How to care for (sensitive) baby skin? Five questions to dermatologist Elodie Mendels

First of all, who is Elodie? Elodie Mendels is an academic paediatric dermatologist at Erasmus UMC. That means she helps parents and children treat all kinds of skin conditions. Besides her work in the field, she also finds it exciting and important to give people information about skin problems in other ways and helps to solve these problems with useful tips & tricks.

Elodie, first of all, can you tell us more about baby skin?

The skin is made up of 3 layers: the epidermis, the dermis and the subcutaneous fatty tissue. The upper layer of the epidermis is called the skin barrier. You can compare this to a brick wall. Between the bricks (we call these skin bricks) is a kind of fat, similar to cement. We therefore call this cement fat. Together, this makes for a good skin barrier. External stimuli and substances are blocked by this wall and the moisture in the skin is retained.

When a baby has just been born, it does not yet have a strong skin barrier: the bricks are not yet fully set together. This means there are still gaps between the skin bricks and thus moisture can get out. As moisture evaporates from the skin, the skin becomes dry. A baby also cools down faster and stimuli and substances between these gaps can penetrate the skin more easily. As a result, skin infections can develop more quickly, for example. This is why it is also so important to wash your hands during maternity visits.

During the first weeks and months, the skin continues to develop into normal, healthy skin. In premature babies, the skin is extra vulnerable. It takes longer for a strong skin barrier to develop. Therefore, be extra careful.

What general skin problems do you often encounter in practice?

I am an academic paediatric dermatologist, so in my practice, I often see children with some more serious complaints. Common skin problems are dry skin, eczema, warts and, for example, acne at teenage age. Certainly, eczema is an important one, about 15% of children in the Netherlands have predisposition eczema, also called atopic eczema, of which about 5% are severe. Often, these children also have asthma and/or (food) allergies in addition. Basic treatment often does not help them

Are these skin problems preventable with the right care?

If only they were! Right now, nothing can be completely prevented. A lot of skin conditions are also hereditary. But you can recognise skin problems as soon as possible and treat them as well as you can so that a child suffers as little as possible. Good guidance is also crucial so that a child literally and figuratively feels good about himself and stays that way. If you see skin abnormalities that do not disappear, see your GP or a dermatologist.

So what can you do to support baby's sensitive skin?

A newborn baby's skin barrier is fragile. Because it is not yet well developed, moisture evaporates more quickly through the gaps between the skin bricks. As a result, the skin dries out more quickly. External stimuli can also enter through these cracks earlier. Lubricating an oily cream or ointment helps the skin wall here. Lubricating from an early age can thus become a regular part of the grooming routine. Not only good for the skin but also for the bonding between you and your child.

What can you do in the first hours and weeks of life to care for the skin?

Three tips from Elodie:

1. Leave the vernix on for as long as possible. When a baby is just born, there is often a grey-white oily layer on the skin, this is called vernix caseosa. Premature babies often don't have this layer yet. In the womb, vernix protects the baby's skin. It is a combination of sebum, proteins and dead skin cells, among other things. All these substances are good for protecting the skin, preventing moisture from evaporating from the skin and preventing stimuli from entering. It even has an action against bacteria. So ideally, you want to leave this layer on for the first few days. But don't worry if some of the vernix is already gone at birth.

2. Avoid bathing for a while. A baby does not need to bathe for the first few days, say a week. In babies, the foul-smelling sweat glands are not yet active and babies don't get dirty. And most importantly, bathe by's skin is fragile. Water and soap contact actually dehydrates the skin, so it is better to wait a little longer. Use a bath oil. When bathing a baby, do so with water at about 37/38 degrees.

3. Add some drops of bath oil without perfume and preferably do not use soap. This is because soap dissolves the cement grease between your skin stones. This again creates gaps that evaporate the moisture from your skin, thus making it dry.

And what about water, is the pH of water different from the pH of skin?

With water, this is mainly to do with heat, prolonged bathing and bathing too often. Bathing once every three days is fine. Tip: when bathing your baby with oil - make sure you hold your child securely with a towel to lift him out of the bath. After bathing, pat the skin dry and you can apply an oily cream or ointment without perfume. Then you provide a natural protective layer.