Newborn Skin with Dr. Susan Primmer (Pedcast)


Dr. Paul Smolen here, your pedcast host now for 4 years running. Welcome to a very special edition of We are very fortunate to have my good friend, colleague, and kid-skin expert, dermatologist Dr. Susan Primmer, returning to share her wisdom and experience with us today. Your in for a treat. She is double board certified in pediatrics and dermatology and has over 30 years of clinical experience. Need I say more? Welcome Dr. Susan Primmer.  I’ve got some strange questions for you today Sue;


Question 1: Why do newborns smell and feel so good? They have a distinctive smell, don’t they?

Dr. Primmer: Because of the micro biome they carry. Epidermis thinner. Skin barrier breaks down easier allowing penetration of irritants easier however.



Question 2: Why do babies get those raised red spots people call strawberries? Are they really pieces of the placenta?

Dr. Primmer: Maybe to the placenta stuff. Mention that usually only a problem if they are in vital areas like around the eye or in an airway. Also syndrome of internal and external. Mention propranolol treatment. Many leave a faint remnant.


Question 3: Why do so many babies get a rash all over just after birth? Are these really hives and if they are, why do they get this rash. Does it mean anything?


Dr. Primmer: No one really knows. Some think that it is the baby’s reaction to food that is new for them. Some think this might be an immune reaction to bacteria that now inhabits their skin. One thing we know is that premature babies don’t get them, possibly because their immune systems are too immature.


Question 4: What is different about a premature baby’s skin from a term baby’s skin.


Dr. Primmer: Thinner, poorer insulation for heat and water loss, more easily torn, more permeable to things that touch it. Practical advice; should especially avoid premies touching shampoos, wipes, moisturizers with lactic acid, and clothes that contain aniline dyes.


Question 5: Why do dermatologists believe babies have those distinctive marks on their face and eyelids nevus flamus (spelling?) and mongolian spots on their backs?

Dr. Primmer: We don’t know.

Dr. Smolen: the Doc Smo theory.


Question 6: What is the physiologic reason newborns get acne and why does it predictably break-out between 1-2 months of age.

Dr. Primmer: Acne is a hormonally driven rash. Pregnancy and delivery are all about sex hormones. Presumably, exposure to high levels of these hormones stimulate the oil glands in newborns to function like a teen…hence acne. Some babies have oil glands that are more sensitive to these hormones.


Question 7: What is vernix and what is it’s function?  Should we be washing it off so quickly?


Dr. Primmer: Some think not. Protective function and helps with thermoregulation…temperature control, moisturize the skin, protect the skin from infection, lubricate baby during birth. Some think that the baby should not get a bath for 24 hours to let the vernix work.


Question 8: Dr. Primmer. You have been caring for newborns and infant’s skin for over 30 years. What is your best advice for parents who have a new baby with regards to the baby’s skin care?


Dr. Primmer:

       -Use as little soap as possible…removes the good bacteria from the baby’s skin and changes the pH.

       -Don’t use wipes if possible

       -Cleanse with a soft cotton cloth




Another great pedcast with Dr. Susan Primmer. The children of NJ are lucky to have you Sue. I love to listen to your wit and wisdom. Thanks for sharing it with us. Please come back soon. You know you are always welcome here.


This is Dr. Paul Smolen, bringing you more portable, practical, pediatrics. Please make listening or reading to a regular part of your week. Go ahead and subscribe at to get an email notice when new content is posted or sign up on my iTunes page and subscribe there. Where else can you get a free pediatric education on your schedule and a few laughs to boot? AND.. I’m proud that my first book called “Can Doesn’t Mean Should, Essential Knowledge for 21st Century Parents”, just came out and is available at Amazon, iBooks, Barnes and Noble as well as many fine bookstores. Please check it out and write a review. I know that after reading it, you will be the best informed parent in the room unless your in a room with other parents that have read my book. Thanks for joining us. Until next time.