Skincare Tips in Pregnancy During Monsoon

Pregnancy is a phase in a woman’s life where you have to take extra care of yourself. Your body constantly undergoes a variety of changes. If you are pregnant during the summer season, it becomes very uncomfortable to pass the days due to excessive heat, sweating etc. But monsoon also doesn’t bring much relief as the level of humidity increases.

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At times, monsoon and pregnancy don’t go well together as the body’s immune system becomes more susceptible to infections. This may result in dysentery, indigestion, cold and cough, and many skin related problems. Dry skin, rashes, eczema, pimples, prickly heat boils are some of the common skin problems that arise in pregnant women during the monsoon. So, it becomes very necessary to keep yourself fit and healthy and take care of your skin to beat the odds of monsoon.

Skincare Tips for the Monsoon

A little change in the way of skincare can do wonders during the monsoon season. Here are some pointers :

  • Keeping yourself hydrated is one of the best ways to make your skin flawless and healthy. Drinking enough water helps in flushing out the unwanted toxins.
  • Pregnancy hormones make your skin more sensitive to sunlight darkening your skin. Stay indoors as much as possible and if you have to go out wear a hat, use an umbrella or cover exposed areas with a light scarf.
  • As it is not possible to avoid sunlight totally, dermatologists suggest applying sunscreen lotion at least 30 minutes prior to going out.
  • Taking a Neem water bath daily helps in fighting bacteria and other germs making your skin free of rashes. Neem water can be prepared easily at home by boiling Neem leaves for around 15 to 20 minutes.
  • Wear clothes made of breathable fabrics like cotton which absorb sweat and keep your skin dry.
  • During monsoon, soil and sewage make the rain water dirty, it may cause skin infections if your feet get exposed to such water. Wash your hands and feet immediately with mild disinfectant soap and warm water after coming from outside.

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Avoid using skincare products containing harmful chemicals:

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During pregnancy, read the skin care product labels carefully regarding the ingredients as using products containing chemicals may be harmful to you and your baby in the womb.

  • Hydroquinone: Commonly present in skin whitening cream, hydroquinone is not good at all for you and your developing baby. Using such products may have different types of ill effects.
  • Salicylic Acid: Present mostly in acne products, salicylic acid is dangerous for pregnant women as it may lead to preterm birth, low birth weight or malformation of the baby.
  • Spray or fragrances: Using spray on tanned areas or fragrances during pregnancy is not a good idea. Though it may not do much harm to the skin as it will not be absorbed much but inhalation of the chemicals in the spray may cause DNA mutations.
  • Hair Removers: As hair removers contain different type of chemicals, avoid using them as much as possible.
  • Bath Products: Most of the luxurious bath products contain chemicals which are not good at all for pregnant women. These chemicals may cause different types of allergic reactions. Rather opt for non-luxurious bath products free from chemicals.

A little skin care during the monsoon can make your pregnancy peaceful by avoiding any kind of skin problems. But if you face severe skin problems it would be better to consult an expert dermatologist.
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Skin Care During Pregnancy

Pregnancy is a phase in a woman’s life during which your body undergoes different type of changes. These changes occur as your body produces hormones such as progesterone and estrogen. Changes on your skin also occur as a part of pregnancy. If you are lucky enough, you will look luscious and beautiful. But in some, the effect is just the opposite resulting in varied types of skin problems.

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During pregnancy, the area around your chin and mouth are the most common areas affected. Due to the baby bump, stretch marks also occur on your skin. So, it becomes very essential that you take care of your skin during pregnancy. From the foods you eat to products you use on your skin, all have effects on your baby. Though most of the skin products are safe, there are some which may be harmful to your developing baby.

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You can combat stretch marks by using cocoa butter which is safe to use during pregnancy. It helps in diminishing blemishes, as well. You may also notice darker skin in certain areas, especially around the areolas due to hyper pigmentation. In order to make the dark patches fairer, you can use lotions which are safe to use during pregnancy.

