Top Testers' Clinic with Dr Philippa Kaye: Treating keratosis pilaris, checking moles and stopping a hair pulling habit

A: "Keratosis pilaris is a condition where there are small bumps on the skin, most often on the upper arms and legs. This is due to a build up of keratin in the skin and tends not to be itchy. Has a doctor seen your child’s skin and diagnosed them with this condition? If not please do take them to the doctor as there are various other skin conditions which can cause bumps and rashes so do get them checked out.

"Keratosis pilaris is not infectious and you may notice that it is better at certain times and worse at others, for example often worse during the winter months. Avoiding washing with perfumed soaps and other products which dry out the skin and apply a simple emollient, which are available over the counter from your pharmacy or supermarket." Dr Philippa Kaye

Checking a child's moles

Q: "I have a question regarding moles on children. My son has a few and I was wondering what I should be looking out for. Is the location of the moles a concern or only if the shape, texture or colour were to change? Also as the child grows will the moles?" Celia Aldridge

A: "Doctors tend to advise on the ABCDE rule when looking at moles:

A – asymmetry – moles that look asymmetrical, should be checked. You should be able to imagine that you could fold a mole in half and the two halves look similar, if they don’t see your doctor.

B – borders – if the border of a mole begins to look irregular, ragged, blurred, notched or as if one part of it is growing in a different direction, please get checked.

C – colours – if the mole has two or more colours please see a doctor.

D – diameter - if a mole is over 6mm it should be assessed.

E – evolving – if a mole is changing in any way, including if it becomes itchy, bleeds, is crusty or becomes numb see your doctor.

Sometimes moles grow as the child grows, but sometimes not meaning that although they stay the same size they may look proportionally smaller as the child gets bigger. If you have any concerns please get them checked and don’t forget the sun cream to protect your child’s skin." Dr Philippa Kaye

Breaking a hair pulling habit

Q: "I would love any advice you can give on how to stop my daughter from pulling her hair out on one side (she sucks her fingers with her other hand). She twirls the hair around her fingers then passes it to her other hand and sucks on it. Occasionally we find hairs in her poo. We know it’s a habit and she does it for comfort. Our health visitor and GP say the best way is to distract her. We are trying, but it only helps so much and she does it most at night for comfort if she wakes up when we aren’t there. She is now 2 1/2 and has been doing it since her hair started to grow. Any further advice would be great - thank you." Kate Elizabeth

A: "Trichotillomania is a condition where there is an irressitable urge to pull out your own hair, which may be the hair on your head or your eyelashes or eyebrows. Here the urge to pull out the hair cannot be ignored and pulling on the hair gives relief from the tension. It can be related to stress and anxiety and doesn’t tend to start in children until about 10 years old. You mention that your child is much younger, and that it started when her hair started to grow and that it is a habit perhaps for comfort.

"Distraction can help as has been suggested, perhaps by encouraging her to play with a doll’s hair instead of her own, or have something else like a fidget of some kind that she can twirl in her fingers. If she likes the sensory stimulation then a variety of soft fabrics or ribbons may be helpful as an alternative. Putting her hair up at night so she can’t get to it easily, or even wearing a hat may be helpful as can wearing gloves or socks over their hands at night so they can’t pull. If you notice there are particular times that it happens more than others, for example before bed, then it might be better to focus the distraction around that time. Try not to tell her off or focus negative attention on the behaviour and if you continue to have concerns please go back to your doctor." Dr Philippa Kaye

Please note: this advice is not personalised or meant to replace individual advice given to you about your child by your doctor or medical team. As always, if you are concerned about your child’s health then please seek medical advice.

Read more:

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