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Expert Q&A:
What can I do about my 14-month-old's swollen, dry thumb?

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Answered by Anthony Mancini M.D.
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Dr. Mancini received his undergraduate and medical educations at the University of Arizona, and trained in pediatrics, pediatric dermatology, and dermatology at Stanford University. He is currently Associate Professor of Pediatrics and Dermatology at Northwestern University's Feinberg School of Medicine and Head of the Division of Dermatology at Children's Memorial Hospital in Chicago, Illinois.



Dr. Mancini has served as a member of the AAP Executive Committee, Section of Dermatology since 2001. He is a member of the AAP Super CME Planning Group and the AAP Pedia Link Pediatric Dermatology Project Team, and is Secretary-Treasurer of the Society for Pediatric Dermatology. His teaching accomplishments include the Faculty Excellence in Education Award from the Department of Pediatrics at Northwestern, which he has received for the last eight years. Dr. Mancini is a peer reviewer and/or sits on the editorial board for several academic journals, and has published over 75 peer-reviewed articles, abstracts, and book chapters. He is co-author of Hurwitz Clinical Pediatric Dermatology, 3rd edition, and is an associate editor for the comprehensive dermatology textbook Dermatology. His special interests include infectious skin diseases and exanthems of childhood, vascular malformations and hemangiomas, and neonatal skin maturation and skin disorders.



Dr. Mancini is a Fellow of the American Academy of Pediatrics and the American Academy of Dermatology. He and his wife, Nicola, a neonatal intensive care nurse, have three children (Mallory, Christopher, and Mackenzie) and reside in Evanston, Illinois.
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Question


What can I do about my 14-month-old's swollen, dry thumb?

Answer


Repeated cycles of moisture followed by evaporation of that moisture leads to excessive drying, redness, and cracking of the skin. Obviously, the ideal "treatment" of your son's condition will occur naturally when he stops the thumb-sucking behavior. In the meantime, keep the thumb well moisturized with a thick moisturizing cream, and be sure to see his doctor if there are any scabs, oozing areas, or pus bumps, which could represent secondary infection with bacteria or yeast. You could also try to substitute a pacifier for the thumb, an option that works for some children but not others. Use of the pacifier can then be gradually weaned as desired.
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