What Causes Eczema in Babies?

Shelley Masini
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    Although baby eczema is one of the most common skin conditions to occur in children under the age of 10, it can be very upsetting when it first appears on our baby’s beautiful, new skin. And even if we suffer from eczema as adults, it’s important for us to learn how eczema affects children, so we’re better prepared to support our little ones with this very particular form of skin condition.Let’s tackle a stream of potential questions on this itchy affliction.

    First of all, what exactly is “baby eczema?”

    The term “eczema” is really an umbrella term for various conditions that cause the skin to become red, itchy and inflamed. While there are many types of eczema, when we refer to “baby eczema” we are most commonly referring to atopic dermatitis. This is a recurring inflammation caused by an overactive immune system. In other words, something in the child’s environment triggers their immune system and the skin has a reaction to it...again and again and again.

    But how do they get it?

    First of all, eczema is not contagious. Your child did not get it from another child or touching a surface or animal. And you cannot get it from your child. No, baby eczema is a result of a genetic predisposition and environmental triggers. Eczema tends to be hereditary, or run in families. Many children who have it come from a family with a history of eczema, as well as hay fever and asthma. Angelica, mother of a boy and a girl, two years apart, reports that both her children developed baby eczema. When she saw it on her son, the older of the two, she said, “I didn’t freak out because I knew what it was from my own experience with eczema.” For children who suffer from atopic dermatitis, either their skin is having an allergic reaction to an environmental trigger due to this hereditary predisposition, or there is a problem with their skin’s natural moisture barrier so that instead of holding moisture in, it loses moisture and dries out, resulting in irritation and infection.

    How common is baby eczema?

    The National Eczema Association reports that 13% of children under 18 in the United States are living with eczema.  It typically appears in children in the first six months to five years of age. In fact, according to the American Academy of Pediatricians (AAP), “about 65% of patients develop symptoms before age 1, and about 90% of them develop symptoms before age 5.” Angelica’s son got it when he was about 8 months old. “For my daughter, it was closer to one year old.”

    Can you cure it or prevent it from happening?

    There is no cure for eczema, and there are no certain ways to prevent eczema from making its first appearance. The Mayo Clinic reports on some evidence that taking probiotics during pregnancy, as well as breast-feeding and using petroleum jelly products (like Vaseline) on your baby’s skin after birth may reduce the risk of the eczema rash from developing, but research is still inconclusive.The good news is that while atopic dermatitis can’t be cured, most children tend to outgrow it at some point, often before the age of four. And for those few who continue to have eczema throughout their lives, there are many treatments to help control and manage flare-ups.

    What’s a “flare-up”?

    Remember that word “recurring?” Baby eczema comes and goes. When the skin becomes irritated by a trigger there will be what is called a “flare-up,” when the skin gets red, itchy and inflamed. Then with treatment and attention, it will typically get better and resolve in about a week.The goal with baby eczema is to reduce the number of these flare-ups. Dry and irritated skin tend to be more prone to flare-ups. By keeping the skin moisturized and providing that critical moisture barrier, while at the same time, avoiding irritants and triggers, flare-ups can be minimized helping your baby’s skin stay healthy and comfortable. Here is a list of the most common triggers:

    • Dry air
    • Scented soaps
    • Pollen
    • Animal dander
    • Food
    • Stress
    • Sweat
    • Extreme temperatures

    Most important when it comes to triggers is learning your child’s specific triggers. Triggers are not the same for all children and will also change as each child grows. Consult with your child’s physician often. They will be able to help identify allergens and irritants that may trigger a flare-up.

    What does baby eczema look like?

    Baby eczema can appear suddenly and in various locations. Where and how it appears tends to change with the age of your child. “Over the years,” Angelica continues, “the eczema flare-ups would look different and appear in new locations. At one point, I thought it was ringworm based on the shape as it appeared on my son's skin.”When baby eczema first appears, it is typically on the face or head and occurs in red, weepy patches. As your child grows it will start to affect areas that are easily irritated, like the knees and elbows when they start crawling, and the creases of the knees and elbows, where sweat can cause irritation. The eczema may also take on a more dry, scaly and thick appearance.

    How do I help my baby when they have a flare-up?

    As already mentioned, the best way to help your baby is preventing flare-ups by knowing and limiting their contact with triggers while also maintaining a daily bathing and moisturizing routine to help maintain a healthy moisture barrier.But inevitably your baby will have a flare-up. Thankfully there are many topical and oral treatments, some medicated and some natural. What you use will depend on the location and severity of the eczema, and your child’s physician will be able to help you determine the best course of treatment for your baby’s age and particular outbreak. We will go into more detail on symptoms and treatments in the next article.

    When should I talk to my baby’s doctor?

    First and foremost, baby eczema needs to be properly diagnosed by your child’s physician, as there are other skin rashes and conditions that can easily be mistaken for it. As your child lives with eczema you will become familiar with its cycles and outbreaks, so that if there is a change to triggers, location, or severity you’ll know it’s time to consult the doctor.  Once your baby is diagnosed with atopic dermatitis, here is a list of good reasons to contact your baby’s physician:

    • The rash starts to look discolored, crusted over, weepy (if not typically weepy), or blisters develop
    • Your baby has a fever with the rash
    • The flare-up doesn’t go away after a week
    • You want to try any new treatments
    • Your baby develops secondary conditions like asthma or hay fever

    Baby eczema, or atopic dermatitis, is an uncomfortable condition for your child, but it is not uncommon nor unmanageable. By learning about this skin condition and staying tuned into your child’s environment and flare-ups you’re taking important steps to help relieve their discomfort and keep their beautiful new skin healthy.Always consult with your child’s physician or our 24/7 pediatric team if you have concerns about this or anything else.