Q: My child has had small bumps on his cheeks since he was 2. Is he destined to have skin problems when he is older?
A: There's really no true predictor for whether childhood skin problems will continue into adolescence or adulthood. It mainly depends what the issue is. Those bumps you describe could be keratosis pilaris, which are basically blocked hair follicles that look like tiny, firm goose bumps. They usually subside on their own before puberty, but you can ask your pediatrician or dermatologist about trying a gentle moisturizer with lactic acid, which can help unclog the hair follicles and smooth the bumps. Your child might also have a mild case of eczema (one of the most common skin conditions in children), which about 40 percent of kids outgrow by adolescence. Eczema is a persistent dry, itchy skin rash that can look like red, dry patches. If you suspect your child has eczema, bring it up at the next pediatrician appointment. The doctor may suggest an over-the-counter remedy like a moisturizer, or prescribe a mild topical steroid cream to clear up the problem. Since eczema can be exacerbated by allergies to foods like milk, eggs, and wheat, you can watch for these triggers and speak to your pediatrician if you see a pattern. He or she may refer you an allergist for further evaluation. Children with eczema should use only gentle, fragrance-free soap. It could be also be that your child simply has very sensitive skin that's easily irritated by things like harsh laundry detergents or even friction from his own sweat. Many people with sensitive skin also suffer from dry skin, so your first line of defense against irritation should be slathering on a gentle moisturizer daily. You should also use fragrance-free soaps and make sure all products are alcohol-free to prevent drying skin out even more. Most products formulated for babies are good options and will work well even as a child gets older.
If this sensitive skin persists into adolescence, teach your son what triggers reactions in his skin -- common irritants include materials like wool and latex, as are laundry bleach and medicines like certain topical antibiotics. When it comes to caring for his skin (especially when hormones increase at puberty), encourage him to read labels, since most mainstream acne treatments will be too harsh.