SOFT and supple are common terms used to describe a baby’s skin. However, unknown to most parents, baby skin can be dryer than it appears to the naked eye. A clinical study involving 51 parents and 51 babies carried out in 2005 by Johnson & Johnson in the United States revealed that 90% of parents believed that their child’s skin was not dry.
However, dermatologist evaluation found that over 60% of these babies had dry skin.
“Baby skin is more vulnerable than an adult’s,” said Robert Kwon, regional director of professional marketing with Johnson & Johnson.
He said newborns have low skin hydration as they move from an aqueous environment of amniotic fluid as foetuses to a dry one after birth.
In the first few years, an infant’s skin continues to develop and is more delicate and permeable than adult skin.
Infant skin is also dryer due to lower concentration of natural moisturising factors which act as natural moisturisers.
In addition, baby’s skin cells are smaller than an adult’s, which lead to higher moisture loss.
“Baby’s skin absorbs water faster than adults’ but loses it quicker, too,” said Kwon.
He added that many parents do not realise that their baby’s skin can be mild or moderately dry.
“Chances of allergens getting into skin are also reduced if a baby’s skin is well-hydrated,” said Kwon.
Mild to moderately dry skin can increase the chances of developing atopic dermatitis or eczema, an inflammation of the skin.
The exact cause of eczema is undetermined but likely due to a combination of dry, irritated skin and a malfunction in the body’s immune system. Signs of eczema include itchy red patches on skin. The condition sometimes clears up with regular moisturising.
Dermatological Society of Malaysia’s vice-president Dr Koh Chuan Keng said that in the short run, mild to moderately dry skin has a predisposed risk to infection.
“If skin loses its natural oils, it loses the protective barrier. However, there is only a slight increased risk (of infection),” he said.
“Unless skin is very dry until it cracks, then there is a risk. Otherwise, dry skin mainly causes itchiness which can disturb a child’s sleep at night, but there is no major health concern.”
Dr Koh concurred that dry skin is linked to eczema.
“There can be other causes of eczema but most of the time it is because of dry skin and also due to an auto-immune disease which attacks the skin, leading to symptoms of eczema.”
Although rare, dry skin can also indicate a genetic condition called ichthyosis which causes skin to flake, scale and sometimes turn red.
“Using a moisturiser is the solution to ichthyosis,” said Dr Koh.
Although the risk of having severe dry skin in Malaysia is much lower compared to that of temperate countries, there is still the possibility of clinically dry skin, as shown by the study mentioned earlier.
Just how dry is “dry skin”?
Using an analogy, Kwon said: “Imagine a freshly cut stalk of rose left overnight in a vase without water. The next day, the rose is still soft and plump but not as hydrated or moist as the day before.”
The parents’ naked eyes cannot detect this dryness because they don’t have well-hydrated skin to compare their baby’s skin against.
One way to train the eye is to moisturise only one hand for a few days and compare it against the other to see the difference in hydration levels.
As babies constantly release perspiration and sebum, their skin requires proper cleansing. Using a cleanser in addition to water effectively removes urine, faeces, saliva, food residue and dirt.
However, cleansers tend to strip the body of protective body oils.
“It is important to use mild cleansers that protect infant skin barriers, yet remove dirt and oil without drying the skin,” said Kwon.
Parents are also advised to use a mild cleanser that does not alter the normal pH level of the skin surface, or irritate the baby’s skin or eyes.
Salty sea water and chlorine in swimming pools also contribute to skin dryness.
“Make sure the salt water or chlorine is rinsed off right after the child comes out from the sea or swimming pool,” he said, adding that keeping children well hydrated helps replenish moisture loss from skin.
A lengthy bath time also leads to dry skin. A general rule is to limit baths to about 20 minutes, use warm water and if possible, a fragrance-free, soap-free cleanser.
Parents should also reduce the time a child spends soaking in soapy water and ensure that all traces of cleanser are rinsed off.
Towel dry lightly after bathing and apply moisturiser immediately or within a few minutes. This will lock in the moisture that’s still on the skin.
“Lotion is basically water that has oil in it. The water hydrates skin and the oil locks in the water and also provides hydration,” said Kwon.
Sleeping in air-conditioned rooms is common in Malaysia, but it has a drying effect on skin.
“A humidifier will help reduce dryness but how you clean the skin will also affect its level of hydration,” said Kwon.
If your child’s skin is dry even with daily moisturising, try using a thicker cream or ointment. Moisturise twice a day if necessary. Baby oil can be used in lieu of lotion or moisturiser but it is generally not necessary for mildly dry skin.
According to Dr Koh, when skin develops patches, powdery flakes, or feels rough, especially at the elbows, then it needs moisturising.
“Most of the time you don’t even have to touch it to know it’s rough – looking at it is enough. That’s when parents need to use a moisturiser,” he said.
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