Vision and Skin Issues in Infants: A Pediatric Guide

About vision?

Hello Dr.
Lin: I apologize for bothering you again...
I would like to ask you a few questions: 1.
My daughter is almost one year old, and her sleep schedule is mostly similar to that of an adult.
She rarely naps during the day, and if she does, it’s usually for no more than two hours.
At night, she can sleep from around 10 PM to after 7 AM, but recently she has been going to bed later, around 11 PM.
To encourage her to sleep earlier, I turn off all the lights in her room so that she won't get up and wander around, and will lie down quietly.
My question is, will this practice have any negative impact on her vision? (Since it appears completely dark in front of her.) 2.
Recently, she has had mild nasal discharge, and I took her to see a doctor who prescribed medication for her.
I noticed that whenever she is about to catch a cold, the skin on both sides of her cheeks feels rough and not smooth, and there are small red spots appearing around that area (sometimes this happens during seasonal changes as well), which feels like a rash.
What could this be? The pediatrician who treated her cold mentioned it might be atopic dermatitis, while my family thinks it could be due to excessive heat in her body.
What is your opinion on this? If it is atopic dermatitis, does it require treatment, or will it heal on its own? What other symptoms are associated with atopic dermatitis? Thank you for your answers, doctor...

Xiao Fen, 30~39 year old female. Ask Date: 2005/10/11

Dr. Lin Huizhen reply Pediatrics

Dear Xiao Fen,
1.
Generally, long-term issues affecting vision are often related to prolonged lack of eye use, such as strabismus or excessive myopia and hyperopia, which fail to properly stimulate the retina, leading to vision problems.
Daytime use of the eyes, even with minimal light stimulation at night, typically does not adversely affect vision.
2.
It sounds less like atopic dermatitis.
Atopic dermatitis usually persists for extended periods, and children often experience itching.
The skin serves as one of the body's defense systems, and children's skin is particularly sensitive.
Small rashes may occur due to oiliness, dryness, or minor bodily changes.
If these rashes do not last too long, do not cover a large area, and resolve within a few days, it is generally acceptable and may not require medication.
Wishing you good health and all the best from the Pediatric Department of Tainan Hospital.

Reply Date: 2005/10/11

More Info

When it comes to selecting appropriate sunscreen products for children with darker skin, there are several important factors to consider. First and foremost, it is essential to understand that all skin types, regardless of melanin content, require protection from harmful UV rays. While darker skin has a higher natural SPF due to increased melanin, it is still susceptible to sun damage, including sunburn, skin aging, and an increased risk of skin cancer over time.

Choosing the Right Sunscreen
1. Broad-Spectrum Protection: Look for sunscreens labeled as "broad-spectrum," which means they protect against both UVA and UVB rays. UVA rays can penetrate deeper into the skin and contribute to skin aging and cancer, while UVB rays are primarily responsible for sunburn.

2. SPF Rating: Choose a sunscreen with an SPF of at least 30. Higher SPF ratings provide more protection, but no sunscreen can block 100% of UV rays. It’s also important to apply enough product; most people do not use enough sunscreen to achieve the SPF listed on the bottle.

3. Water-Resistant Formulas: Since children are often active and may sweat or go into the water, selecting a water-resistant sunscreen is crucial. Look for products that specify they are water-resistant for either 40 or 80 minutes.

4. Physical vs. Chemical Sunscreens: For children, especially those with sensitive skin, physical (or mineral) sunscreens containing zinc oxide or titanium dioxide are often recommended. These ingredients sit on top of the skin and reflect UV rays, making them less likely to cause irritation compared to chemical sunscreens, which absorb UV radiation.

5. Hypoallergenic and Fragrance-Free: Opt for hypoallergenic and fragrance-free products to minimize the risk of allergic reactions or skin irritation, especially for children with sensitive skin.

6. Age Appropriateness: Ensure that the sunscreen is suitable for your child's age. Some products are specifically formulated for babies and young children.

Application Tips
- Apply Generously: Use about one ounce (a shot glass full) of sunscreen to cover the entire body. Don’t forget areas like the ears, back of the neck, and tops of the feet.

- Reapply Regularly: Sunscreen should be reapplied every two hours, or immediately after swimming or sweating.

- Timing: Apply sunscreen 15-30 minutes before sun exposure to allow it to absorb into the skin effectively.

Additional Skin Care Considerations
For children with darker skin, it’s also important to address any existing skin conditions, such as atopic dermatitis or post-inflammatory hyperpigmentation, which can occur after skin injuries or rashes. These conditions may require specific treatments or moisturizers to help manage symptoms and improve skin texture.

Conclusion
In summary, while darker skin may have some natural protection against UV rays, it is still crucial to use sunscreen to prevent skin damage. Choose a broad-spectrum, water-resistant sunscreen with an SPF of at least 30, preferably a physical sunscreen that is hypoallergenic and suitable for children. Regular application and reapplication are key to effective sun protection. Additionally, addressing any underlying skin conditions with appropriate skincare can help maintain healthy skin for your child. Always consult with a pediatric dermatologist if you have concerns about your child's skin or if they experience persistent issues.

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