Children's Health - Dermatology
Just like adults, children have dermatological issues. Certain conditions affect children more frequently than adults. In this blog post, we will explore a number of dermatological conditions and available treatment options to get your child back to feeling their best. The common conditions we will discuss include diaper rash, acne, eczema, warts, Molluscum Contagiosum, and scars.
Diaper Rash
What is diaper rash?
Diaper rash is a common form of inflamed skin (dermatitis) that appears as a patchwork of bright red skin.
Signs and Symptoms
• Skin signs – Diaper rash is marked by red, tender-looking skin in the diaper region, like the buttocks, thighs, and genitals.
• Changes in your baby’s disposition – Your baby may seem more uncomfortable than usual, especially during diaper changes. Your baby may also become fussier or cry when the affected area is washed or touched.
Causes of Diaper Rash
Diaper rash is often related to wet or infrequent diaper changes, skin sensitivity, and chafing. While it usually only affects babies, it can affect anyone that uses diapers regularly.
Compounded Treatment Options
• Poole’s Diaper Cream (Nystatin, cholestyramine, hydrocortisone, zinc oxide) – Poole’s diaper cream is a combination of Nystatin (anti-fungal), Cholestyramine (binds bile acid present in stools which will reduce the skin irritation), Hydrocortisone (anti-inflammatory), and Zinc Oxide (skin protectant). It is applied to the affected area after each diaper change.
• Cholestyramine and Aquaphor – Cholestyramine binds bile acid present in stools which can cause skin irritation. Aquaphor is an ointment that acts as a skin protectant.
Acne
What is acne?
Acne is a skin condition that occurs when hair follicles become plugged with oil and dead skin cells. It can cause whiteheads, blackheads, and pimples. Acne is most common among teenagers but can affect any age. It can vary in its severity and cause emotional distress and scarring. It typically appears on the face, chest, upper back, and shoulders.
Signs and Symptoms
Acne signs vary depending on the severity:
• Whiteheads (closed plugged pores)
• Blackheads (open plugged pores)
• Small, red, tender bumps (papules)
• Pimples (pustules), which are papules with pus at their tips
• Large, solid, painful lump under the skin (nodules)
• Painful, pus-filled lumps under the skin (cystic lesions)
Causes of Acne
There are 4 main causes of acne:
• Excess oil production
• Hair follicles clogged by oil and dead skin cells
• Bacteria
• Inflammation
Certain things may trigger or worsen acne and include:
• Hormonal changes – Androgen (ex: testosterone) are hormones that increase in boys and girls during puberty and cause the sebaceous glands to enlarge and produce more oil (sebum).
• Medications – Certain medications may trigger or make acne worse and may include corticosteroids (ex: prednisone), testosterone, and lithium.
• Diet – Studies indicate that eating certain foods, including carbohydrate-rich foods like bread, may worse acne. Further study is needed to determine if dietary restrictions would improve acne.
• Stress – Stress doesn’t cause acne, but if you already have acne, stress can make it worse.
Compounded Treatment Options
• Retinoic Acid – Retinoic Acid, a form of Vitamin A, can be made into a cream form that is applied to the skin once daily. When used topically, it can unclog pores and reduce more outbreaks by preventing dead skin cells from clogging pores. Retinoic acid may cause dryness, irritation, and redness when you first begin it. This can be minimized by using it every other day until your body adjusts to it or mix it with moisturizer. It can also make you more sensitive to sunlight, so sunscreen should be used daily while using retinoic acid.
• Clindamycin/Benzoyl Peroxide – Clindamycin is an antibiotic, and benzoyl peroxide is a topical antiseptic. This combination works to treat acne by killing the bacteria that can lead to acne. It is typically applied 1-2 times daily. It may cause dryness, irritation, and redness when you first begin to apply it.
Eczema
What is eczema?
