Eczema is often seen in young infants. Since every parent wants their child to look like an Anne Geddes photo, you can imagine how often babies with eczema are brought into the office! In infants under 2 months of age, seborrhea is often confused with eczema. Seborrhea present with oily scales, often on the face and scalp (where it is called "cradle cap"), tends to resolve on its own or responds to mild oils or lubricants. Eczema, or atopic dermatitis, consists of red, dry patches seen on the cheeks and bodies of infants and in the creases of arms and legs in older children. There is often a family history of eczema, allergies, and asthma. It is important for parents to discuss these issues with their pediatrician as the key to successfully treating eczema in children is not only treating the symptoms, but preventing the outbreaks as well.
The first line of treatment for eczema is moisturizing the skin. Limiting bathing, which washes away the body’s natural oils, is the initial step. Emollients, usually petroleum-based, are used to decrease dryness and can help prevent the discomfort seen with cracked, red skin. In more severe cases, low-dose anti-inflammatory ointments can be used, the most common being hydrocortisone ointments. These have a steroid base and are available in low doses over the counter and in higher concentrations through a prescription from your pediatrician. Care must be taken with these ointments as overuse can cause complications such as thinning of the skin. Triggers should also be investigated and may consist of laundry detergents, foods, and environmental exposure.
The typical course of eczema is significant improvement in the first year, with continued improvement over the first few years. Rarely, children with severe eczema are referred to the dermatologist where research is being done on the use of immune system modulators. Thankfully, it is the rare child that needs more than fewer baths and some petroleum jelly!