Paediatric Dermatology Unit

For many years, it was believed that the skin barrier—the hydrolipidic film that prevents transepidermal water loss and the penetration of harmful agents through the skin—was fully formed by around the seventh month of gestation, meaning that babies were born with complete protection. However, subsequent research has shown that the maturation of this structure continues for several years after birth.

During this period, babies are more vulnerable to the damaging effects of physical, chemical and biological agents on their skin, as these penetrate more easily and reach deeper layers than in older individuals. Although infant skin has the same structure and number of layers as adult skin, each of these layers is significantly thinner and more permeable, making it much more fragile when exposed to friction or rubbing and more prone to dehydration.

In addition, in newborns the sebaceous glands show very limited activity, meaning that the natural emulsion of water and lipids that forms the hydrolipidic barrier is almost absent at this stage of life.

A similar situation occurs with pigmentation. Melanin is the pigment that protects the skin from solar radiation and gives colour to the hair, eyes and epidermis. Newborns have melanocytes (the cells responsible for producing melanin), but their activity is minimal. This is why, when exposed to sunlight, adults tan, whereas babies burn.

As the baby grows, the skin gradually matures. The layers of the dermis become thicker, and the lipid and amino acid composition of the skin barrier changes, increasing resistance to dehydration and reducing vulnerability to the harmful effects of certain external agents.

Nevertheless, paediatric skin remains more delicate than adult skin, and both skincare and treatments for paediatric dermatological conditions must be specifically tailored to meet these particular needs.

A significant proportion of children attend medical consultations influenced by fear. Fear of pain, anxiety about being separated from their parents during examination or diagnostic tests, and apprehension about interacting with the specialist can make the experience unpleasant for both children and their families.

The specialist team at the Paediatric Dermatology Unit of Grupo Pedro Jaén uses specific tools and communication skills to engage, reassure and calm children, ensuring that consultations take place in a relaxed and reassuring environment, preferably in the presence of their parents.

These resources are particularly valuable when applying treatments that may be uncomfortable or painful and require the child’s cooperation, such as laser therapy, extensive curettage or cryotherapy sessions. Depending on each case, many of these procedures are performed with the support of nitrous oxide or conscious sedation, under the supervision of an anaesthetist.

This approach allows the child to undergo treatment in a calmer, more relaxed state, minimising pain and stress. As a result, consultations are non-traumatic and treatment adherence is improved when follow-up sessions, wound care or complementary treatments at home are required.