What Are The Symptoms Of Atopic Dermatitis In A Child
Symptoms may come and go, or occur most or all of the time. Any area of the body may be affected. In babies, symptoms usually affect the face, neck, scalp, elbows, and knees. In children, symptoms usually affect the skin inside the elbows, on the back of the knees, the sides of the neck, around the mouth, and on the wrists, ankles, and hands.
Symptoms can occur a bit differently in each child. They can include:
Dry, scaly skin
Pale skin on the face
Small, raised bumps that may become crusty and leak fluid if scratched
Rough bumps on the face, upper arms, and thighs
Darkened skin of eyelids or around the eyes
Skin changes around the mouth, eyes, or ears
Raised, red areas
The symptoms of atopic dermatitis can be like other health conditions. Make sure your child sees his or her healthcare provider for a diagnosis.
Causes Of Eczema In Babies
Although the cause of eczema isnt completely understood, up to 10% of babies and toddlers have it. If you have a family history of eczema, asthma, or hay fever, your baby may be more likely to develop it. Eczema in adults may not look the same in a child, which is why identifying symptoms and triggers is important to protect your babys skin. Triggers of eczema in babies may include the following:
- Many soaps, disinfectants, and fragrances can make eczema worse for your babys skin.
- Common products that may cause flare-ups include detergents and dryer sheets, bubble baths and some shampoos, disinfectants such as chlorine, dyes, and coarse fabrics such as wool and other rough materials.
- Typical allergens such as dust mites, pet dander, pollen, and mold can cause itchy, inflamed skin. Eczema is not an allergic reaction to a substance, but allergens or irritants in the environment can trigger it.
- Make your home an allergy-free zone by vacuuming and wet dusting frequently and keeping soft toys to a minimum and washing them often. Groom pets regularly.
- Extremes in temperature and humidity may trigger an eczema flare-up.
- Environmental triggers include very hot or very cold temperatures, high or low humidity, cigarette smoke, and pollution.
- Keep your babys bedroom temperature between 68 F and 72 F and maintain even humidity in your home.
- Use a humidifier if the air in your home is dry.
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What Can Make It Worse
Each baby is different. But there are some common eczema triggers to avoid, including:
Dry skin. It can make a baby’s skin itchier. Low humidity, especially during winter when homes are well-heated and the air is dry, is a cause.
Irritants. Think scratchy wool clothes, polyester, perfumes, body soaps, and laundry soaps. These can all trigger symptoms.
Stress. Children with eczema may react to stress by flushing. That can lead to itchy, irritated skin. And that, in turn, ramps up their eczema symptoms.
Heat and sweat. Both can make the itch of infant eczema worse.
Allergens. Itâs not certain, but some experts believe that removing cowâs milk, peanuts, eggs, or certain fruits from a childâs food may help control eczema symptoms. Remember that your baby can get exposed to these foods if their mother eats them before they breastfeed. Find out the connection between food and eczema flares.
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Will My Child Ever Outgrow Eczema
A common question amongst parents is: will my child ever outgrow eczema? The normality is that the severity of eczema can be outgrown and usually is. In most cases, dry skin will remain with the individual into adulthood. Other health-related issues tied to eczema such as asthma could also be something that follows into adulthood.
I personally feel like Ive outgrown eczema, but I still have tons of eczema like symptoms I deal with. As a child, my eczema was extremely bad and most of the time not tolerable. I noticed as my teenage years came that my eczema got better. I think based on research and my own experiences many eczema sufferers will outgrow the extreme side of things but may never be able to get rid of it completely. The key is to keep a consistent treatment routine, and it all starts when you are a child.
What Can Trigger My Babys Eczema Flare
- scented soaps, bath and skincare products, laundry detergents and dryer sheets
- synthetic or woollen fabrics, or clothes made using certain dyes
- environmental allergens such as pets, pollen and household dust
- food allergens such as milk, egg, wheat, soya and peanuts
- unusually hot conditions that can cause overheating or excessive sweating, or during the winter when its cold and humidity is low.
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Wear Gloves To Protect The Skin On Your Hands
Wear vinyl or plastic gloves for work that requires you to have your hands in water. Also, wear gloves when your hands are exposed to anything that can irritate your skin. Wear cotton gloves under plastic gloves to soak up sweat from your hands. Take occasional breaks and remove your gloves. This will prevent a buildup of sweat inside your gloves.
Wear gloves when you go outside during the winter. Cold air and low humidity can dry your skin. Dryness can make your eczema worse. Wear clothes made of cotton or a cotton blend. Wool and some synthetic fabrics can irritate your skin.
Eczema And Atopic Dermatitis Treatment
Your doctor may prescribe a corticosteroid cream or ointment to apply to your rash. This will help reduce itching and calm inflammation. Use it right after bathing. Follow your doctors directions for using this medicine or check the label for proper use. Call your doctor if your skin does not get better after 3 weeks of using the medicine.
