Mother and Baby

Wednesday Lunch Club Q+A With Dermatologist Dr Tabi Leslie

Missed our Wednesday Lunch Club with Dr Tabi Leslie? Don’t worry, you can read all of the expert advice she shared here

Every week at Mother&Baby we bring you the Wednesday Lunch Club – a chance to get brilliant advice for your parenting questions from a top expert. This week, Dr Tabi Leslie was on standby to answer your questions.

A regular spokesperson for the British Skin Foundation, Dr Leslie also practices as a consultant adult and paediatric dermatologist. She deals with all skin problems including skin cancer, eczema, acne and rosacea, psoriasis and also tends to skin infections such as impetigo, allergies and urticaria (hives) and pigmentary disorders, as well as moles and birthmarks.

If you missed the chat, here’s what happened…

'If the eczema is not improving then there may be secondary infection or allergies involved'

My 17 month old son suffers badly from eczema. I feel there are triggers such as teething and, more recently, certain foods. I have changed all his moisturisers and body washes to Elave baby products. Is there anything else I can do to help him? Anonymous question.

Dr Tabi Leslie: If the eczema is not improving then there may be secondary infection or allergies involved. Check for perfumes and preservatives in the moisturiser and washes which may be aggravating the skin. If you feel the eczema flares after applying the cream or feeding your baby certain foods than an allergy may be likely.

If the eczema is oozing, angry and red there may be an infection which needs to be treated by your GP. Doctors will also prescribe a sedative antihistamine at night to break the itch scratch cycle which may be perpetuating the inflammation. It will also hopefully allow you and the rest of the family to get some sleep and reduce stress.

My toddler has really bad eczema behind her knees and on her arms. I've tried lots of different things that the doc has recommended but a friend told me a mud bath cleared up her eczema - would anything a bit more unusual like this help? It's really irritating her and isn't pleasant. Anonymous question.

Dr Tabi Leslie: Eczema can fail to respond to treatment if the skin is sensitive to any creams being applied or if there is an infection present in the skin. I do not usually recommend alternative therapies as I find conventional therapies recommended by your doctor can be effective if used correctly.

Finding the right moisturiser and bath oil is important, and you may need to try a few different ones before you find the one most suitable for your toddler's skin. You should see your GP who can decide if topical antibiotics or topical steroids are required. Occasionally antibiotics by mouth are needed.

I hate saying this, which is why I'm emailing and not writing this on Facebook, but my three week old baby's head is covered in scabs and red bumps and it looks really horrid. I put a hat on her head to hide it because I'm ashamed to say I'm embarrassed. When will this go and will it go? Anonymous question.

Dr Tabi Leslie: Most babies get a scaly, flaky scalp referred to as cradle cap (seborrheic dermatitis). Often just moisturising with creams or oils such as olive oil can improve the situation. Leaving the oil on overnight is better. Also make sure the baby's shampoo is fragrance free and recommended for sensitive skin.

'Most babies get a scaly, flaky scalp referred to as cradle cap (seborrheic dermatitis)'

If the scalp is infected or the dermatitis/eczema is severe and not responding to these simple measures then you will need to take your baby to the GP who may give you medicated shampoos or creams to reduce the inflammation.

Babies do grow out of this on their own but it can be more common and resistant to treatment and therefore last longer in those with a family history of eczema or psoriasis.

Since becoming a mum, I've noticed lots of fine lines – probably due to sleep deprivation and letting my diet slip. What's the most effective skincare you can recommend? I need results! Anonymous question.

Dr Tabi Leslie: This is a common complaint in women following pregnancy especially with weight loss. Changes around the eyes can often be due to lack of sleep, inadequate hydration and not having the time to care for the skin and maintain a healthy diet.

An effective moisturiser which suits your skin should be used daily. Regular fluids and healthy meals as well as resting will also help. If there are dark circles due to lack of sleep, then the concealers or camouflage agents available from cosmetics counters can be helpful in getting an immediate result.

My skin has freaked out since I had my son and I have spots all over my forehead. Is this due to hormones? Will it settle down? I previously had very good skin, so it's stressing me out! Product recommendations would be great. Anonymous question.

Dr Tabi Leslie: This is quite a common occurrence with the change in hormones during and after pregnancy so try not to worry as the situation may be temporary. You may wish to try an over the counter product such as benzoyl peroxide or salicylic acid.

If that does not help, do go and see your doctor who can prescribe other topical treatments not necessarily available over the counter. If you are not breastfeeding or pregnant again, then your doctor may prescribe a retinoid (vitamin A cream) such as adapalene.

Also you may need antibiotics by mouth which should calm your skin down. If you require contraception, then in addition dianette and yasmin are both useful to treat acne prone skin hormonally.

I've got skin that goes quite flushed, does it mean anything or is it just about being fair? Is there anything I can do? Anonymous question.

Dr Tabi Leslie: Some people naturally flush, especially if their skin is fair as this can be more obvious. However, flushing is quite a common symptom which can be associated with certain skin conditions such as rosacea. This is often treated with topical therapies as we would avoid other treatments such as antibiotics by mouth in someone who is pregnant or breast-feeding.

If the flushing is associated with rosacea, this can often be reduced by consuming less caffeine, red wine or spirits and spicy food. Hot drinks could also be avoided. It is best to discuss your symptoms with your doctor in case there are other underlying causes in your particular instance of flushing.

I am currently eight weeks pregnant and experiencing a resurgence of my acne I experienced in my late teens. I have read lots of mixed messages on the Internet about what is safe or not safe to use (i.e. sacylic acid and bezyl peroxide etc). Could you recommend any products that will work while being safe to my baby? Anonymous question.

Dr Tabi Leslie: Acne can frequently flare up during pregnancy, as often prior to the pregnancy, women have stopped their oral contraceptive pill which may have been controlling their acne or any other treatments they have been taking systemically for their acne which has to be stopped for the safety of the foetus.

Topical therapies are the safest treatments in pregnancy. However, the topical retinoids (vitamin A creams) should be avoided. Salicylic acid, benzoyl peroxide, azelaic acid and topical antibiotics should be safe. The topical antiseptic face washes should also be completely safe. If in doubt, always discuss any treatments with your doctor and pharmacist.

Is it normal for a child of 19 months to still be getting cradle cap? He never had it as a small baby and now it's on and off all the time and it itches him terribly. The doctor has prescribes Oilatum but it doesn't really keep it at bay. Kerry Hill.

Dr Tabi Leslie: Cradle cap usually resolves itself in the first few months but it is not uncommon for it to continue for longer. If you feel the current treatment is aggravating or not helping the situation then it is advisable to change to a different treatment.

Moisturising is usually effective but do go back to the doctor to report the lack of progress so that the situation can be reassessed. Further treatment for eczema may need to be initiated.

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