Baby Eczema: The Ten Things Every Parent Should Know

Shelley Masini
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    It can be disconcerting to discover that your child has baby eczema, but this skin condition is actually more common than you might suspect. Atopic dermatitis, as it’s clinically known, affects over 13% of all children under the age of 18 in the United States and typically first appears between the ages of six months and five years. In fact, the American Academy of Pediatricians (AAP) reports that 65% of children with baby eczema develop symptoms before the age of one.Given how common baby eczema is and how early on it can affect your child, let’s get you all the information you need so you’re prepared to recognize and manage it.We’ll go over:

    • Causes
    • Triggers
    • Symptoms
    • Itchiness
    • Infection
    • Skin Care
    • Treatment
    • Food Allergies
    • Other Skin Conditions
    • Doctor Supervision

    1. Causes

    First of all, eczema is not contagious. Your child did not get it by someone else with eczema touching them, nor can they pass it on to anyone else.According to the National Eczema Association, atopic dermatitis is “a chronic, inflammatory condition that is a result of an overactive immune system response to triggers inside and outside the body.”What exactly does that mean?Basically, baby eczema tends to run in families with a history of eczema, as well as hay fever, asthma, and other allergies. For children who suffer from it, one of two things happens. Either their skin is having an allergic reaction to something in the environment due to their genetic predisposition, or their skin doesn’t have a sufficient moisture barrier to hold important moisture in and, thus, dries out. Either situation results in red, itchy, inflamed skin that is susceptible to infection and can recur often if not properly managed.

    2. Triggers

    Regardless of your child’s eczema is caused by allergies or a compromised skin barrier, certain triggers will result in what is known as an eczema flare-up. This is when the skin is actively inflamed and itchy. (The rest of the time your child will not have any visible rash.)If your baby has eczema, your first goal is to determine what triggers affect them. Just as adults are allergic or bothered by different irritants, so it is with children. Children have different triggers. Moreover, as they grow, their triggers may change as well.The most common triggers are:

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

    Through careful observation and trial-and-error, you will come to know what your child’s triggers are, which is half the battle in preventing an eczema flare-up.

    3. Symptoms

    The primary symptoms of baby eczema appear during a flare-up and usually appear as a red, inflamed rash that itches...a lot! We’ll discuss the itchiness in more depth next, as that symptom is particular to eczema, but let’s look at the other symptoms here as they can vary.Just like eczema triggers, the symptoms for atopic dermatitis change child-by-child because location and appearance tend to change with age. Per the National Eczema Association, here is a summary of symptoms’ location and an appearance by age range. Learn more about this in our article on symptoms and treatment.AgeTypical LocationsAppearance0 - 6 monthsCheeksChinForeheadScalpRed and weepy patches6 - 12 monthsKneesElbowsAreas easily irritatedMore prone to infection as the areas are irritated = yellow crusting over patches or pus-filled bumps1 - 5 yearsCreases of kneesCreases of elbowsWristsHandsAnklesLichenification may start = dry, scaly, thick, with deep lines running through patches5 years +Creases of kneesCreases of elbowHandsRed and itchy patches

    4. Itchiness

    One of the primary symptoms of a baby eczema rash is that it’s itchy.You may find your baby rubbing the affected area on carpet or bedding in an attempt to get some relief. Unfortunately, itching only makes the rash itchier and, worse, can lead to infection as it creates open wounds allowing germs a way in.Getting a handle on the flare-up will, of course, help with the itchiness; we’ll get to that soon.In the meantime, here are some ways to provide your baby with relief from the itching:

    • Keep baby’s nails clipped
    • Use cotton mittens at bedtime so they don’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 bathwater
    • Dress them in loose-fitting clothes to prevent further irritation
    • Tell them not to scratch and distract them with games & activities...this actually helps!

    5. Infection

    Even if you do safeguard your baby from itching, infection is still a possibility. Eczema skin tends to be dry and will crack, also allowing bacteria, viruses, and other germs to get in.It can sometimes be challenging to distinguish a normal eczema flare-up from one with a secondary infection.Here are some of the signs to help you recognize an infection:

    • The usual treatments won’t work. Either eczema stays the same or gets worse.
    • Eczema may look different, with yellow, orange or honey-colored crusting, blisters, and sores, or even streaks of redness.
    • Your baby may suffer from fever or flu-like symptoms.

    If your child does develop flu-like symptoms with a fever over 100.4, seek immediate medical attention.If you suspect an infection at all, make an appointment with your baby’s physician so the area can be assessed and properly treated. The physician may need to prescribe an oral antibiotic, antiviral medication, or even an anti-fungal ointment.

