As your little one explores their environment, minor accidents are bound to happen. Curiosity can lead to cuts, scrapes, bruises, and scars. More often than not, these incidents are frightening, but not dangerous. Want to know how to handle every bump and bruise? Here's the scoop on how to handle it when your tot takes a tumble.
Baby skin is very vascular, with a lot of little blood vessels at the surface. So don't freak out if a wound is bleeding a lot -- staying calm is key. The next step? "Hold firm pressure directly over the area for 15 minutes with a clean cloth," says Kristina Collins, MD, dermatologic surgeon at Vitalogy Skincare in Austin, TX. If the bleeding does not stop at that point, contact a doc for further guidance.
Stick with the basics here -- no need to get fancy. Allison Hanlon, MD, a surgeon and assistant professor in the department of dermatology at Yale School Of Medicine says, "There is a misconception that applying hydrogen peroxide will prevent infection and aid in wound healing. Hydrogen peroxide can actually be toxic to the healthy cells needed for the wound to heal." To block out bacteria, Hanlon recommends gently washing the area with a non-fragranced soap or non-soap cleanser and water. Cetaphil Antibacterial Cleansing Bar is a good first choice. If debris remains in the cut after this process, consider a trip to the MD.
"Antibiotic ointments and sprays are popular for wound care, but are not necessary for clean wounds," Hanlon says. "Studies have shown that in surgical wounds treated with petrolatum or topical antibiotics, there was no difference in infection rates."
In fact, there are downsides to using OTC topical antibiotics: First, they are a very common cause of allergic contact dermatitis (a red itchy rash) in children; and second, unnecessary use can contribute to the grow-ing problem of drug-resistant bacteria.
So what should you do? Skip the bacitracin or neomycin, and watch for an indication that an infection is brewing. "Signs of infection, such as increased tenderness, drainage or redness tracking away from the wound, usually occur a few days after the cut or scrape. If the site shows signs of infection, notify your pe-diatrician or dermatologist for further evaluation," advises Hanlon.
"It is definitely a myth that the wound should be allowed to air or scab," Collins says. Research has shown that keeping a scrape well lubricated, not dry, actually speeds up and promotes wound healing. To help the healing along, Hanlon likes to apply a thin layer of white petrolatum ointment 1-2 times a day with dressing changes until the skin has closed.
Getting a Dora bandage can help to quell the trauma of a cut. Just be careful in babies under the age of 1 because bandages can be a choking hazard, especially if the boo-boo is on their finger. Alternatives include non-stick covers such as Telfa (which is readily accessible at your local drugstore) and paper tape.
It is important to distinguish between scars and the skin changes that happen during normal healing. As the cut begins to resolve, the area can turn pink, purple or even brown. This discoloration, called post-inflammatory hyperpigmentation, generally goes away after a few weeks or months, and represents an expected response to skin injury. Scars, on the other hand, do not fade. They become permanent, and can be flat or thickened, like keloids. In general, you should worry more about a deeper cut. "Scrapes or cuts that are on the top layer of skin usually do not heal with a scar," Hanlon says. "Wounds that penetrate the deeper layers of skin may result in scarring."
To avoid post-inflammatory hyperpigmentation, use a broad spectrum SPF 30 containing titanium dioxide or zinc oxide, and reapply every two hours. Ultraviolet light can definitely make skin discoloration last longer. To promote healing and reduce scarring, Anthony Rossi, MD, a dermatologic surgeon at Memorial Sloan Kettering Hospital in NYC, likes to use a prescription cream called Biafine. It has an alginate (a natural wound dressing derived from different types of algae and seaweeds) that speeds things up. Collins also suggests silicone strips (think of a bandage that has a special healing properties) to reduce the thickness and appearance of scars -- and help keep baby's skin blemish free.
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