Newborn Skin Peeling: What's Normal And What's Not?

Newborn skin peeling is a typical response to pregnancy and delivery. It is caused by the loss of a protective coating called vernix caseosa or vernix, which develops on the baby's skin during gestation. This coating, which is a thick, waxy, cheese-like substance, protects the baby's skin from the amniotic fluid in the womb. After birth, when this coating is wiped off, the baby's skin starts to peel as it adjusts to the new environment. The amount of peeling varies depending on the baby's gestational age and the amount of vernix present at birth. While newborn skin peeling is generally normal, in some cases, it can be a sign of an underlying health condition such as eczema, ichthyosis, or psoriasis.

Newborn skin peeling is normal and usually resolves on its own

Newborn skin peeling is a typical response to the change in environment after birth. In the womb, a baby is surrounded by amniotic fluid and protected by a thick waxy coating called vernix caseosa or vernix. This coating, which forms around the 20th week of pregnancy, acts as a barrier between the baby's skin and the amniotic fluid, helping to keep it soft and moisturised.

After birth, a nurse will wipe the vernix, along with any blood or amniotic fluid, off the newborn's skin. With the protective coating gone, the baby's skin starts to adjust to the new environment, and the outer layer begins to flake and peel off within 1 to 3 weeks.

Nearly all newborns experience some degree of skin flakiness and peeling, especially on the hands, soles of the feet, ankles, and face. Premature babies tend to have less peeling than babies born at or after 40 weeks, as they are born with more vernix.

The top layer of skin typically sheds within the first few weeks of life, but the process can vary from baby to baby. In some cases, it may take a month or two for the skin to stop peeling.

While newborn skin peeling usually resolves on its own and doesn't require special care, there are some simple strategies that can help protect and soothe your baby's skin:

• Keep bath times short (5-10 minutes) and infrequent (2-3 times a week).
• Use lukewarm water and fragrance-free, soap-free cleansers.
• Apply a hypoallergenic ointment or moisturiser to your baby's skin, especially after bath time.
• Avoid harsh chemicals, perfumes, and scented products. Opt for baby-specific laundry detergents and skincare products.
• Keep your newborn hydrated with breastmilk or formula.
• Protect your baby's skin from the sun and cold air by dressing them appropriately for the weather.
• Use a humidifier in your baby's room to add moisture to the air.

When to seek medical advice:

While newborn skin peeling is typically normal, in some cases, it may be a sign of an underlying health condition such as eczema, ichthyosis, or psoriasis. If you are concerned about your baby's skin, contact your paediatrician or a paediatric dermatologist for advice.

Skin conditions like eczema can cause peeling

While newborn skin peeling is a normal occurrence in the first few weeks after birth, skin conditions like eczema can also cause a newborn's skin to peel.

Eczema, or atopic dermatitis, is a skin condition that causes skin peeling and red, dry, itchy patches. It is rare for eczema to be diagnosed right after birth, but it can develop later in infancy, with 60% of people with eczema developing it before their first birthday.

The exact cause of eczema is unknown, but several factors can trigger a flare-up, including exposure to irritants such as shampoos, detergents, dairy products, soy products, and wheat.

Eczema can be managed by avoiding triggers, keeping bath times to a minimum, and in some cases, using over-the-counter creams, prescription medications, or phototherapy.

If you notice that your newborn seems uncomfortable, is itching, or is in pain, it is important to see a healthcare provider. Additionally, if the skin peeling persists beyond a few weeks, it is worth mentioning to your child's healthcare provider.

Vernix caseosa, a protective coating, is washed off after birth

Vernix caseosa is a waxy, cheese-like coating that covers babies' skin during their time in the womb. It is made up of shed skin cells and sebaceous secretions. It typically shows up around week 19 of pregnancy and continues to thicken until week 34.

The vernix acts as a protective barrier between the baby's skin and the surrounding amniotic fluid, protecting and hydrating the skin. It also helps to reduce friction as the baby moves through the birth canal during delivery. Additionally, it can protect the baby from bacterial infections and may help regulate their body temperature after birth.

While it used to be standard practice to bathe newborns immediately after birth, there is now a growing trend to delay the first bath. This allows the vernix to remain on the baby's skin for longer, providing continued protection and hydration. The World Health Organization (WHO) recommends waiting at least six hours, and preferably 24 hours, after birth before giving the first bath.

The vernix will slowly absorb into the baby's skin, so it can be gently rubbed in during the first 24 to 48 hours. Any excess vernix can be gently wiped away with a soft cloth, along with any blood or amniotic fluid.

By delaying the first bath, you can maximize the benefits of the vernix caseosa for your newborn's skin.

Premature babies tend to have less peeling than full-term babies

It is normal for newborns to experience skin peeling and flaking within the first few weeks of their life. This is because newborns are exposed to dry air for the first time after birth, which can be a difficult transition for their skin. In addition, the protective coating that the baby had in the womb is no longer there, so the outer layer of skin will start to flake.

How to Care for Your Baby's Peeling Skin

If your newborn's skin is peeling, it is important to keep their skin moisturized and protected. Here are some tips to care for your baby's peeling skin:

• Keep baths short (no more than 10 minutes) and use lukewarm water.
• Use a gentle, fragrance-free cleanser instead of soap.
• Apply a hypoallergenic moisturizer to your baby's skin after bathing.
• Avoid chemicals and fragrances in shampoos, soaps, and laundry detergents.
• Keep your baby hydrated with breast milk or formula.
• Protect your baby's skin from the sun and cold, dry air.
• Use a humidifier in your baby's room to add moisture to the air.

It is important to note that you should not pick at or peel your baby's skin, as this could damage healthy skin and introduce bacteria. If your baby's skin becomes very red, raw, swollen, or has a discharge or bad smell, contact your healthcare provider, as this could be a sign of a skin infection, allergy, rash, or condition such as infant eczema.

Bathing newborns in lukewarm water and moisturising can help

Keep bath time short

Long baths can strip the skin of its natural oils, so it is recommended to keep bath time for newborns to a maximum of 5 to 10 minutes, two to three times a week.

Use lukewarm water

When you do bathe your newborn, use lukewarm water, as hot water can dry out their skin.

Moisturise

Apply a hypoallergenic ointment or moisturiser to your baby's skin twice a day, including after bath time. This will help to seal in moisture and keep your baby's skin soft.

Avoid harsh chemicals

Avoid harsh chemicals, perfumes, and scented products, as these can irritate your baby's skin. Choose fragrance-free, soap-free cleansers, and wash your baby's clothes with a detergent designed for sensitive skin.

Keep your baby hydrated

Breast milk or formula will help to keep your baby hydrated, which can reduce dry skin.

Protect your baby from the elements

Keep your newborn out of direct sunlight and dress them in soft, loose-fitting clothes made from natural materials. In cold weather, wrap them up warmly and cover their hands and feet.

Frequently asked questions