You can also opt for natural and oil-free skin products during the gestation period. Such products don’t contain harmful chemicals which are not good for the baby in the womb. There are some products especially made for pregnant women. Otherwise, you can consult an experienced dermatologist to treat different types of skin problems that occur during pregnancy.

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You should avoid using skin products that contain the following ingredients:

  • Benzoyl Peroxide
  • Salicylic Acid
  • Any type of Retinoid

Make pregnancy the most beautiful phase of your life by eating well and taking care of your skin. You will definitely like playing the role of mom-to-be. Stay happy, and your pregnancy will definitely be beautiful!

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Infant Skin Care

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The skin is the largest organ in the human body. Besides serving as a protective barrier, it has the function of thermoregulation, UV protection, protection from invasion of microbes and external antigens, repair and regeneration of wounds and synthesis of nutrients. It also has immunological  and sensory autonomic functions. We must remember that the skin of the neonate is not the miniature of the adult skin.

Differences between adult and term or preterm neonate skin

  1. The skin of the newborn is 20 to 30% thinner than the adult skin.
  2. Newborn skin is less hydrated and has reduced natural moisturization factor compared to adult.
  3. Ratio of body surface area to weight of a term neonate is up to 5 times that of an adult and that of preterm is 7 times than of an adult.
  4. Stratum corneum or the outermost layer of skin of a preterm baby is thinner than that of a term baby.
  5. At birth, the pH of newborn skin is slightly acidic whereas the adult skin has acidic pH from 5 to 5.5. Alkaline pH predisposes to diaper dermatitis and favours colonisation of Staphylococcus aureus and Candida albicans.

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The skin of the newborn undergoes structural and functional modifications from the first few days of life up to almost the first year to adapt to the transition from the utero wet world to the extrauterine environment. The structural and functional immaturity of the skin of a preterm baby results in increased transepidermal water loss, susceptibility to mechanical trauma, microbial invasion and percutaneous absorption of toxins. In order to reduce the morbidity associated with immature skin barrier, optimum care for the skin of a newborn is essential.

 Cleansing and cleansers

Cleansing is a process of removing dirt, sebum, micro-organisms, exfoliated corneum cells from the skin surface by a complex interaction between the skin barrier, dirt, body secretions and a surfactant. Water is a good cleanser which removes the water soluble dirt but not the fat soluble particles.

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Cleansers are surface active substances that emulsify the fat soluble particles and convert them into water soluble matter which can be washed off with water. Today a wide variety of soaps, special soaps and liquid cleansers are available in the market.

Cleansers are classified into three categories, namely true soaps, syndet bars and combars. Soaps are fatty acids derived from animal fat or vegetable fat processed with sodium or potassium hydroxide by saponification.

True soaps are composed of long chain fatty acid-alkali salts with a pH between 9 and 10. The high alkaline nature causes dissolution of lipids from the skin surface, disruption of acid mantle and stratum corneum barrier and raises the pH of the skin, Soap precipitates in hard water producing insoluble calcium or magnesium salts that prevent foam formation. Use of soap particularly in diseases of the skin may cause dryness and irritation of the skin resulting in redness and itching.

Special additives added to the soaps have resulted in the various subsets of soaps such as superfatted soaps, transparent soaps, medicated antibacterial soaps. Superfatted soaps contain increased oil and fat which help in minimizing the dryness of skin. Transparent soaps contain glycerine and sucrose. Antibacterial soaps contain antibacterial agents such as triclosan, triclocarban. These soaps reduce the skin biofilm bacterial count by blocking the lipid synthesis in the bacterial cell wall.

Syndets or synthetic detergents are synthetically derived organic quarternary ammonium compounds or polymerized or sulfonated fatty acids. They have a pH of 5.5 to 7. They are less likely to produce dryness and irritation of the skin.

Combars are composed of alkaline soaps to which surface active agents with a pH of 9 and 10 are added. They are milder cleansers than true soaps.