    6. Skin Care

    The goal will baby eczema is to reduce the number of flare-ups. In turn, this helps prevent everything already discussed: symptoms, itchiness and possible infection.There are two ways to help prevent flare-ups. One you already know! Identifying and limiting contact with triggers. The second, and just as important, is your baby’s daily skincare. This means a daily bathing and moisturizing routine that helps your baby’s skin maintain that all-important moisture barrier against dryness, irritants, and allergens. It should not be skipped, even when no rash is visible.When bathing and moisturizing a child prone to baby eczema:

    • Use a mild cleanser (fragrance-free) and lukewarm water
    • Try to average no more than a 15-minute soak
    • Rinse completely and pat dry
    • Apply appropriate moisturizers (also fragrance-free) or ointments (petroleum jelly products are best) while skin is still damp
    • Moisturize face and entire body twice a day

    Consult the American Academy of Dermatologists (AAD) for their online Eczema Resource Center which includes easy-to-reference guides on how to bathe your child, select a moisturizer, and apply it.

    7. Treatment

    While preventing contact with triggers and maintaining a daily skin-care routine will go a long way in helping to manage your child’s baby eczema, some additional treatment may be necessary. Luckily, there are many medicines, both prescription and over-the-counter, available.Always consult with your child’s physician before using any treatment. They will help identify the best medicine or ointment that will be specific to your child’s age, triggers, as well as the severity and location of your baby’s eczema. They may recommend topical treatments and/or oral treatments, to include oral antihistamines and topical steroids to reduce inflammation and relieve the itching.Many parents are interested in natural remedies, which is understandable. Again, it is important to check with your child’s physician, as children can have allergic reactions to or serious systemic side effects from natural products and herbal remedies.

    8. Food Allergies

    The relationship between atopic dermatitis and food is complicated. For example, not all children who have food allergies will have baby eczema. Similarly, even though this is a distinct possibility a child with baby eczema will develop a food allergy (along with hay fever and/or asthma), not all children with baby eczema will have food allergies, and even those who do may not suffer eczema flare-ups due to those food allergies.A food allergy on its own will show the following symptoms soon after your child eats or touches certain foods:

    • Flushed, red skin or hives
    • Itching on the inside of the mouth
    • Swollen face, lips, or tongue
    • Vomiting and/or diarrhea
    • Stomach cramps
    • Dizziness or lightheadedness
    • Difficulty breathing

    If your child does have a food allergy as well as baby eczema, the next step is to determine if that food allergy causes an eczema flare-up or not. The most common foods linked to baby eczema are cow’s milk, eggs, peanuts, and soybeans. That said, the Journal of American Academy of Pediatrics states that more than 90% of parents “incorrectly believe that food allergy is the sole or main cause of their child’s skin disease.”The only way to know if a specific food does cause a flare-up is to do a “challenge” test. Learn more about this in our recent article on baby eczema and food, and be sure to enlist the help of your child’s physician before conducting a “challenge” test.

    9. Other Skin Conditions

    Though atopic dermatitis is the most common skin condition to affect children, it is far from the only one. In fact, there are many other rashes that can afflict your baby and be mistaken for baby eczema.Here are just a few:

    • Baby Acne: Baby acne is as common as baby eczema, affecting 20% of newborns, and it often appears in the same areas as red or white bumps on the cheeks, nose, and forehead. Unlike baby eczema, it presents at birth or soon after, is not itchy, and will go away on its own after 3-4 months.
    • Milia: This skin condition also appears in tiny white bumps on a baby’s face, though it can also appear on arms and legs and affect children of all ages, not just newborns. It is caused by dead skin flakes trapped under the skin’s surface and usually goes away without treatment after a few weeks.
    • Cradle Cap: Clinically known as seborrheic dermatitis, this is a non-itchy form of eczema thought to be associated with a combination of oily skin and yeast found on the body. It commonly presents on the scalp but can also affect the face, neck, ears, armpits, diaper area or anywhere there are folds and creases in the skin. It appears scaly, yellowish, crusty, and sometimes red, but isn’t painful or uncomfortable. It usually shows up in babies who are 2 weeks to one year old and goes away on its own.
    • Heat Rash: Heat rash affects children who become overheated or exposed to hot or humid weather and is caused by sweat trapped under the skin. It goes away after a few days and is preventable.

    Remember that the most distinguishing characteristic of baby eczema compared to the rashes noted above is that it will always be itchy.Learn more about these skin conditions and others in our recent article, Baby Eczema vs Other Skin Conditions, and consult the Baby Center for a visual guide to all of the conditions described above and more.

    10. Doctor Supervision

    We’ve already touched upon the need to keep in close contact with your child’s physician should your baby have atopic dermatitis. Not only is an official diagnosis needed, especially given the many other skin conditions out there, but your child’s doctor will help monitor the severity of eczema and match the appropriate treatment.Because baby eczema is an ongoing, recurring skin condition, parents will become adept at managing their child’s eczema and preventing flare-ups by using the tools in their proverbial toolkit: identifying triggers, maintaining good skincare, and using recommended or prescribed medicines and ointments. Even still, it’s equally important to know when to seek physician assistance.Make an appointment 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, hay fever, or a food allergy

    There’s a lot to learn about baby eczema, but the more you learn hopefully the more manageable it becomes. Remember that baby eczema is both common and treatable. The key is learning about your baby’s eczema and working together with your child’s physician.For a limited time, enroll in our subscription plan for free! Sign-up before Wednesday and we'll cover the enrollment fee for you!