Acne in children is one of the most common skin diseases, especially in adolescence. We are talking about a violation of the hair follicles and sebaceous glands, which become clogged, leading to the formation of pimples and cysts.
Acne or Acne vulgaris by its medical name is defined as inflammation of the sebaceous glands. Most often this occurs during puberty, as a result of hormonal activity. In addition to pain and discomfort, acne in boys and girls is fraught with social isolation, the constant need to hide damage, low self-esteem, and in some cases even the development of anxiety and depression. That's why it's so important to understand what acne is and what the most effective ways to treat it are.
What is atopic dermatitis
Atopic dermatitis is a chronic skin disease characterized by a relapsing course.
Babies with atopic dermatitis are bothered by itching and dry skin. Foci of inflammation can be located throughout the body, but they especially “love” children’s cheeks and folds, as well as the area under the diaper. Statistics indicate that atopic dermatitis occurs in every fifth baby [1]. Why is he dangerous? Lack of treatment can lead to the development of severe forms of atopic dermatitis, the spread of inflammation and the atopic march. In this condition, the disease begins to “march” through the child’s body, provoking the appearance or exacerbation of concomitant diseases. In 20-43% of cases, the development of bronchial asthma is possible, and twice as often - allergic rhinitis or eczema [2].
In addition, disruption of the hydrolipid barrier that occurs with atopic dermatitis in children can cause a secondary infection. Unfortunately, atopic dermatitis cannot be “outgrown.”
Symptoms of atopic dermatitis in children
According to recent studies [3], in 45% of babies, atopic dermatitis debuts between the ages of two and six months. In 60% of patients during the first year of life.
With atopic dermatitis in children, clinical symptoms and localization of inflammation largely depend on age. There are infant (up to one and a half years), child (from one and a half years to puberty) and adult phases. The following symptoms are common to all phases:
- Severe dryness of the skin (xerosis), which cannot be treated with regular baby cream .
- Redness and inflammation on the skin (especially symmetrical ones).
- Itching, causing severe discomfort to the child.
- Recurrent course (alternating periods of remissions and exacerbations). Moreover, in the cold season, deterioration is more often observed, and in the warm season, improvement is observed.
According to the nature of the course, acute and chronic stages of atopic dermatitis are distinguished, which are expressed by different signs (symptoms):
● Acute stage. Rough red spots (erythema), nodular rashes (papules), swelling, and crusts (including weeping) may appear on the baby's skin.
● Chronic stage. Accompanied by lichenification (thickening of the skin), cracks on the soles and palms, scratching, and increased pigmentation of the skin of the eyelids.
Which moles are not dangerous, but require mandatory consultation with a doctor?
A blue nevus
is a spot, nodule or node of dark blue, black or gray color up to 1 cm in size. The color is due to the large number of cells with melanin in the dermis. Such moles have a dense consistency and are most often located in the scalp area, on the dorsum of the hands and feet. Blue nevi usually appear in early childhood, more often in girls, and grow slowly.
Spitz nevus
- This is a reddish-pink or yellowish nodule, most often located on the face and limbs in pre-teen children, and quickly increases in size. It may be a sign of poor nutrition and gastrointestinal problems. Removal is usually required.
Galonevus
makes itself felt in people with reduced immunity and severe autoimmune diseases. A white rim appears at the site of the mole. Occurs more often in childhood and adolescence.
Spotted nevus
is a light brown café au lait spot ranging in size from 1 to 15 cm or more. Against its background there are small dark brown spots or nodules of 2-3 mm. Lesions usually develop before the onset of puberty. The reason is a failure in the structure of pigment cells containing melanin.
Mongolian spot
- a pigment disorder of a grayish-blue color, usually located in the lumbar region, sacrum, buttocks, less often - on the head under the hair. In Mongolian newborns it occurs in 90% of cases, in representatives of other nationalities - no more than 0.5%. As a rule, it disappears in early childhood.
Nevus Ota
- a gray or blue spot around the eye caused by genetic neurological factors. May be subtle or bright. Mainly found among Asian peoples.
Flaming (wine) nevus
looks like an irregularly shaped red or purple spot. Arises from birth, formed from dilated capillaries. As the child grows, it enlarges and becomes lumpy and never resolves on its own. The exception is nevus of Unna. A red spot (sometimes called a “stork bite” or “angel’s kiss”) is located on the back of the neck, sometimes on the eyelids and bridge of the nose. Approximately a third of newborns have it and disappear by 3-5 years.
