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Caring for Your Child's Skin
Skin care isn’t just for grown-ups: Parents also need to be aware of their children’s skin health needs — and signs that they might need to enlist a medical professional’s help. Pediatrician Nivedita More, MD will discuss the basics of caring for children’s skin, as well as common skin issues like eczema and signs that it might be time to schedule an appointment with your child’s pediatrician.
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Learn more about Nivedita More, MD
Nivedita More, MD
Nivedita More, MD, completed medical school at Seth GS Medical College and KEM Hospital in Mumbai, India, and residency training at Children’s Hospital of Orange County in Orange County, California, where she worked as a critical care transport physician. She then operated Kidiatrics Medical Group in Rancho Santa Margarita, California, as a solo pediatric practice for over 15 years. She joined Bayside Medical Group in 2017. Dr. More strives to provide personal, individualized care for every patient that is sensitive to the cultural background of the patient and family. Her clinical interests include newborn care, lactation support for mothers, behavioral issues, asthma, ADHD, and teen health. She is fluent in Marathi and Hindi and speaks some medical Spanish. Dr. More is treasurer and an executive board member of AAPCA1 (American Academy of Pediatrics, California Chapter 1), which encompasses 48 counties in Northern California. In her free time, she loves staying active outdoors, gardening, cooking and spending time with my family.Learn more about Nivedita More, MD
Transcription:
Scott Webb: Skin conditions from rashes to eczema and even warts are common in our kids. And joining me today to discuss the signs and treatment options, is Dr. Nivedita More. She's a pediatrician with Stanford Children's Health.
This is Health Talks from Stanford Children's Health. I'm Scott Webb. Dr. More, it's great to have you back on. I was just thinking to myself, you know, I don't spend a lot of time thinking about my kids' skin, unless I have to, if they have a rash or something like that. But I'm sure there's a baseline for all of us parents, whether it's things we can do, products we can buy, foods we can avoid and so on. So maybe let's start here. What's a baseline to help better take care of our kids' skin?
Dr. Nivedita More: As baseline, I'd recommend that parents keep their child's skin with baths, they moisturize daily and they also treat it for any concerns that they may have. I also want to make sure that they keep their skin protected from any infections if there are any.
Scott Webb: And along those lines, when we think about, you know, shopping for soap and shampoo and other products, what do we need to know and what should we avoid?
Dr. Nivedita More: It is truly inundating with the number of products that are on the shelves these days. And it can be very difficult to make a good choice for your child's skin. The keywords parents need to look for when they're shopping for skin products are hypoallergenic, fragrance-free, cleanser and mainly alcohol-free. I prefer that these products be endorsed by the National Eczema Association if possible, but that's not always the case. And it's hard to not be attracted to those that say natural and organic on them, but these don't always tend to be hypoallergenic or fragrance-free. So it's important to understand these key terms here. I also tell parents to use a cleanser and not a soap for the child's skin, since soaps can be very drying for their delicate skin too.
Scott Webb: Yeah, they definitely can. And you're so right, I walk down the aisles when one of my kids asked me to get something and my head just started spinning. There's just so many products, so many things. And as you say, your eye kind of gets drawn to natural and organic and so on, but those may not always be the best products, right?
Dr. Nivedita More: That is so true. That is so true.
Scott Webb: So let's talk then about when you have parents with their children in the office, what are the main concerns that you're hearing about, questions you're getting and so on?
Dr. Nivedita More: In terms of skin conditions, eczema or atopic dermatitis is by far the commonest skin concern I encountered in children in practice. About one in 10 children have eczema and I do see other skin problems, obviously. Some of them include warts, hives, diaper rashes, cradle caps in newborns, you know, insect bites in the summertime usually some, skin infections and acne just to name a few of them.
Scott Webb: Yeah, we're going to address some of the things on that laundry list there today that parents and kiddos come in with. But let's talk more about eczema. What exactly is eczema and what are the most common symptoms?
Dr. Nivedita More: Yeah. Eczema usually results in really dry, scaly patches on the skin, which can be easily irritated and look red. The redness is a result of the inflammation of the skin. The skin can get itchy, especially if it's untreated or moisturized inadequately. Depending on the severity of the eczema, this can all interfere with the child's day-to-day activity, including sleep sometimes, especially due to the uncontrolled itch that can result from the eczema.
Scott Webb: So doctor, if a child is diagnosed with eczema, what should we do to take care of their skin? Are there any dietary or hygienic changes that we can make?
Dr. Nivedita More: You know, the best way to keep eczema under control is to establish daily skincare regimen, so to say, and actually stick with it. It is important to know your child's triggers and avoid them if possible. And it is also important to use some over-the-counter and/or prescription medications consistently as prescribed by your pediatrician to definitely keep some of these skin conditions at bay.
