Dr June Tan Sheren shares information about the most common skin conditions found in children living in the tropics:
Molluscum Contagiosum
What is it?
Molluscum contagiosum, also frequently known as “water warts”, is a viral skin infection causing tiny pearly-looking bumps. Sometimes you may be able to see a depression in the centre of the bump. It is common in young children and is contagious. It can be transmitted to other areas of skin or to other children. The bumps can appear anywhere and can be numerous, but are harmless. Problems can arise if your child scratches or picks at the bumps as this could lead to bacterial infection.
How do we treat it?
Molluscum usually clears on its own within 6-12 months but can take as long as 3 years to resolve, as immunity to the virus takes time to develop. There are various treatment methods that your doctor might recommend if needed such as cryotherapy (freezing), curettage, or applying a medicated cream to the surface. Prevention is better than cure! Avoid sharing towels, clothing, goggles and other sporting gear.
Viral Warts
What are they?
Warts are caused by infection with human papillomavirus (HPV). There are over a hundred types of HPV that can affect different parts of the body causing different conditions. Common warts, or verrucae, are caused by HPV infecting the skin through small cuts, scrapes and weak spots, commonly in the hands and feet and other parts of the limbs. They appear as raised, rough bumps and if you look closely you may see tiny black dots in them that are actually blood vessels. Although warts may spread and look unsightly, they are harmless and will usually last 1 to 2 years if untreated. They may be painful if they grow large or in clusters and if they are on the soles of the feet.
What’s the treatment?
There is no treatment that specifically kills the wart virus, so the goal of treatment is to remove the skin that contains the wart virus. There are many types of treatment for warts. Common treatment options include applying medication like salicylic acid, freezing, or burning with electrosurgery or laser. It usually takes several visits to get rid of the warts.
Impetigo
What is it?
School sores is the common name for impetigo, an infection of the skin by staphylococcus or streptococcus bacteria. These bacteria often live on the skin and in the nose and throat without causing problems but may cause infection when the skin barrier is breached. It may appear as itchy sores, sometimes starting as blisters that burst and become weepy before being covered by a honey-yellow crust. It often occurs on the face and limbs but can occur anywhere on the body. It is highly contagious and common in pre-schoolers and school children.
How is it treated?
Impetigo is treated with antibiotics that, depending on the severity, can be given topically as a cream or ointment, or given orally. It can look serious, but is usually a mild and superficial infection that is easy to treat. Children should avoid touching affected areas and encouraged to wash their hands frequently.
Candidiasis
What is it?
More commonly known as ‘thrush’, Candidiasis is due to the fungus Candida which thrives in a warm and moist environment. In children, it can infect skin folds like the diaper area and should be considered if a nappy rash appears more difficult to treat than usual. Frequent nappy changes particularly after every bowel movement is advisable to prevent nappy Candidiasis, with the use of a barrier cream. The infection clears with anti-fungal creams.
Atopic Dermatitis (AD)
What is AD?
Atopic dermatitis or eczema is an itchy, dry, inflammation of the skin which tends to be chronic and goes through varying phases of severity. It is the commonest type of skin disorder in children. It is often associated with a family history of eczema, asthma or hay fever, with many external factors that can cause flare-ups. The rash is often itchy and red, and over time dryness and scaling develop. Babies with AD usually have a red, dry rash on their face, sometimes on their scalp, body, arms and legs. Toddlers and older children often have the rash in the skin creases around the knees, elbows, wrists and ankles. It is important to effectively manage AD – poorly-controlled AD not only causes excessive itch and discomfort, it can also become secondarily infected by bacteria and viruses.
How is AD treated?
Good control can be achieved with avoidance of triggers and appropriate skin care. Common triggers are heat, synthetic or prickly fabric, use of bath soaps that dry the skin excessively, exposure to cigarette smoke and dog and cat dander. Contrary to popular belief, AD is not usually caused by any specific allergy. Your doctor can recommend good skin moisturizers, emollients and non-soap cleansers for bath to protect the skin. The use of an appropriate corticosteroid cream is safe and an essential part of treatment of flare-ups, and again your doctor will be able to advise on appropriate use. For many children, AD gradually improves as they get older.
