Use common sense for dermatologic concerns


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.


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.

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