Anemic nevus
- white spots with irregular edges on the chest or back. The reasons are a violation of the development of blood vessels in a certain area of the skin. It is practically not noticeable in infants, but is more pronounced at school age.
The interpretation of moles - moleosophy - was one of the ways to predict fate in ancient times. So, for example, owners of moles on their faces were considered exalted persons. A mole on the right side of the chest for representatives of the stronger half is a sign of an easy character, on the left - a sign of love; on the woman’s right breast - a sign of material well-being, on the left - to her first-born boy.
The main danger of moles is that some types can degenerate into melanoma, a malignant neoplasm with an aggressive course. It occurs in both young people and children, and the frequency of detection is increasing year by year. Over more than half a century, the prevalence of the pathology has quadrupled. Among all malignant tumors, melanoma accounts for less than 10%, but causes 80% of deaths from cancer.
Causes of atopic dermatitis in children
Atopic dermatitis can be considered a hereditary disease, because the most important role in its occurrence is played by a genetic factor [3]:
- In 80% of children, it occurs if both parents have or have had atopic dermatitis.
- In more than 50% of children - if at least one of the parents was sick, especially the mother (this doubles the risk of transmitting the disease “by inheritance”).
Some prenatal factors can also provoke atopic dermatitis in a baby: for example, poor nutrition of the expectant mother, contact with toxic substances, infections suffered during pregnancy, as well as bad habits and stress.
In addition, atopic dermatitis more often develops in babies who suffered oxygen deprivation during childbirth, were born prematurely and were bottle-fed (perinatal factors).
Big ones - under the knife!
Melanoma can make itself felt by changing the color of the nail to brown or black, and the appearance of spots on the palms and soles.
To monitor atypical nevi, the patient usually undergoes dermatoscopy every 3–12 months. A biopsy is taken from suspicious lesions and histological examination is performed to establish a diagnosis. All congenital moles larger than 2 cm should be under constant medical supervision; in any case, they will have to be removed. If necessary, the baby will have a skin passport to monitor the number, dynamics of growth and identify any changes in moles. The operation is usually performed shortly before the onset of puberty. Especially often, cells degenerate on a giant congenital nevus (more than 15 cm in diameter) in adolescence.
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Diagnosis of atopic dermatitis in children
For a long time it was believed that atopic dermatitis in children is predominantly an allergic disease. However, it has now been proven that this is, first of all, a disease with dysfunction of the epidermis! And food allergies are detected only in 30-40% of children with atopic dermatitis.
The symptoms of atopic dermatitis are almost always influenced by certain environmental triggers. This could be chlorinated or “hard” water, soap, contact with an allergen, unfavorable climate and even stress. Another common trigger is bacteria that enter the skin through a damaged epidermal barrier.
Only a doctor (pediatrician, dermatologist, allergist) can make a diagnosis of “atopic dermatitis in children”! It takes into account the presence of external signs of disease and itching, as well as hereditary factors. Laboratory tests may be prescribed for children to carry out diagnostics. For example:
- General detailed (clinical) blood test.
- Biochemical general therapeutic blood test.
- General (clinical) urine analysis.
- Study of the level of total immunoglobulin E in the blood.
- Skin testing with allergens.
- Skin biopsy.
Treatment of atopic dermatitis in children
In modern medicine, there are three degrees of severity of atopic dermatitis in children:
- Easy. The child responds well to treatment, remission can last more than 10 months, the itching is minor, the redness is slight. Exacerbations occur no more than twice a year.
- Medium-heavy. Exacerbations occur 3-4 times a year, and periods of remission are reduced to 2-3 months. The therapy gives less pronounced results, the redness “stubbornly” returns.
- Heavy. Long-term exacerbations are interrupted by short periods of remission - up to one and a half months. Treatment helps little or for a short period of time; the baby’s behavior is greatly affected by itching [4].
At all stages of atopic dermatitis, pediatricians and dermatologists recommend emollients - cosmetic skin care products. They moisturize the skin and help restore the level of lipids - the most important structural components. During periods of exacerbation, emollients can be applied frequently and generously.
Pay attention to the composition; it is advisable that emollients are not addictive. Their main tasks are to help the skin produce its own lipids, providing effective hydration and softening. In addition, the constant use of emollients prolongs periods of remission and alleviates the symptoms of atopic dermatitis.