Scott Webb: Yeah. One of the things you mentioned there about being consistent, that's the hardest thing with kids, you know, because they just have varying schedules and they can be difficult to wrangle to be consistent with some of these things. But we all parents, we just do our best and I know that eczema can look like a rash, but there's so many other types of rashes that parents have to deal with. What are some of the most common ones that you see and treat?
Dr. Nivedita More: Absolutely. I do see other skin problems in practice as I mentioned earlier. Some of them being warts, hives, diaper rashes in little children who are not potty trained yet, insect bites with the summertime coming up and skin infection. Adolescents definitely come up with acne and, you know, these are just to name a few of them that I see in practice regularly.
Scott Webb: Yeah, so many and rashes of course are just so common, having had two kids myself, and just a lot of, "Dad, what is this?" And I say, "What? That looks like a rash to me. We should probably go to the doctor." Let's just talk more about diet, right, And trying to make sure that our kids eat well, that they're, you know, mentally and physically well, and also to try to avoid some of these skin conditions. Specifically, what can we include or eliminate or try to limit in the diet to prevent eczema and other skin conditions?
Dr. Nivedita More: It is important to understand that eczema or atopic dermatitis falls under a group of conditions called atopy, which actually means allergy. I actually call it the cousin of asthma, hay fever and food allergies, so to say. Sounds funny, but it really is. And, you know, studies are showing that children with eczema have a higher degree or higher rate of food allergies. But food actually is not considered one of the direct triggers of eczema. There are other variety of triggers that aggravate eczema like irritants or weather conditions or other allergens like pollen and things like that. Physical triggers are definitely a concern where too much of hot water use during baths can trigger eczema. If there's a family history of eczema, definitely the children are more prone to getting eczema in life. There is no cure for eczema, but it can definitely be treated.
Scott Webb: Here's the million-dollar question for you, because I've read both sides of this, right? I've read some things that said you shouldn't bathe kids with eczema too frequently. And then I've also read that it said they should have a daily bath or shower. So the million-dollar question, doctor, which is it?
Dr. Nivedita More: You know, it's really important that baths are part of your child's bedtime routine regularly. I know you said kids have these varying schedules, but routines are important for children and baths can be one of them. This clears the skin off the allergens, which can be one of the triggers with eczema. What is also important is to use the right cleansers instead of soaps as I mentioned earlier during bath time. I usually recommend that the bats be short, no more than five to ten minutes and that luke warm water be used instead of hot water to avoid the skin from getting super dry.
Scott Webb: Yeah, that's all good advice. And you're so right, kids are creatures of routine and establishing a schedule and staying in that routine as much as possible, especially when they're younger, is just better for all of us. And I had this issue when I was a kid, I had warts on my hand and I found it very unsightly and it really bothered me. And my mom took me to the doctor and we got rid of them. So I know that it's a common condition for children. What do we need to know about warts?
Dr. Nivedita More: You know, warts are actually caused by a virus and they usually self-resolve with time. If parents are bothered by them or they're spreading a lot, there are definitely home remedies that can be used to get rid of them. But if they are unsightly, a lot of them, parents don't like them, children don't like them, definitely, we are here to help with remedies for warts as well.
Scott Webb: What's the difference between a rash and hives. I know that we've established that rashes are common and hives may also be common, but maybe less so. What do we need to know or what should we do if we notice our child is breaking out in hives?
Dr. Nivedita More: Yeah. Hives can be caused by a variety of things and, you know, hives are these raised rashes on the skin of children or adults actually. And they can range from mild, like a few, to an all-body rash, which is kind of a raised sty-like lesion on the skin and, depending on the cause, one can have few hives or they might have a full-body rash. And usually again, they self-resolve without intervention most of the time if they're few. But parents can give their child some Benadryl or apply a topical steroid over-the-counter medicine to help with the itching associated with these hives. Now, if their child has more than a few hives or all-body hives, then they need to seek medical attention to prevent escalation to something more serious like anaphylaxis, which can be deadly.
Scott Webb: Yeah, it certainly can. And it's always a pleasure to have you on. And you've said here that, you know, some of these things, a lot of things may self-resolve, or there's some home remedies. But in general, when should parents contact pediatricians with their concerns about their children's skin?
Dr. Nivedita More: If there's something on their child's skin that does not resolve on its own in a few days, like I mentioned earlier, if it causes pain or itching, or if it's oozy or crusty, it just doesn't look right, you know, I recommend that the parents connect with their child's pediatrician. Luckily, in the day of telehealth and video visits and telemedicine, frequently, I will ask a parent to send me a picture of their child's skin condition and make a decision to treat with either an over-the-counter remedy or prescription medications. Picture speaks a thousand words when it comes to skin problems, so we definitely capitalize on it these days.
