Five Common Baby Skin Conditions and How to Tell Them Apart

Something has come up on her skin overnight and you are trying to work out from a phone screen whether it matters.

Baby skin is thinner and more reactive than yours, so rashes are common in the first years. The hard part is that several of them look alike and are handled completely differently.

Eczema

Looks like: dry, flaking, itchy skin, sometimes weeping or thickened. Usually elbows, arms and skin folds like the backs of the knees, though it turns up anywhere.

Triggered by: sensitive or allergic skin, weather, food, insect bites. Runs in families alongside asthma and hay fever.

What helps: avoiding soaps and other irritants, and moisturising consistently. The moisturising is the treatment, not an afterthought.

See a doctor if: it is widespread, weeping, keeps coming back, or is stopping her sleeping. Prescription treatment exists and works, and there is no prize for managing without it.

Nappy rash

Looks like: redness in the nappy area. Early, faint redness or small dots. Worse, raised bumps, oozing, or yellow crusting.

Caused by: friction from a nappy that does not fit, moisture from one left on too long, diarrhoea, or harsh detergent.

What helps: frequent changes, water, patting dry, a barrier cream.

See a doctor if: no better in a few days, spreading beyond the nappy area, blistering, oozing pus, or with a fever.

Hives

Looks like: raised swollen patches, often paler in the middle, hot and stinging.

Caused by: infection most often in children, then food, medicines, insect bites, and physical triggers like temperature.

Worth saying plainly: not all hives are an allergy. Assuming they are leads parents to cut out foods that had nothing to do with it.

Emergency if: hives come with swelling of the lips, tongue or face, any difficulty breathing, or she goes floppy.

Heat rash

Looks like: tiny red itchy spots and mild swelling on her head, neck, arms, shoulders or legs.

Caused by: hot humid air plus clothing that traps sweat, which is most of the year here.

What helps: a cooler room, a cool bath, one thin layer of clothing.

See a doctor if: the spots fill with pus, or a fever arrives with them.

Baby acne

Looks like: red skin with small red or white bumps, usually on the face. About 20% of newborns get it.

Caused by: not fully understood. Sebaceous gland activity and your hormones are thought to be involved, and Malassezia yeast has been linked to it, though it cannot be called the main cause.

What helps: nothing, and that is the answer. It clears by itself within a few months.

See a doctor if: the spots are pus-filled, spreading, or she is unwell alongside them.

What to do about any of them

• Clean and dry. Pat, do not rub
• Take the trigger away where you can find it: a food, a cleaning product, friction, heat, insect bites, damp
• Use fewer products, not more, while skin is irritated

Mama's Choice Baby Rash Cream uses eight natural ingredients including centella asiatica to calm irritated skin, and works across the body rather than only under a nappy.

Mama's Choice Baby Skin Vitamin Lotion is the everyday moisturiser, with avocado, olive and vitamins C, E, B3 and B5.

Where a barrier cream is the wrong tool

A barrier cream works by putting a layer over the skin. That helps an irritant rash, which is the most common kind, and does nothing at all for these:

• Fungal (Candida): bright red, clearly edged, small satellite spots around it. Needs an antifungal
• Bacterial: pus, yellow crusting, skin hot to the touch
• Severe eczema: needs prescription treatment

Adding more cream in any of those cases just delays the thing that would have worked.

Red flags, any age

• A rash with a fever, especially under three months
• A rash that does not fade when you press it
• Blisters, open sores, or pus
• A baby who is floppy, hard to wake, or refusing feeds
• Any swelling of lips, tongue or face, or difficulty breathing

The last two need attention today. Most of the rest of this page can wait for an ordinary appointment.