Other variants of cleansers

Soapless cleansers are lotions that are primarily composed of either glycerine or propylene glycol and cetyl/steryl alcohols and they can be wiped off without using water.

Liquid cleansers with appropriate blend of anionic, non-ionic and amphoteric surfactants are available. They are milder in nature and do not disrupt the skin barrier or acid mantle.

An ideal skin cleanser is one that is mild and has minimal interaction with skin and removes all unwanted materials from the skin. It should not affect the acid mantle of skin surface. It should be colourless and fragrance free and should not irritate the skin or eyes.

Shampoos

 

Shampoos that are available in the market are soapless and consists of a principal surfactant for detergent and foaming power, secondary surfactants to improve and condition the hair and additives to complete the formulation and special effects. Formaldehyde is the most common preservative used in shampoos and does not cause any side effects due to the short contact.

Baby shampoos should be ideally fragrance free and should not cause eye irritation. Medicated shampoos with ketoconazole, tar, zinc pyrithione, salicyclic acid are available for special hair conditions.

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Vernix Caseosa

 

It is a naturally occurring complex, lipid rich substance coating the skin surface of the fetus. It is a chalky white material with shed epithelial cells, sebum and sometimes lanugo hair.

Preterm babies have very little vernix compared to the term babies and post term babies may not have vernix.

Vernix is highly beneficial. It is a natural cleanser and moisturizer with anti-infective, antioxidant and wound healing properties. It helps in the development of acid mantle and supports the normal bacterial colonization. WHO guidelines mention that vernix should not be removed at the time of birth.

Bathing the newborn

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WHO guidelines mention that the initial bath for term newborn should be given 6 hours after birth. Any baby who is term and weighs more than 2.5 kgs could be given bath 6 hours after birth. In term IUGR babies only sponge bath is to be given until the baby’s weight crosses 2.5 kgs. There are some studies which have advocated bath after fall of the umbilical cord. Bathing makes the baby calmer and quieter than washing with cloth or sponge. The tactile stimulation that occurs during bathing provides a pleasurable experience for the baby and promotes the bonding between the baby and the parent or the caregiver.

How to give a bath:

  • Should be given in a warm room
  • Temperature of the bathwater should not exceed 37°C
  • Check the temperature of the water before placing the baby in the bath
  • If tub bath is given, the depth of the water should be 5cm up to the hip of the baby
  • Bathtubs may be a potential source of infection hence they must always be disinfected
  • Bath duration should not exceed 5 minutes in order to prevent overhydration of the skin which may lead to easy fragility of the skin and decrease threshold for injury


Routine bathing

Routine bathing of newborns and infants does not cause any harm. Daily baths are more preferable but during winter and in the hilly regions babies may be given bath twice or thrice in a week. 

Cleansers

Use of alkaline soaps during the neonatal period is to be avoided. If possible, liquid cleansers with acidic or neutral pH may be used which will not affect the skin barrier function or acid mantle. Syndets and mild soaps may be used in infants.

Care of the diaper area

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Diaper area is exposed to excessive hydration, occlusion, friction and maceration. Faecal ureases catalyze the breakdown of urea to ammonia, which increases the pH of the skin surface. The pH increase will contribute to the activity of faecal enzymes, proteases, ureases and lipases which are highly irritant to the skin. Water and wet cloth are the gold standards for cleansing the nappy area. Mother should be advised to use only cloth napkins which should be changed frequently. It is important to keep the area dry. After defecation, moistened cloths or cotton balls soaked in lukewarm water can be used for cleaning the area. In case diapers are used, barrier creams containing zinc oxide and petrolatum based preparation could be used. Cloth napkins are to be washed with a mild detergent in warm water and dried in sunlight. Use of antiseptics to be avoided as a routine.

Care of the umbilical cord

Umbilicus should be kept dry and clean. Lukewarm water should be used for cleaning and cord should be kept exposed to air.