Scott Webb: Yeah, definitely. I know Stanford Children's Health has been at the forefront really, you know, doing telemedicine, telehealth. And as you say, oozy and crusty, those are never good things, right? If it's oozy and crusty or anything else that isn't self-resolving, or we don't think we can cure ourselves, best to reach out to pediatricians, perhaps be referred to a specialist and so on. So, doctor, great to speak with you again. Thanks so much. You stay well.
Dr. Nivedita More: Thank you very much for having me on.
Scott Webb: For more information, go to stanfordchildrens.org. And we hope you found this podcast to be helpful and informative. If you did, please share it on your social channels and be sure to check out the full podcast library for additional topics of interest. This is Health Talks from Stanford Children's Health. I'm Scott Webb. Stay well, and we'll talk again next time.
Scott Webb: Skin conditions from rashes to eczema and even warts are common in our kids. And joining me today to discuss the signs and treatment options, is Dr. Nivedita More. She's a pediatrician with Stanford Children's Health.
This is Health Talks from Stanford Children's Health. I'm Scott Webb. Dr. More, it's great to have you back on. I was just thinking to myself, you know, I don't spend a lot of time thinking about my kids' skin, unless I have to, if they have a rash or something like that. But I'm sure there's a baseline for all of us parents, whether it's things we can do, products we can buy, foods we can avoid and so on. So maybe let's start here. What's a baseline to help better take care of our kids' skin?
Dr. Nivedita More: As baseline, I'd recommend that parents keep their child's skin with baths, they moisturize daily and they also treat it for any concerns that they may have. I also want to make sure that they keep their skin protected from any infections if there are any.
Scott Webb: And along those lines, when we think about, you know, shopping for soap and shampoo and other products, what do we need to know and what should we avoid?
Dr. Nivedita More: It is truly inundating with the number of products that are on the shelves these days. And it can be very difficult to make a good choice for your child's skin. The keywords parents need to look for when they're shopping for skin products are hypoallergenic, fragrance-free, cleanser and mainly alcohol-free. I prefer that these products be endorsed by the National Eczema Association if possible, but that's not always the case. And it's hard to not be attracted to those that say natural and organic on them, but these don't always tend to be hypoallergenic or fragrance-free. So it's important to understand these key terms here. I also tell parents to use a cleanser and not a soap for the child's skin, since soaps can be very drying for their delicate skin too.
Scott Webb: Yeah, they definitely can. And you're so right, I walk down the aisles when one of my kids asked me to get something and my head just started spinning. There's just so many products, so many things. And as you say, your eye kind of gets drawn to natural and organic and so on, but those may not always be the best products, right?
Dr. Nivedita More: That is so true. That is so true.
Scott Webb: So let's talk then about when you have parents with their children in the office, what are the main concerns that you're hearing about, questions you're getting and so on?
Dr. Nivedita More: In terms of skin conditions, eczema or atopic dermatitis is by far the commonest skin concern I encountered in children in practice. About one in 10 children have eczema and I do see other skin problems, obviously. Some of them include warts, hives, diaper rashes, cradle caps in newborns, you know, insect bites in the summertime usually some, skin infections and acne just to name a few of them.
Scott Webb: Yeah, we're going to address some of the things on that laundry list there today that parents and kiddos come in with. But let's talk more about eczema. What exactly is eczema and what are the most common symptoms?
Dr. Nivedita More: Yeah. Eczema usually results in really dry, scaly patches on the skin, which can be easily irritated and look red. The redness is a result of the inflammation of the skin. The skin can get itchy, especially if it's untreated or moisturized inadequately. Depending on the severity of the eczema, this can all interfere with the child's day-to-day activity, including sleep sometimes, especially due to the uncontrolled itch that can result from the eczema.
Scott Webb: So doctor, if a child is diagnosed with eczema, what should we do to take care of their skin? Are there any dietary or hygienic changes that we can make?
Dr. Nivedita More: You know, the best way to keep eczema under control is to establish daily skincare regimen, so to say, and actually stick with it. It is important to know your child's triggers and avoid them if possible. And it is also important to use some over-the-counter and/or prescription medications consistently as prescribed by your pediatrician to definitely keep some of these skin conditions at bay.
Scott Webb: Yeah. One of the things you mentioned there about being consistent, that's the hardest thing with kids, you know, because they just have varying schedules and they can be difficult to wrangle to be consistent with some of these things. But we all parents, we just do our best and I know that eczema can look like a rash, but there's so many other types of rashes that parents have to deal with. What are some of the most common ones that you see and treat?
Dr. Nivedita More: Absolutely. I do see other skin problems in practice as I mentioned earlier. Some of them being warts, hives, diaper rashes in little children who are not potty trained yet, insect bites with the summertime coming up and skin infection. Adolescents definitely come up with acne and, you know, these are just to name a few of them that I see in practice regularly.
