As with other parts of the human body, the skin is an organ which develops and changes throughout your lifetime. While the skin of infants and young children is generally more fragile, it is also able to rapidly grow and heal. Pediatric skin requires a different level of care to mature skin as it faces a unique set of challenges and ailments. Sun exposure during childhood can lead to a number of diseases and disorders which can have a significant impact on a child’s quality of life and cause considerable long-term complications, therefore proper diagnosis and treatment of these conditions is vital.
The skin of infants is more vulnerable than adult skin and appears smooth and delicate. While the epidermis (the outer layer of skin) has largely the same structure as adult skin, the stratum corneum (the top layer of the epidermis) is not as robust. The collagen fibres (protein which gives skin its volume and strength), hair follicles and sebaceous (oil-producing) glands are immature.The adhesion between the epidermis and the underlying dermis is not as strong in youth as it is in adulthood. This is why young children have increased responses to certain kinds of stimulation, such as insect bites.
The collagen and hair follicles in skin become modified with increasing age, along with a steady increase in skin thickness from birth to adulthood. Toddlers and children also have smaller cells on the surface of their skin (corneocytes), indicating a quick replacement of these cells. The epidermis is formed from cells in the basal (bottom) layer; these migrate to the surface and are constantly sloughed off. Research shows that in healthy adults this process takes between 28-40 days, by comparison, the cells on the surface of young skin are renewed as often as every 15-30 days.
Children have low levels of lipids (fats/oils) in the surface of their skin. At puberty, this fat content of skin increases dramatically in both males and females. Several studies indicate that the water content of children''s skin is also often lower than in adults. It has been theorised that the reduced hydration is related to the fat content, with skin containing less lipids being a less effective barrier to water loss through evaporation.
Babies and children are more sensitive to a range of environmental conditions as they have a larger skin surface area to weight ratio. This means that chemicals absorbed through the skin have a greater effect. It also means that their heat regulation differs, with infants losing heat through their skin more rapidly in cold temperatures compared to adults.
Skin care for infants [age 0-12 months]
The following guidelines for infant skin care are provided by the Royal Children''s Hospital in Melbourne.
It is recommended that a baby be bathed approximately 2-3 times per week; excessive bathing may remove the skin''s natural oils (sebum) and cause dry skin. It is also advised that the use of harsh soaps be avoided as they may contain irritants or allergens. The skin should be dried carefully, particularly in the creases of the neck, groin and armpits. An emollient (a substance which moisturises and softens skin), in the form of a cream or lotion, should then be applied within three minutes. This can be applied up to three times daily and is particularly important for babies with dry, flaky or sensitive skin.
Skin care for toddlers and children [age 1 year-puberty]
The American Academy of Dermatology recommends the use of mild, fragrance-free cleansers and soaps on toddlers and young children. The AAD also suggest application of a topical moisturiser after bathing to prevent dry skin and rashes. Instituting sun protection measures is another vital aspect of skin care during childhood, as children are particularly susceptible to damage by solar UV radiation. Good methods of sun protection include: shielding exposed skin with the regular application of a high SPF, broad-spectrum sunscreen; covering the skin with lightweight, sun-protective clothing; wearing broad-rimmed hats and seeking the shade. Dermatologists encourage parents to regularly assess their child''s skin for signs of allergy, infection or injury. These may include dryness, redness, itchiness, swelling and changes in colour or texture; concerns should be addressed by a qualified physician.