Antihistamines like hydroxyzine reduce itching. They can help make it easier to not scratch. A new class of drugs, called immunomodulators, works well if you have a severe rash. Two drugs in this class are tacrolimus and pimecrolimus. These drugs keep your immune system from overreacting when stimulated by an allergen. However, they can affect your immune system. So the Food and Drug Administration recommends that these drugs be used only when other treatments wont work.
Try not to scratch the irritated area on your skin, even if it itches. Scratching can break the skin. Bacteria can enter these breaks and cause infection. Moisturizing your skin will help prevent itchiness.
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Family History And Genetics
Dr. Wan said, AD is driven by a complex interplay of genetic and environmental factors. Understanding how molecular mechanisms of AD vary across individuals and how they interact with extrinsic influences will be key. There is no one single factor that will perfectly predict persistence or remission of AD. Only a few studies have looked at the role of inheritance and genetics in persistence of AD. In a European cohort of 1,038 children, children born to two parents who both had allergies were found to be five times more likely to develop early onset, persistent AD compared to children with parents that had no allergy history.9 A study following 411 Danish children until age 13 found that a family history of paternal asthma or paternal AD associated with greater risk of persistent AD in children.10 Another study with a cohort of 260 Chinese individuals with AD onset before the age of 2 also found that family history of asthma associated with persistent AD.11
Since the filaggrin gene is frequently mutated in AD and its mutation has been previously associated with more severe disease, mostly in European populations, the filaggrin gene of the 260 Chinese patients with AD was sequenced. However, there was not found to be any association between filaggrin mutations and persistent AD in this particular population.11 One study found an association between variations in the filaggrin-2 gene and persistent AD in African American patients.12
How Is Baby Eczema Treated
Treatment varies for baby eczema based on what caused your childs symptoms to flare up and the severity of their symptoms. Treatment for baby eczema could include:
- Eliminating or avoiding triggers: Avoid scented or fragranced soaps, lotions or detergents. These things can cause eczema to flare. Your provider might test your babys skin to identify if theyre allergic to certain things in their environment that they contact regularly. If youre able to identify what causes your babys eczema triggers, avoiding those causes helps your babys skin heal and prevents future eczema flare-ups.
- Using topical corticosteroids: These are prescription-strength ointments that you rub on your babys skin like a lotion. Corticosteroids help reduce itching and swelling. For mild eczema, apply topical OTC 1% hydrocortisone ointment twice a day for no longer than two weeks. For moderate to severe eczema, your healthcare provider may recommend prescription-strength steroid ointments. Any steroid ointment should not be applied for longer than two weeks since it may lead to discoloration by thinning out the skin.
- Applying moisturizer to your babys skin: Keeping your babys skin hydrated can reduce symptoms, soothe their skin, remove discomfort and prevent flare-ups. Choose moisturizers designed for babies and products that dont contain fragrances. The best time to apply moisturizers to your babys skin is after a bath and a couple of times throughout the day when their skin appears dry.
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Diagnosing Food Allergy And Eczema Flare
- Your child’s doctor may suggest the steps listed below:
- Remove the suspected food or foods from your child’s diet for 2 weeks. The eczema should greatly improve.
- Then give your child that food when the eczema is under good control. This is called a “challenge.”
- If the food is causing flare-ups, the eczema should become itchy and red. The flare-up should occur quickly within 2 hours of eating the food.
- If this occurs, avoid giving this food to your child. Talk to your child’s doctor about the need for any food substitutes.
- If the eczema does not flare-up, your child isn’t allergic to that food.
A Dermatologist Can Help You Apply These Findings To Your Situation
When thinking about whether to try something that may reduce your childs risk, many factors play a role. Its essential to consider the climate where you live, family history of allergies, and many other factors.
Your dermatologist can help you develop a strategy thats best for you and your family.
ReferencesAmerican Academy of Dermatology. Atopic dermatitis: Risk factors for disease development. Last accessed January 31, 2018.
Blattner CM and Murase JE. A practice gap in pediatric dermatology: Does breast-feeding prevent the development of infantile atopic dermatitis? J Am Acad Dermatol. 2014 71:4056.
Epstein TG, Bernstein DI, et al. Opposing effects of cat and dog ownership and allergic sensitization on eczema in an atopic birth cohort. J Pediatr. 2011 158:265-71.
Little C, Blattner CM, et al. Update: Can breastfeeding and maternal diet prevent atopic dermatitis? Dermatol Pract Concept. 2017 7:63-5.
Ownby DR and Johnson CC. Does exposure to cats or dogs in early life alter a childs risk of atopic dermatitis? J Pediatr. 2011 158:1846.
Natsume O and Ohya Y. Recent advancement to prevent the development of allergy and allergic diseases and therapeutic strategy in the perspective of barrier dysfunction. Allergol Int. 2018 67:24-3
Pelucchi C, Galeone C, et al. Pet exposure and risk of atopic dermatitis at the pediatric age: A meta-analysis of birth cohort studies. J Allergy Clin Immunol 2013 132:616-22.
