also decrease sweating. They may also help decrease anxiety.
- Botulinum toxin injections. Treatment with botulinum toxin (Botox) blocks the nerves that trigger the sweat glands. Most people don’t feel much pain during the procedure. But you may want your skin numbed beforehand. Your health care provider might offer one or more of the methods used to numb the skin. These include topical anesthesia, ice, and massage (vibration anesthesia).Each affected area of your body will need several injections. It may take a few days to notice results. To retain the effect, you’ll likely need repeat treatments about every six months. A possible side effect is short-term muscle weakness in the treated area.
Surgical and other procedures
- Iontophoresis. With this home treatment, you soak your hands or feet in a pan of water while a device passes mild electric current through the water. The current blocks the nerves that trigger sweating. You can buy the device if you have a prescription from your health care provider.You’ll need to soak the affected areas for 20 to 40 minutes. Repeat the treatment 2 to 3 times a week until your symptoms improve. After you get results, you can reduce treatments to once a week or once a month to maintain the effect. Talk with your health care provider if you experience side effects.
- Microwave therapy. With this therapy, a handheld device (miraDry) delivers microwave energy to destroy sweat glands in the armpits. Treatments involve two 20- to 30-minute sessions, three months apart. Possible side effects are a change in skin sensation and some discomfort. Long-term side effects are unknown.
- Sweat gland removal. If you sweat heavily only in your armpits, your health care provider may suggest removing those sweat glands. This may be done through scraping them away (curettage), suctioning them out (liposuction), or using a combination of the two (suction curettage).
- Nerve surgery (sympathectomy). During this procedure, the surgeon removes a small section of the spinal nerves that control sweating in your hands. A possible side effect is permanent heavy sweating in other areas of your body (compensatory sweating). Surgery is generally not an option for isolated head and neck sweating. A variation on this procedure treats the palms. It interrupts the nerve signals without removing the sympathetic nerve (sympathotomy), which reduces the risk of compensatory sweating.Because nerve surgery has a risk of side effects and complications, it is usually only considered for people who have tried many other treatments without good results.
