If you’ve noticed your baby’s skin is a bit more sensitive, dry, or rashy than usual, it could be baby eczema. Understanding what causes this skin condition and how to treat it can help you soothe your baby’s skin and keep them comfortable. Let’s explore the world of baby eczema.
Estimated reading time: 7 minutes
Table of contents
What Is Baby Eczema?
Eczema (atopic dermatitis) is a fairly common skin condition in babies and young children, with one in ten children being affected. It is characterized by dry, itchy, and inflamed patches on the skin. Baby eczema often appears on the face, scalp, elbows, and knees.
These pictures in this article are of one of my sons when he had an eczema flare up between the ages of 4 to 5 months old. He dealt with some degree of eczema throughout his childhood, though never as extreme as when he was a baby. Now, as a teenager, he occasionally develops patches of eczema on his forearms or the crook of his arm. I share this so that you can have some hope if your baby is struggling with eczema. It will very likely improve over time!
Causes of Baby Eczema
Eczema is often a multifactoral condition, meaning that it’s caused by a combination of genetic, environment, and other factors. Here are a few of the most common theories for the causes of eczema:
Lack of Fillagrin: Eczema may be caused, at least in part, by the lack of a specific protein called filaggrin, found in the outermost layer of the skin. Fillagrin helps form a protected barrier on the skin’s surface that retains moisture and keeps bacteria and irritants out of the body. Unfortunately, some of us are born with a genetic mutation that can affect the production or function of filaggrin. This leads to a weaker skin barrier and skin that is prone to dryness, irritation, and eczema.
Environmental Triggers: Various external irritants like soaps, detergents, fragrances, as well as allergens like dust mites, pet dander, pollen, and certain foods can all contribute to baby eczema.
Immune System Response: Eczema can also be related to an overactive immune system response to harmless substances, leading to skin inflammation.
Microbiome: The balance of microbes on the skin can also play a role. Certain bacteria, like Staphylococcus aureus, are found in higher quantities on skin with eczema and can worsen the condition.
Climate and Weather: Dry, cold air in the winter often aggravates eczema, as does frequent sweating in warmer weather.
What Are the Symptoms of Baby Eczema
For most babies, eczema shows up in the first six months. It usually appears first on the cheeks, often spreading to other areas of the face, head, and outer arms and legs.
Some characteristics that set it apart from other common rashes are:
- Eczema is always itchy
- It is red and may even look raw and weepy
- In babies, the rash often appears the same on both sides of the body. For example, you might see similar rashes on both cheeks, both elbows, or both knees.
- Eczema is not usually found in the diaper area
- May appear as thickened, cracked, or scaly skin
Factors That May Trigger An Eczema Flare-Up
Environment and Eczema:
- Heat and Sweat
- Insect Bites and Stings
- Specific Foods
- Wool, Synthetic fibers, or any clothing or material that is rough or scratchy
- Dry Air
- Herpes Virus (cold sores)
Food Allergies and Eczema:
Food allergies have been found to be a factor in 30% of children with severe eczema. If you suspect a certain food is triggering your child’s eczema, there is a fairly simple experiment you can try to determine whether it is indeed a factor.
First, remove the suspected trigger food from your child’s diet for two weeks. During this time you should see an improvement in the eczema flare-ups. After the two weeks is over, reintroduce the food and watch for a reaction. You should see a reaction within two hours of the feeding. If the eczema becomes red, inflamed, and/or itchy, then you can assume it is causing a reaction. In the future, avoid giving that food to your baby and talk with your child’s doctor about formal allergy testing and nutritional substitutions if needed.
Eczema and Skin Infections:
Because children with eczema don’t have a strong skin barrier, germs and bacteria that normally live on the skin are better able to get through and cause infection. Scratching exacerbates this problem by irritating the skin further and introducing virus and/or bacteria under the skin.
If you see the signs of infection on your baby (scabbing, oozing, blisters, yellow crusting, pus, and/or a rash that won’t go away) contact your pediatrician. They may need to prescribe an antiviral or antibacterial medication to treat the infection.
Treatment for Baby Eczema – How You Can Help
Because eczema is so itchy, it can cause significant discomfort for your baby, especially if they scratch or if they are unable to sleep due to the itchiness or pain. There is no cure for eczema, but there are several things you can do to alleviate symptoms and help make your baby more comfortable.
1. Keep your Baby’s Skin Hydrated
- Don’t over-bathe your baby
- Use warm, not hot bath water
- Use only fragrance-free, hypoallergenic cleansers to wash the specifically dirty parts of your baby (armpits, neck, genitals, etc)
- Pat your baby dry after the bath, rather than rubbing with a towel
- Apply any medication or topical ointment first, followed by a moisturizer right after the bath, even if/when the skin clears
- Dress your baby in soft clothing, washed in fragrance-free detergent
2. Help Control the Itchiness
- Implement a skin care routine that is as gentle as possible
- Keep your baby’s nails cut short and kept clean
- Put socks over their hands, especially while they sleep to prevent scratching
- Apply wet wraps to alleviate itchiness and moisturize dry skin
TIP: An Easy Way to Apply “Wet Wraps”
- First bathe your baby and apply and medications and/moisturizers to the skin
- Soak a onesie or pair of pajamas in water, then wring it out
- Put the damp clothes on your baby and layer with dry pajamas over the top
- Leave the damp clothes on for at least 30 minutes
- Keep your baby warm during this time
3. Heal the affected skin
- Talk to your child’s doctor to determine the best method to heal the skin and control flare-ups
- Both topical steroids and non-steroid medications are available depending on the area and severity of the Eczema
4. Prevent Infection
- Talk to your child’s doctor if you suspect that your child has an infection. They may require an antiviral or antibacterial medication.
- Giving your baby a diluted bleach bath may help kill the germs and bacteria on his or her skin that could potentially lead to infection. Consult with your pediatrician or dermatologist before attempting a bleach bath.
How To Give Your Baby A Diluted Bleach Bath
- Add plain bleach to a full tub of lukewarm bath water (Use 1 tsp of bleach for every gallon of water)
- Do not use splash-free or scented bleach!
- Let your child soak in the water for 5-10 minutes
- Rinse the bleach water off completely
- Apply a moisturizer directly after the bath
Dealing with eczema can be challenging, but with the right care and treatment, most babies find relief. Understanding your baby’s skin needs and responding with gentle care can make a big difference.
(1) Schmitt, B. (2020). Eczema. American Academy of Pediatrics. https://www.healthychildren.org/English/tips-tools/symptom-checker/Pages/symptomviewer.aspx?symptom=Eczema
(2) Stein, S. (2020, March 6). Eczema in Babies and Children. American Academy of Pediatrics. https://www.healthychildren.org/English/health-issues/conditions/skin/Pages/Eczema.aspx
(3) Stein, S. (2020, March 6). How to Treat & Control Exzema Rashes in Children. American Academy of Pediatrics. https://www.healthychildren.org/English/health-issues/conditions/skin/Pages/How-to-Treat-and-Control-Eczema-Rashes-in-Children.aspx
(4) Osawa R, Akiyama M, Shimizu H. Filaggrin gene defects and the risk of developing allergic disorders. Allergol Int. 2011 Mar;60(1):1-9. doi: 10.2332/allergolint.10-RAI-0270. Epub 2011 Dec 25. PMID: 21173567.
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