Dermatology/Baby skin care

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Question
Hi Dr. Fisher,
I am from India. We have a 9 months old baby girl. Her skin is becoming dry and rough. I bathe her twice as it is peak summer here now. I am using Himalaya soap now. I tried Johnson & Johnson and dove as well. But the skin is still the same. I don't know if I should use a lotion in this season. We stay indoors most of the time.
Could you please suggest some skin care products for her.

Answer
Your baby most likely had atopic dermatitis but a picture would be most helpful to make a diagnosis.

also known as atopic eczema, is a type of inflammation of the skin (dermatitis). It results in itchy, red, swollen, and cracked skin. Clear fluid may come from the affected areas, which often thicken over time. It typically starts in childhood with changing severity over the years.In children under one year of age much of the body may be affected. As they get older the back of the knees and front of the elbows are the most common area for the rash. In adults the hands and feet are most affected.Scratching worsens symptoms and affected people have an increased risk of skin infections. Many people with atopic dermatitis develop hay fever or asthma.

The cause is unknown but believed to involve genetics, immune system dysfunction, environmental exposures, and difficulties with the permeability of the skin.If one identical twin is affected, there is an 85% chance the other also has the condition.Those who live in cities and dry climates are more commonly affected. Exposure to chemicals or frequent hand washing makes symptoms worse. While emotional stress may make the symptoms worse it is not a cause. The disorder is not contagious.The diagnosis is typically based on the signs and symptoms. Other diseases that must be excluded before making a diagnosis include contact dermatitis, psoriasis, and seborrheic dermatitis.

Treatment involves avoiding things that make it worse, daily bathing with application of a moisturising cream afterwards, applying steroid creams when flares occur, and medications to help with itchiness.Things that commonly make it worse include wool clothing, soaps, perfumes, chlorine, dust, and cigarette smoke. Phototherapy may be useful in some people. Steroid pills may occasionally be used if other measures are not effective.Antibiotics (either by mouth or topically) may be needed if a bacterial infection develops. Dietary changes are only needed if food allergies are suspected.

Atopic dermatitis affects about 20% of people at some point in their lives. It is more common in younger children.Males and females are equally affected.Many people outgrow the condition.Atopic dermatitis is sometimes called eczema, a term that also refers to a larger group of skin conditions.Other names include "infantile eczema", "flexural eczema", "prurigo Besnier", "allergic eczema", and "neurodermatitis".

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Michael S. Fisher, <B>Ph.D., M.D.</B>

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