Use common sense for dermatologic concerns

September 1, 2017

Dr Farber shares 8 common sense tips for handling dermatologic concerns.

1. ­Parents are often told not to use lotion on newborns as it can block their pores. I do not know of any evidence in support of this statement. That having been said, I do tell parents that the lotion will probably do more for the parents than the infant, as the newborn skin will smooth out on its own in a few weeks.

2. ­Clobetasol 0.05% for 6 weeks can be tried for alopecia areata.1

3. ­Terbinafine is good for Trichophyton tonsurans, griseofulvin for Microsporum.2

4. ­Topical sirolimus can be used for facial angiofibromata in tuberous sclerosis.3

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5. ­Tretinoin has been reported to be useful for stretch marks, but the evidence is not convincing.4

6. ­Baby acne (in the first few weeks of life, not in older infants) may be a yeast infection. Ketoconazole may help,5 but it usually will not be needed.

7. ­Perioral dermatitis is a known complication of prolonged steroid use. I have seen this in a child who was taking an inhaled steroid for asthma, using a spacer with a mask. This condition will improve if the steroid is stopped, but it may take some time. Topical erythromycin, which is inexpensive, may help.6

8. ­Eczema is often better felt than seen. Discolored but smooth skin is usually not active eczema but postinflammatory.

REFERENCES

1. Lenane P, Macarthur C, Parkin PC, et al. Clobetasol proprionate, 0.05%, vs hydrocortisone, 1%, for alopecia areata in children: a randomized clinical trial. JAMA Dermatol. 2014;150(1):47-50.

2. Chen X, Jiang X, Yang M, et al. Systemic antifungal therapy for tinea capitis in children: an abridged Cochrane Review. J Am Acad Dermatol. 2017;76(2):368-374.

3. Wataya-Kaneda M, Nakamura A, Tanaka M, et al. Efficacy and safety of topical sirolimus therapy for facial angiofibromas in the tuberous sclerosis complex: a randomized clinical trial. JAMA Dermatol. 2017;153(1):39-48.

4. Ud-Din S, McGeorge D, Bayat A. Topical management of striae distensae (stretch marks): prevention and therapy of striae rubrae and albae. J Eur Acad Dermatol Venereol. 2016;30(2):211-222.

5. Rapelanoro R, Mortureux P, Couprie B, Maleville J, Taïeb A. Neonatal Malassezia furfur pustulosis. Arch Dermatol. 1996;132(2):190-193.

6. Tempark T, Shwayder TA. Perioral dermatitis: a review of the condition with special attention to treatment options. Am J Clin Dermatol. 2014;15(2):101-113.