What is normal?Suggestions for skin careCommon skin conditions
What is normal?
Childhood is a time of growth and discovery, and children are actively exploring their environment at this stage. Signs of minor skin trauma such as small cuts and bruises are normal in this age group. This is also the age where common moles (acquired melanocytic naevi) may begin to appear – while these should be monitored into adulthood for signs of change, their appearance in a child or young adult is normal.
Suggestions for skin care
It is time to teach children about appropriate sun protection, and kindergartens and schools are often excellent at reinforcing these messages with "no hat, no play".
In Victoria, our adage is “Sunscreen in September”, but this will vary depending on where you live. Sunsmart has information on UV levels throughout Australia and when UV protection is required. There is a particularly useful free smartphone app with this information.
Sun protection includes wearing hats that shade the face, ears and neck, as well as regular application of sunscreen.
Another message at this age group is to teach children that we should all check our own skin at least once every three months, ideally at the start of every new season: March, June, September and December.
Common Skin Conditions
Kids love to explore, so common cuts and grazes can be expected. It’s also a time when some skin conditions can start to occur. Commonly occurring issues include head lice, warts, molluscum, impetigo, chicken pox and eczema. Some of these go away with time, some will respond well to treatment and some of them may persist.
Warts are particularly common in childhood. These are small growths that often have a bumpy, “cauliflower” appearance, arising most frequently on the backs of the fingers and toes, and also on the knees. Warts are caused by the human papillomavirus (HPV), and are spread through direct contact. Although unsightly, they are harmless and most will disappear over time.
Another common viral skin infection frequently encountered in childhood is molluscum contagiosum. This condition involves clusters of small round bumps that can be brown, pink or white in colour, often with a central dot or pit (umbilicated). These are typically located in moist areas such as the armpits or groin, but can also occur on the stomach, face, arms and legs.
Unlike chickenpox, molluscum contagiosum can persist for months or even years, eventually resolving spontaneously. Like chicken pox, secondary infection from scratching may cause scarring.
Impetigo or school sores may also occur in this age group. These are yellowish fluid-filled blisters that are initially contagious. Children must not attend school while the blisters are present. Treatment includes prescription topical or oral antibiotics.
Although not as common nowadays thanks to an effective vaccine, chickenpox is still a common skin condition among children. Caused by the varicella-zoster virus and highly contagious, it is characterised by many small, itchy red spots, which can become blisters. These usually first appear on the face, stomach and back, but can spread to anywhere on the body.
Other symptoms may include a high fever, chills, vomiting, and diarrhoea. Although the illness typically resolves within a few weeks, scratching of itchy spots together with secondary infection can leave small, pit-like scars on the skin.
While there is (usually) no treatment needed for the virus, sometimes topical antibiotics are prescribed to help reduce this complication.
Psoriasis may occur initially during childhood. Partly related to a genetic susceptibility, this condition is characterised by red patches covered with white scale, and may sometimes resemble eczema. Psoriasis usually improves in the summer months. There are many different prescription treatments available, including topical treatments (creams and ointments), tablets and UV light phototherapy.
Eczema (atopic dermatitis), as with infants, is common in childhood. The principles of avoiding aggravating factors, together with appropriate treatment, remain the same.
Head lice are very common in this age group and may present with itching of the scalp. While there are many treatments available, rubbing conditioner through the hair to suffocate the lice and combing them out is often more effective than using chemical treatments.
The term "alopecia" refers to hair loss. Although uncommon, alopecia areata in children can progress to complete loss of hair on a child's head, body and face. If you observe sudden or significant hair loss in your child, then you should take your child to see a dermatologist for specialist medical diagnosis and advice.
Acne can start to occur in this age group. There is increasing evidence that low glycaemic index foods may help acne, so the importance of a healthy diet is emphasised.
However, if acne persists after appropriate skin care, there are more sophisticated prescription treatments available. If it is severe or causing concern for any reason, consider consulting your doctor. Even relatively mild acne can often cause great distress and damage to self-esteem and self-confidence, at this vulnerable time of life.
Of greatest concern is the development of cystic acne, which is characterised by painful lumps or blind pimples under the skin. These lesions may cause permanent scarring, and assessment by a doctor for referral to a dermatologist is strongly recommended.