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Other Types Of Eczema
Eczema is the name for a group of skin conditions that cause dry, irritated skin.
Other types of eczema include:
- discoid eczema a type of eczema that occurs in circular or oval patches on the skin
- contact dermatitis a type of eczema that occurs when the body comes into contact with a particular substance
- varicose eczema a type of eczema that most often affects the lower legs and is caused by problems with the flow of blood through the leg veins
- seborrhoeic eczema a type of eczema where red, scaly patches develop on the sides of the nose, eyebrows, ears and scalp
- dyshidrotic eczema a type of eczema that causes tiny blisters to erupt across the palms of the hands
Page last reviewed: 05 December 2019 Next review due: 05 December 2022
Does Eczema Get Better With Age
Its not uncommon for people to have eczema their whole life. In most cases as you age eczema symptoms get better they just never truly go away completely.Eczema can go into a remission stage, and this can be something that lasts for years without those daily eczema woes.
Studies have shown that between the ages of 3-6 that any type of eczema can dramatically improve. If the child has a good daily regimen for treating their eczema this will usually be the case. The child could start to see flare-ups more often as they start to go through puberty in their teenage years. Teenage years are filled with a frenzy of hormones which really restarts those eczema symptoms.
It has been said that 2 out of every 3 childrens eczema will get better with age and that they will outgrow it altogether. I can absolutely vouch for this personally. My eczema has gotten extremely better ever since I was a child. There have only been 2 reasons why my eczema gets bad in adulthood:
Not sticking to my daily moisturizing treatment Eating very poorly
When I eat healthy and stay with my daily treatments my skin is always at its best. I have never been able to get rid of eczema forever, but I have been able to control it consistently as an adult. Any type of eczema can surely get better as you age you just need to handle eczema with absolute consistency every single day.
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When Does Eczema Start
About 1 in 10 children have eczema of some sort or another, so its a pretty common condition.
About half of all babies who do have eczema develop symptoms within the first year of their lives, and nearly all children who are going to develop eczema do so before theyre five. So generally, if theyve got to five without any eczema, theyre likely not to develop it later in childhood! However, people can develop eczema for the first time in adulthood, which is known as adult onset eczema.
Does Your Child Need To See A Doctor About Eczema
Yes. Take your child to see your GP if your child:
- might have eczema for the first time
- is very itchy and uncomfortable
- has eczema thats weeping or bleeding
- has eczema that hasnt improved much after a few days, even though youve been treating it as usual
- is having trouble sleeping because the rash is so itchy
- has painful or eczema that has developed pus
- has eczema and is generally unwell for example, has a fever and/or is sweating, feeding poorly or tired.
You should also take your child to the GP if youre not sure whether the rash is eczema.
If your childs eczema doesnt improve with a combination of medical treatment and management at home, your GP might refer your child to a dermatologist. If the GP thinks your childs eczema might be from allergies, they might also refer you to an allergy and immunology specialist.
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Inspect Your Childs Environment For Triggers
Common environmental triggers include dust, rough fabrics, and even high temperatures that can irritate your childs skin, leading to a flare-up. To prevent these itchy, red breakouts, inspect your childs environment and remove or prevent contact with:
- Tight or rough clothing
For further flare-up protection, pat your childs skin dry with a soft towel and then apply an emollient cream immediately after bath time.
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What Percentage Of Babies Have Eczema
Its common that one out of every five babies under the age of two years old have some sort of eczema. The percentage of babies that are actually born with eczema is higher in colder climates, polluted climates, or if there is a family history of dry skin.
A babys eczema also differs by demographic. According to the National Eczema organization, African American babies suffer at a higher percentage than any other race in the United States. African American babies make up about 20.2% then Asians at 13%, Native Americans at 13%, Whites 12.1%, and lastly Hispanics at 10.7%. Atopic Dermatitis is at the top when it comes to babies who have eczema. One of the other types of eczema will usually occur as you get older and location can play a huge role in how bad it can become.
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What Does It Look Like
The signs of eczema in infants include itchy, dry and scaly skin, redness and swelling of the skin and small bumps that open and weep when scratched. In infants and young children, eczema is usually found on the face, outside of the elbows, and on the knees.
In older children and adults, eczema tends to be on the hands and feet, the arms, and on the back of the knees.Keep in mind that all patches of dry skin are not eczema. The cold, dry outdoor air and indoor heating can dry all babies skin in winter, causing dry patches. In children prone to dry skin, so can the sun, air conditioning, and pool and salt water.
We dermatologists usually say if its not itchy, its not eczema you cant make a diagnosis of eczema unless there is an itchiness that goes with the rash. Babies with cradle cap, also known as seborrheic dermatitis, can also have a wide-spread rash, which is not eczema in itself. But it is common for cradle cap and eczema to co-exist in the first several months of life.