Ichthyosis at birth: what parents should know

A baby may be born with a shiny, tight membrane, peeling skin, or widespread thick scaling. These appearances can occur in inherited ichthyosis and in related newborn skin conditions, so appearance alone does not establish the exact type. A neonatologist or dermatologist can examine the skin, eyes, mouth, and flexibility, then decide whether genetic assessment is useful.

Newborn skin can lose moisture readily. Tight or shedding skin may also make temperature control, feeding, movement, and closing the eyelids more difficult. The team will assess the whole baby rather than treating the scales in isolation.

Follow the hospital team’s plan for warmth, hydration, bathing, and prescribed moisturising. Use only products recommended for a newborn; avoid scraping scales, fragranced products, essential oils, and adhesive dressings. Keep nails short and handle peeling areas gently. Ask how often to apply the recommended emollient and how to protect the eyes if the lids do not close comfortably.

After discharge, keep follow-up appointments even when the surface looks calmer. A written routine can help caregivers track skin changes, wet nappies, feeding, and temperature.

Contact the newborn team urgently for poor feeding, fewer wet nappies, unusual sleepiness, fever or low temperature, breathing difficulty, increasing redness, pus, blisters, or skin that becomes painful. Seek prompt help if the baby cannot close the eyes, seems dehydrated, or is difficult to wake.

Which form of ichthyosis is suspected? Which moisturiser and bathing routine are suitable? How should we check hydration and temperature at home? When should the eyes, ears, or joints be reviewed? Would genetic counselling help our family?