It is not uncommon for babies to be afflicted with baby eczema, also known as atopic dermatitis. This non-contagious skin condition affects over 10% of children, first appearing between the ages of six months and five years.In our previous article, we explored the causes of atopic dermatitis and provided some general information to help parents understand this common and itchy skin affliction. Here we’ll revisit some common baby eczema symptoms go into more detail on possible treatments.

Baby Eczema Symptoms

If the rash on your baby’s skin doesn’t itch, chances are it isn’t eczema. Eczema is very itchy. It can range from mild, allowing your baby to continue their normal activities, to severe, when they simply can’t control the need to itch!While the itchiness is universal, the other symptoms of atopic dermatitis can vary by child. Baby eczema is usually a dry, red rash, but let’s look at how the location and appearance change with a child’s age. Here is a summary of the symptoms as explained by the National Eczema Association:Birth to 6 months:

• Typically appears on the face or head, most especially the cheeks, chin, forehead, and scalp.
• Red and weepy in appearance.

6 to 12 months:

• It starts to appear in areas that are often irritated, like the knees and elbows, as your baby starts crawling.
• It becomes more prone to infection, which will look like yellow crusting or small pus-filled bumps.

1 to 5 years:

• Moves into the creases of knees, elbows, and wrists along with spreading on to the hands and ankles.
• Lichenification may start. This is when the skin becomes even more dry, scaly, and thick, with lines sometimes running through the patches

5 years and up:

• Can remain in the creases of knees and elbows, or may just appear on the hands.
• Mostly presents as red, itchy patches unless it becomes infected.

Treatment

There is no cure for eczema, but there are ways to manage it and even prevent outbreaks. Treatment is two-fold:

1. Preventing flare-ups
2. Managing flare-ups

Preventing flare-ups

Baby eczema is caused by a combination of genetic and environmental factors. It tends to run in families that suffer from hay fever, asthma, and other allergic reactions. It also affects children whose skin is prone to dryness. In the first case, when the child’s skin comes into contact with an allergen, or in the second case, with an irritant, the immune system has a reaction in the form of an itchy rash on the skin. This is what we call an eczema flare-up.Avoid triggers. A big part of treating baby eczema is knowing what causes your child’s flare-ups and safeguarding them from these allergens and irritants, known as triggers. Here is a list of the most common triggers:

• Pollen
• Animal dander
• Dry air
• Extreme temperatures
• Sweat
• Wool
• Harsh soaps
• Stress

Just as with the symptoms of baby eczema, each child’s triggers are different and will also change as they grow older. Your child’s physician can help you determine what your child’s specific triggers might be.Regardless, it’s a good idea to avoid skin irritants, in general. The American Academy of Pediatricians (AAP) recommends putting your child in soft fabrics, like those made from 100% cotton. They also recommend using a mild laundry detergent with no dyes or perfumes and avoiding fabric softener in the dryer.Maintain a good skincare regime. Proper daily bathing and moisturizing are essential for children with atopic dermatitis. This will go a long way in preventing a flare-up, as it helps maintain the skin’s critical moisture barrier, and should be done even when no rash is visible.When bathing and moisturizing a child prone to baby eczema:

• Use a mild cleanser and lukewarm water
• Try to average no more than a 15-minute soak
• Rinse completely and pat dry
• Apply appropriate moisturizers or ointments while skin is still damp
• Moisturize face and entire body twice a day

When it comes to choosing bath products and moisturizers, you should opt for fragrance-free and petroleum jelly products, like Vaseline.The American Academy of Dermatologists (AAD) has a helpful online Eczema Resource Center that includes many handy guides like the three below which cover how to bathe your child, select a moisturizer, and apply it. Click on each guide to reach a printer-friendly version at the AAD website.

Managing flare-ups

No matter how much you try to protect your child from their triggers, they will inevitably have a flare-up. Dealing with itchiness:First, to provide your child with some instant relief and prevent infection, you need to address the unavoidable itchiness that accompanies baby eczema. The cruel reality is that itching only provides momentary relief and will actually make the area itchier in the long run! It can also lead to infection. Of course, the best way to treat the itchiness is to get the eczema flare-up under control, but in the meantime:

• Keep baby’s nails clipped.
• Use cotton mittens during naptime and bedtime so your baby doesn’t scratch in their sleep.
• Apply cold compresses (to be followed immediately by moisturizer).
• Add colloidal oatmeal (found at most health and beauty stores) to their bath water.
• Dress them in loose fitting clothes.
• Distract them with games and activities.

Medicines & remedies:Depending on the severity and location of your baby’s eczema, your child’s doctor may prescribe or recommend various medicines or ointments. There are topical treatments and oral treatments, as well as over-the-counter and prescription versions of each. It’s not uncommon for your baby’s physician to recommend topical steroids to reduce inflammation and relieve the itching. They may also try oral antihistamines.  Working together with your child’s physician, you can find a successful treatment specific to your child’s age and triggers, as well as the location and severity of their eczema.  For parents who are interested in natural remedies, a word of caution from Dr. Anna Bender, a pediatric dermatologist at Weill Cornell Medicine and New York-Presbyterian quoted in The Bump: “Even natural products have the potential to cause a worsened rash called contact dermatitis, so check with your doctor first before applying something new to your baby’s skin.” For example, tea tree oil can cause an allergic reaction and herbal remedies can have serious systemic side effects.

When to see the doctor:

Even if you feel confident in managing your baby’s flare-ups, it’s always a good idea to keep in touch with your child’s physician. Not only do you want to keep them apprised of the condition, but you will want to consult with them immediately if any of the following should occur:

• The rash persists and doesn’t get better
• The rash changes in appearance or becomes infected
• Your baby develops a fever or any secondary conditions, like asthma

Hopefully, this article helps you to recognize the symptoms of baby eczema and reassures you that there are many ways you and your child’s physician can help prevent and treat flare-ups. Use this handy one-page Eczema Action Plan from the AAD to help manage your baby’s eczema treatment and contact the 24/7 Blueberry Pediatric Team with any concerns or questions.