The Mustela Stelatopia line of cosmetics will help restore skin comfort for a long time! Stelatopia emollients are effective at all stages of atopic dermatitis , incl. at its first signs - increased dryness of the skin.
Studies have confirmed that the use of Stelatopia emollient cream can reduce the likelihood of developing atopic dermatitis by 51% ! [6]
Treatment (use of hormonal drugs) for atopic dermatitis in children can only be prescribed by a doctor, taking into account age, symptoms, concomitant diseases and test results. Self-medication can be dangerous!
- For external therapy for moderate and severe degrees of atopic dermatitis, topical glucocorticosteroids, topical calcineurin inhibitors and others are used.
- In case of mild disease, the use of Stelatopia Emollient Cream reduces the severity of inflammation after 32 hours, due to the presence of sunflower oil in the distillate [5].
- In systemic therapy, the drugs dupilumab, cyclosporine, glucocorticosteroids and others are used orally or in injection forms.
- To relieve itching - clemastine, hifenadine, cetirizine, chloropyramine, levocetirizine and others. The use of Stelatopia emollient cream as a cosmetic skin care product reduces the severity of itching in 80% of cases [7].
- Physiotherapy treatment may include phototherapy. Sometimes, in the treatment of atopic dermatitis, diet therapy, acupuncture, plasmapheresis and some other methods may be prescribed.
Special attention area
The transformation of a benign tumor into a malignant one can occur slowly, over several months or years, or it can happen suddenly, in a very short time. But if trouble strikes, dangerous cells will begin to divide rapidly, so it is important not to miss the moment and undergo regular preventive medical examinations. Please note: in these cases, you need to run to the dermatologist as fast as you can.
- Pigment formations of asymmetrical, irregular shape and outline, similar to a geographical map.
- Multi-colored moles with shades of brown, red, gray and blue.
- The nodules are regular in shape, but unevenly colored.
- Sharply growing moles.
- Causes concern - itches, hurts or bleeds.
- Eight spots larger than 6 mm.
- Multiple scatterings (from 50 pieces) larger than 2 mm.
Prevention of atopic dermatitis in children
For atopic dermatitis, primary, secondary and tertiary preventive measures are distinguished.
Primary prevention
is aimed at preventing the occurrence of atopic dermatitis in children.
Recommended:
- Expectant mothers with a tendency to allergic reactions should exclude allergenic foods from their diet.
- Introducing complementary foods to babies begins at four months of age.
- Pregnant women and newborns at risk should take probiotics containing lactobacilli.
- Practice breastfeeding whenever possible.
- Eliminate exposure of your baby to tobacco smoke.
- Maintain humidity levels and regularly ventilate the children's room.
Secondary prevention
is aimed at eliminating risk factors that, under certain conditions (stress, weakened immunity, etc.) can lead to the occurrence, exacerbation and relapse of atopic dermatitis.
Recommended:
- Regular consultations with specialists.
- Maintaining awareness of new research and drugs in the treatment of atopic dermatitis.
3.Tertiary prevention
is a set of measures aimed at preventing exacerbations or development of complications of atopic dermatitis.
Recommended:
- Avoid contact of the baby with provoking factors: soap (it dries the skin), clothes made of rough or synthetic fabrics, low-quality cosmetics, etc.
- Take care of your child's skin and apply emollients on a regular basis, including during periods of remission.
- Bath your baby daily using cosmetic cleansers for atopic skin.
[1] Isaac Steering Committee. (1998). Worldwide variation in prevalence of symptoms of asthma. The Lancet, 351, 1225-1235. (International Committee on Asthma and Allergy in Childhood 1998. Worldwide differences in the prevalence of asthma symptoms. The Lancet, 351, 1225-1235). [2] Studies Watson W., 2011, Larsen F.S., 2002, Draaisma E., 2015, ISAAC Steering Committee, 1998. (Studies Watson W., 2011, Larsen F.S., 2002, Draaisma E., 2015 International Committee on the study of asthma and allergies in childhood, 1998). [3] Clinical guidelines. Atopic dermatitis, 2022. [4] Atopic dermatitis: recommendations for practitioners. Russian national consensus document on atopic dermatitis. Ed. P.M. Khaitova, A.A. Kubanova. M.: Pharmacus Print, 2002. 192 p. [5] ODT and inflammation June 2010 [6] Scientific dossier “Atopic-prone skin: latest discoveries” [7] Test report “Stelatopia” emollient cream, self-assessment by users