Eczema, or atopic dermatitis, is a condition that makes skin dry and itchy. It is common in children but can occur at any age. It is typically long-lasting and tends to flare periodically. It may be accompanied by asthma or hay fever. There is no cure, but treatment and self-care can keep new outbreaks from occurring and relieve itching. These options include avoiding harsh soaps, moisturizing skin regularly, and applying medications creams/ointments.
Image Credit: https://nationaleczema.org/eczema/children/
Signs and Symptoms
Signs and symptoms of eczema can vary from person to person. Symptoms include:
• Dry skin
• Itching, which may be severe
• Red to brownish-gray patches, especially on the hands, feet, ankles, wrists, neck, upper chest, eyelids,
inside the bends of the elbows and knees, face, and scalp
• Small, raised bumps, which may leak fluid and crust over when scratched.
• Thickened, cracked, scaly skin
• Raw, sensitive, swollen skin from scratching
• Eczema typically begins before age 5 and can last through adulthood. Some people may experience a more cyclical form that flares up and then clear up for a period of time.
Causes of Eczema
Healthy skin helps retain moisture and protects from bacteria, irritants, and allergens. Eczema is related to a gene variation that affects the skin’s ability to provide this protection. In children, food allergies may also play a role.
Compounded Treatment Options
• Triamcinolone/Cetaphil 1:1 – Triamcinolone is a topical steroid that reduces inflammation and the itching associated with eczema. Cetaphil is a fragrance-free moisturizer safe for sensitive skin that moisturizes skin. By combining the 2 ingredients, it provides relief from itching while moisturizing the skin.
• Tacrolimus/Cyanocobalamin (w/ or w/o Triamcinolone) - Tacrolimus works to reduce/relieve eczema by stopping the immune system from producing substances that may cause eczema. Cyanocobalamin, or B12, has been found in studies to reduce the redness and itching associated with eczema.
• Zinc Pyrithione (Dermazinc)/ Clobetasol - Zinc Pyrithione is common in many dandruff shampoos but may be effective at treating eczema, psoriasis, and other conditions. It has antimicrobial, antibacterial, and antifungal properties. Clobetasol is a corticosteroid that reduces swelling, redness, and itching.
Warts
What are warts?
Warts are a type of skin infection caused by the Human Papillomavirus (HPV) and are transmitted by touch. The infection causes rough, skin-colored bumps to form on the skin. It can take anywhere from 2-6 months for a wart to develop after your skin has been exposed to the virus. They are usually harmless and eventually disappear on their own. They can affect different parts of the body including the hands, feet, and face.
Image Credit: https://www.mayoclinic.org/diseases-conditions/common-warts/symptoms-causes/syc-20371125#dialogId27473302
Signs and Symptoms
Depending on the type of wart that you have as well as its location, warts may vary in their appearance. They
may appear:
• Dome-shaped
• Flat
• Rough
• Skin-colored, gray, brown, or black
Image Credit: https://www.webmd.com/skin-problems-and-treatments/ss/slideshow-warts
Causes of Warts
HPV is a very common virus with more than 150 types including the type that causes chickenpox. HPV enters the body through a cut on the skin and can cause the skin infection that causes warts. The virus can spread from person to person or from different parts of the body through:
• Direct contact with a wart
• Touching something contaminated with the virus, such as towels or shower floors
• Nail biting or cuticle picking
Compounded Treatment Options
• Cimetidine/Salicylic Acid/5-Fluorouracil - Our combination wart paste has a combination of Cimetidine, Salicylic, Acid, and 5-Fluorouracil. When used topically, cimetidine has been shown in studies to eliminate warts with no adverse effects. Salicylic Acid is typically used in acne products but is also used for conditions that involve an overgrowth of skin cells as well as warts. 5-Fluorouracil is commonly used for precancerous skin lesions. Whenused in combination, this wart paste eliminates the wart with no scarring.
Molluscum Contagiosum
What is Molluscum?
