Your Questions About Baby Eczema—Answered
Chances are, you’re already babying baby’s skin. Most parents know that new skin is delicate: ripe for baby acne, cradle cap, rashes and more. But figuring out exactly what you’re dealing with can be a real head-scratcher, and that’s especially true if baby’s skin issues appear to be eczema—an often intensely itchy rash that can cause discomfort, scratching, fussing and even trouble sleeping. (Sounds fun, right?) But have no fear: We talked to an expert to answer some common questions about baby eczema, including how to keep flare-ups at bay.
While there are a few types of eczema, the one that affects children the most is atopic dermatitis (AD). Atopic means baby likely has a heightened immune response to common allergens and dermatitis simply describes a skin irritation. “This is a chronic, but not contagious, condition in which the skin appears inflamed, red, itchy and dry,” says pediatric dermatologist Stephanie Jacks, MD, a committee chair for the Society for Pediatric Dermatology. AD is fairly common—affecting 13 percent of American children—but not every dry patch you spot is eczema.
Eczema can appear at any age, but the majority of children are diagnosed between infancy and age 2, with 3 months old being the sweet spot for the condition to develop. (Way to pile on the new mom anxiety, right?) While eczema’s symptoms differ from child to child, there are some telltale signs, like redness, itchiness, super-dry or scaly skin, plus weepy sores thanks to excessive scratching. “The itch can start before you even see a rash,” says Jacks. When the rash does appear on infants, it’s usually as dry, red, rough patches on the cheeks and around the mouth, and it’s often made worse by drooling. Later on, crawlers can get it on their constantly in-motion elbows and knees. As baby grows to preschool-age, the rash may migrate to folds like inside the elbows, behind the knees and around the neck. If baby’s rash is in another area, it may be allergic contact dermatitis, meaning an allergy to soap, shampoo or lotion might be the culprit. To confirm if baby’s skin issue is eczema, always consult your pediatrician or dermatologist.
It could be family history, it may be due to environmental influences, or both. There’s no one cause of eczema, but experts do know that the skin barrier is part of the issue. According to the American Academy of Pediatrics (AAP), many children with eczema don’t have enough of the protein filaggrin in the outer layer of their skin. This protein helps maintain a strong barrier between the body and the environment. “When this barrier is weakened, the skin loses moisture more easily, making it prone to dryness and irritation,” says Jacks. “The immune system in the skin may also be overly sensitive to environmental triggers such as pet dander or dust mites.” Eczema also runs in families and often goes hand in hand with asthma, food allergies, and/or seasonal allergies.
So, bad news first: There is no cure for eczema. But the good news is: 1) Children may grow out of it (woo-hoo!), and 2) there are many effective treatments. In fact, “most children will respond well to consistent moisturization,” Jacks says. “Apply moisturizer all over at least twice a day, but especially after a bath.” You shouldn’t use just any lotion, however. Jacks recommends avoiding the popular baby-scented options in favor of a thick, fragrance-free cream or ointment that provides more moisture and protection than typical lotions. (Heads-up: Unscented is not the same as fragrance-free.) Consider a gentle option like Eucerin® Baby Eczema Relief Cream, which is free from fragrances, dyes and steroids. It also contains colloidal oatmeal, a skin protectant and proven itch reliever recommended by the National Eczema Association (NEA); ceramides (waxy fat molecules) that work to support the skin’s barrier; and licochalcone, a soothing, natural extract from the licorice root.
For more severe cases, topical medications or stronger meds may be needed too. “Over-the-counter hydrocortisone ointment can be a good place to start,” says Jacks. “But the most commonly used medications for eczema are topical steroids.” These prescription meds are for short-term use only and, when used correctly, are safe and effective.
Gentle skin care is key. Give short 5- to 10-minute baths in lukewarm water, concentrating on cleaning baby’s dirtiest bits, like the neck, armpits, groin, hands and feet. (While baths are typically recommended just two to three times a week, babies with eczema should get a quick wash daily or every other day.) “Always use a gentle, fragrance-free cleanser,” says Jacks, noting that soap is too harsh and drying for baby’s delicate skin. One to consider: Eucerin® Baby’s new Eczema Relief Cream Body Wash, which is soap-, fragrance-, dye- and tear-free. Plus, it contains ceramides and itch-fighting skin protectant colloidal oatmeal—some of the same key ingredients as their eczema relief cream.
After bathing, lightly pat skin dry, leaving it a bit damp to allow for better absorption, then immediately apply your moisturizer of choice. The NEA suggests applying with your palms, lightly stroking downward. Once you’re done, wait a few minutes to let the cream absorb into the skin before dressing baby.
The signature itch of eczema is no joke, and keeping it at bay is critical to help baby feel better, sleep better and stave off scratching. You see, eczema flares often prompt what’s dubbed the “itch-scratch cycle.” Here, the itch leads to scratching, which activates an inflammatory response, which, you guessed it, leads to even more irritated, itchy skin. In addition, all of that scratching can open up sores, cause skin infections and increase skin barrier damage.
To stop the cycle, moisturize regularly and try baby mittens at bedtime. (If you’re using a topical steroid cream, apply that first and then cover with moisturizer.) Jacks also recommends trimming baby’s nails and opting for cotton baby clothes. “Polyester and synthetic fabrics don’t breathe as well and may lead to more scratching,” she says.
“Every child with eczema is different and what triggers their flare-ups can vary greatly,” Jacks says. But fragrances, soaps, pollen, animals, wool, dry air and certain foods are often culprits. “Parents need to pay attention to baby and what seems to make the skin react,” says Jacks. For instance, if baby has a flare where seams or tags touch the skin, you know rough clothing is a likely trigger. If there’s redness and swelling around baby’s mouth or if the rash worsens within two hours of eating, a specific food may be the offender. While it’s possible to help prevent eczema flares, Jacks stresses that you can’t “cure” eczema by removing triggers. “Eczema tends to come and go with intermittent flares even if all triggers and allergens are avoided,” she says. “However, by following a good skin care regimen, you will likely reduce the frequency.”
Daily use of Eucerin® Baby Eczema Relief regimen can help prevent flare-ups.
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Please note: The Bump and the materials and information it contains are not intended to, and do not constitute, medical or other health advice or diagnosis and should not be used as such. You should always consult with a qualified physician or health professional about your specific circumstances.