Care of the scalp

Cradle cap of the scalp is common in newborns. Mineral oil can be applied to the crusts and removed after two to three hours. Baby shampoos which are free from fragrance could be useful in removal of crusts and scales. The pH of the shampoos should be close to that of tears and should not cause irritation to the eyes.

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Baby’s hair wash is to be given after the cord falls with a frequency of twice a week after that.

Use of baby powders

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Mothers should be advised to smear the powder on the hands and then gently apply on the baby’s skin. Accidental inhalation of powders could happen if applied with puffs.

Care of the skin of preterm baby

Preterm babies have immature barrier function which results in increased transepidermal water loss, increased skin permeability, impaired thermoregulation, increased percutaneous absorption and susceptibility to trauma.

There is acceleration of permeability barrier maturation following birth hence within 2 to 3 weeks post-natally, babies develop competent barriers. But in preterm born at 22 to 25 weeks it takes 8 weeks to mature. In these preterm babies acid mantle develops over 2 to 8 weeks after birth. Gentle and minimal handling of the preterm babies is to be practiced. Hand hygiene measures are to be strictly followed by the mother or health care workers.

Sponge bath with water is to be given until the baby weighs 2.5 kgs after which regular bath is advised with mild cleanser. Micropore adhesives may be used to secure IV cannulas and while removing the adhesives use guaze piece soaked with warm water. Gentle application of emollients will help reduce the dryness and maintain the barrier function. Emollients also decrease the risk for invasive infections in preterms by preventing access to deeper tissues and the bloodstream through skin portals of entry.

Emollients

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Emollients are lipid containing substances that soften the skin and prevent transepidermal water loss. They help in restoration of skin barrier and thus retard further damage. Emollients contain hydrocarbon oils like petrolatum, mineral oils, paraffin and squalene. Fatty acids like lanolin acid, stearic acid and fatty alcohol like lanolin alcohol and cetyl alcohol are also used as emollients. Regular use of emollients is indicated in preterm babies. Emollients could be used in term babies with cleansers induced dryness.

Massage – Touch therapy

Touch is considered absolutely essential for growth and development of a neonate.

Lack of appropriate touch results in poor growth of the infant, delayed attachment to parent and psychological disturbances. Systematic application of touch is termed as massage. Massage promotes circulation, suppleness and relaxation of the different areas of the body and tones up the muscles. Massage results in promotion of mother-infant bonding.

Benefits of massage

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  • Increases food absorption hormones such as insulin
  • Increased weight gain by increasing insulin and insulin like growth factor
  • Greater bone mineralisation and more optimal behavioural and motor responses
  • Babies become more active and alert

Oil massage

Oil massage is traditionally practiced in India. Oil enhances skin barrier function, acts as a source of warmth and nutrition and increases weight gain. Infants also showed less stress behaviour and lower cortisol levels following massage. Very low birth weight preterm neonates given oil massage showed better weight gain. Coconut oil, sunflower oil, mineral oil and synthetic oil are being used for massage. Mustard oil is recently been discouraged due to irritant and allergic contact dermatitis potential. Sunflower oil enhances the skin barrier function. Some studies have shown that olive oil can cause erythema and disruption of skin barrier function. During summer one has to avoid oil massage when baby has miliaria rubra. Oil massage should be given before bath during summer and after bath during winter.

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Massage is ideally given by mother, father, grandparents or caregivers. It could be started after the 10th day of life in a well baby. Massage is to be given to babies when they are alert and active, preferably 1 to 2 hours after feed. Massage is to be done in a warm room. Mother or the caregiver has to cut their nails, and remove rings and watch. Strokes should be gentle and firm and not jerky. These gentle strokes should be given from head to foot. As the baby may not lie still, one should work with and not against the movements. Full body massage will take 15 minutes.

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Comfortable signs of baby enjoying massage are happy vocal sounds like cooing, easy breathing pattern, bright-eyed look, ability to focus and take in surroundings comfortably and enjoying stretching, sucking, clasping own hands or feet.

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