Molluscum contagiosum is a viral infection of the skin that results in round, firm, painless bumps that can range in size from the size of a pinhead to a pencil eraser. If the bumps are scratched or injured, the infection can spread to the surrounding skin. It is also spread through person-to-person contact and contact with infected objects. It is more common in children but can also affect adults.
Signs and Symptoms
Molluscum results in bumps on the skin that:
• Are raised, round, and flesh-colored
• Are small – typically smaller than ¼ inch in diameter
• Characteristically have a small indentation or dot at the top near the center
• Can become red and inflamed
• May be itchy
• Can easily be removed by scratching or rubbing, which can lead to a spreading of the infection
• Usually appear on the face, neck, armpits, arms and tops of the hands in children
Causes of Molluscum
The virus that causes Molluscum Contagiosium spreads easily through:
• Skin-to-skin contact
• Contact with contaminated objects, such as towels
• Scratching or rubbing the bumps, which spreads the virus to nearby skin
Compounded Treatment Options
• Povidone-Iodine with DMSO – Povidone-Iodine is a broad spectrum antimicrobial. It is commonly used as a disinfectant prior to surgery. However, research has shown that it can treat molluscum contagiosum with complete resolution within 4-8 weeks of treatment. For more information, please click here.
What treatment options are available for scars and burns at Compounding Solutions Pharmacy?
PracaSil-Plus
PracaSil-Plus is a silicone base designed to improve the appearance of new and old scars, burns, and wounds. It was developed and tested by the Professional Compounding Centers of America (PCCA). Due to the base’s proprietary blend of ingredients, including silicones (in a semipermeable polymer network) and pracaxi oil (which is rich in skin-friendly fatty acids and lipids), it’s been helping make a huge difference for patients with scars, including keloid and acne scars. It can also be used to improve the appearance of burns and wounds. PracaSil-Plus is available without a prescription. For more information about scientific studies involving PracaSil-Plus, please click here.
Copasil
Copasil is an anhydrous (contains no water) silicone base designed to reduce the appearances of old and new scars. It was developed and tested by Medisca, a compounding pharmacy wholesaler. It was designed to help sustain the moist environment around the skin required for wound healing, thus allowing the medication to improve the appearance of a scar. Copasil is available without a prescription.
PracaSil-Plus and Copasil are available without a prescription. However, if you need other active ingredients added, such as Retinoic Acid (Tretinoin) or Hydroquinone, a prescription from a healthcare provider is necessary.
Sources:
https://www.mayoclinic.org/diseases-conditions/diaper-rash/symptoms-causes/syc-20371636
https://pubmed.ncbi.nlm.nih.gov/8876854/
https://www.mayoclinic.org/diseases-conditions/acne/symptoms-causes/syc-20368047#:~:text=Acne%20is%20a%20skin%20condition,but%20acne%20can%20be%20persistent.
https://www.webmd.com/beauty/retinoid-gel-and-cream-treatments
https://my.clevelandclinic.org/health/diseases/15045-warts#:~:text=Warts%20are%20a%20type%20of,touching%20someone%20who%20has%20them. https://www.mayoclinic.org/diseases-conditions/molluscum-contagiosum/symptoms-causes/syc-20375226 https://pubchem.ncbi.nlm.nih.gov/compound/Povidone-iodine
https://www.pccarx.com/Documents/m-files/98436_PracaSil-Plus.pdf
https://www.medisca.com/Pages/ProductDetails.aspx?StockCode=2952&C=B&C2=212
https://pubmed.ncbi.nlm.nih.gov/15149512/ https://medlineplus.gov/druginfo/meds/a602020.html#:~:text=Tacrolimus%20ointment%20is%20used%20to,not%20responded%20to%20another%20medication.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6024571/
https://pubmed.ncbi.nlm.nih.gov/16281635/
https://medlineplus.gov/druginfo/meds/a607072.html
https://www.medisca.com/NDC_SPECS/MUS/2952/Downloads/BR-Alpawash%20&%20Copasil%20Updates%20-%20V01%20SECURED.pdf