Scott Webb: Yeah, so many and rashes of course are just so common, having had two kids myself, and just a lot of, "Dad, what is this?" And I say, "What? That looks like a rash to me. We should probably go to the doctor." Let's just talk more about diet, right, And trying to make sure that our kids eat well, that they're, you know, mentally and physically well, and also to try to avoid some of these skin conditions. Specifically, what can we include or eliminate or try to limit in the diet to prevent eczema and other skin conditions?
Dr. Nivedita More: It is important to understand that eczema or atopic dermatitis falls under a group of conditions called atopy, which actually means allergy. I actually call it the cousin of asthma, hay fever and food allergies, so to say. Sounds funny, but it really is. And, you know, studies are showing that children with eczema have a higher degree or higher rate of food allergies. But food actually is not considered one of the direct triggers of eczema. There are other variety of triggers that aggravate eczema like irritants or weather conditions or other allergens like pollen and things like that. Physical triggers are definitely a concern where too much of hot water use during baths can trigger eczema. If there's a family history of eczema, definitely the children are more prone to getting eczema in life. There is no cure for eczema, but it can definitely be treated.
Scott Webb: Here's the million-dollar question for you, because I've read both sides of this, right? I've read some things that said you shouldn't bathe kids with eczema too frequently. And then I've also read that it said they should have a daily bath or shower. So the million-dollar question, doctor, which is it?
Dr. Nivedita More: You know, it's really important that baths are part of your child's bedtime routine regularly. I know you said kids have these varying schedules, but routines are important for children and baths can be one of them. This clears the skin off the allergens, which can be one of the triggers with eczema. What is also important is to use the right cleansers instead of soaps as I mentioned earlier during bath time. I usually recommend that the bats be short, no more than five to ten minutes and that luke warm water be used instead of hot water to avoid the skin from getting super dry.
Scott Webb: Yeah, that's all good advice. And you're so right, kids are creatures of routine and establishing a schedule and staying in that routine as much as possible, especially when they're younger, is just better for all of us. And I had this issue when I was a kid, I had warts on my hand and I found it very unsightly and it really bothered me. And my mom took me to the doctor and we got rid of them. So I know that it's a common condition for children. What do we need to know about warts?
Dr. Nivedita More: You know, warts are actually caused by a virus and they usually self-resolve with time. If parents are bothered by them or they're spreading a lot, there are definitely home remedies that can be used to get rid of them. But if they are unsightly, a lot of them, parents don't like them, children don't like them, definitely, we are here to help with remedies for warts as well.
Scott Webb: What's the difference between a rash and hives. I know that we've established that rashes are common and hives may also be common, but maybe less so. What do we need to know or what should we do if we notice our child is breaking out in hives?
Dr. Nivedita More: Yeah. Hives can be caused by a variety of things and, you know, hives are these raised rashes on the skin of children or adults actually. And they can range from mild, like a few, to an all-body rash, which is kind of a raised sty-like lesion on the skin and, depending on the cause, one can have few hives or they might have a full-body rash. And usually again, they self-resolve without intervention most of the time if they're few. But parents can give their child some Benadryl or apply a topical steroid over-the-counter medicine to help with the itching associated with these hives. Now, if their child has more than a few hives or all-body hives, then they need to seek medical attention to prevent escalation to something more serious like anaphylaxis, which can be deadly.
Scott Webb: Yeah, it certainly can. And it's always a pleasure to have you on. And you've said here that, you know, some of these things, a lot of things may self-resolve, or there's some home remedies. But in general, when should parents contact pediatricians with their concerns about their children's skin?
Dr. Nivedita More: If there's something on their child's skin that does not resolve on its own in a few days, like I mentioned earlier, if it causes pain or itching, or if it's oozy or crusty, it just doesn't look right, you know, I recommend that the parents connect with their child's pediatrician. Luckily, in the day of telehealth and video visits and telemedicine, frequently, I will ask a parent to send me a picture of their child's skin condition and make a decision to treat with either an over-the-counter remedy or prescription medications. Picture speaks a thousand words when it comes to skin problems, so we definitely capitalize on it these days.
Scott Webb: Yeah, definitely. I know Stanford Children's Health has been at the forefront really, you know, doing telemedicine, telehealth. And as you say, oozy and crusty, those are never good things, right? If it's oozy and crusty or anything else that isn't self-resolving, or we don't think we can cure ourselves, best to reach out to pediatricians, perhaps be referred to a specialist and so on. So, doctor, great to speak with you again. Thanks so much. You stay well.
Dr. Nivedita More: Thank you very much for having me on.
Scott Webb: For more information, go to stanfordchildrens.org. And we hope you found this podcast to be helpful and informative. If you did, please share it on your social channels and be sure to check out the full podcast library for additional topics of interest. This is Health Talks from Stanford Children's Health. I'm Scott Webb. Stay well, and we'll talk again next time.