What Is Seborrheic Dermatitis
Seborrheic dermatitis is a common skin condition. It affects the scalp, face or inside the ear. The affected areas have white to yellowish flakes. The skin also can be red and greasy. When adults get it on their scalp, its commonly called dandruff. In babies, it is known as cradle cap. Seborrheic dermatitis can appear on other parts of the body. This includes the chest, creases of the arms, legs and groin. Seborrheic dermatitis is common in babies younger than three months of age and in adults. In adults. Its more likely to affect adult men than women.
Prevention Of Cradle Cap And Seborrheic Dermatitis
Cradle cap cannot be prevented. However, it is easily treated and need not affect the infantââ¬â¢s quality of life. Not all infants will be affected by cradle cap. Some ways of reducing the chance of skin irritation include:
- Making sure that all traces of shampoo, soap or cleansers are rinsed off the body during bathing, to reduce the chance of skin irritation
- Dressing the baby in well-fitting clothing that allows air to circulate, reducing the chances of skin irritation
- Choosing clothes made of natural rather than artificial fibers, as these improve air circulation and moisture regulation
What Does Infantile Seborrhoeic Dermatitis/cradle Cap Look Like
Cradle cap is the name generally given to the condition when a young infant has thick, greasy scales on the scalp. Cradle cap starts with the scalp becoming thickly coated with greasy, yellowish, waxy scales that stick to the head, making it look crusted. The eyebrows may be scaly, and the forehead, temples, neck fold and behind the ears can also be affected, if the condition is more severe. Extensive cradle cap can also be a marker for a baby developing atopic eczema, especially if there is a family history of atopy. Cradle cap is not usually itchy and causes no discomfort to your baby.
In the nappy area the babys bottom may look red, inflamed and flaky. This can be due to seborrhoeic dermatitis or a generalised yeast infection , if it spreads to the whole nappy area. There may be small, white skin scales, which tend to rub off easily, especially if the nappy is tight, giving the skin a shiny appearance. The redness may extend into the skin folds at the tops of the legs, around the genitals and between the buttocks. It can then spread quite rapidly and widely.
On other areas of the body, such as the face, flexures and trunk, there may be small, dry, salmon-pink patches that join up to cover larger areas. The reason infantile seborrhoeic dermatitis affects other areas of the body is due to its hormonal cause.
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When To Call A Doctor
Make the call if your babys eczema doesnt begin to get better within a week of starting over-the-counter hydrocortisone creams. It may be time for a prescription medicine.
Also check with your doctor if yellow or light brown crust or pus-filled blisters appear on top of the eczema. This could be the sign of a bacterial infection that needs antibiotics.
You should call your doctor if your baby is around anyone who has cold sores or genital herpes. Eczema can make your little one more likely to pick up those germs.
Eczema Face Scratching And Sleep
Baby eczema and sleep can be a tough, heartstrings pulling combination! One Baby Sleep Trainer follower named Peggy asked, Is there any advice on how to sleep train/stop swaddling a 6 month old that scratches her face until she bleeds? My daughter has really bad eczema on her face and one night she broke free and I found blood all over her. I dont want to swaddle forever, but she scratches so much. Please help/advise. And I know Peggy is not alone in her worries! Read on for some tips to combat this itchy situation.
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Can Infantile Seborrhoeic Dermatitis Become Infected
Mild infantile seborrhoeic dermatitis is unlikely to become infected if the skin remains intact. However, if the skin becomes sore and raw, especially in the nappy area, it may then become infected by a yeast called Candida, which normally lives on the skin in this part of the body and can cause thrush. Special creams are available to treat this if your doctor thinks they are necessary. Sometimes seborrhoeic dermatitis can become infected by bacteria if areas of skin, particularly the creases, are severely affected. If your babys skin feels hot, smells odd or weeps, consult your GP.
My Top 5 Tips For Dealing With Baby Eczema
1) above and beyond any of my other tips, my number one is do not feel guilty. You will wonder whether it was something you ate during pregnancy, some cream that you put on your baby when they were small, an animal that they were around as a newborn which set it all off. Whether youre moisturising enough, seeing enough doctors, trying enough of the remedies you are recommended every day by well meaning friends and strangers. Just know that you are doing all you can for your baby to make things as comfortable as possible and that is what really counts.
2) Ive already mentioned it but moisturise, moisturise and moisturise some more. It sounds super simple in principle and ideally should be done at every nappy change but if you have an older child like I do, and are often out and about, it can be difficult to do but do your best. Use whatever you have found personally works best on their skin.
3) Keep nails as short as possible unfortunately babies and toddlers completely lack the ability to restrain themselves from scratching so short nails will help limit the damage they might cause themselves.
4) Dont stop looking for help. If you feel like you have been fobbed off by your GP or have been given just a one diagnosis fits all cream or, worse still, a cream that makes things worse, then go back or go elsewhere. Its frustrating to feel like you are pushing all the time but its sometimes what the system, and you, needs.
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How Can I Help My Child Live With Atopic Dermatitis
Atopic dermatitis has no cure. But it will usually get better or go away as your child gets older. There may be times when your child has few or no symptoms. And he or she may have times when symptoms get worse. This is called a flare-up. To help prevent flare-ups, make sure your child:
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Stays away from triggers. Common triggers include irritants such as wool, soap, or chemicals. Other triggers include allergens such as eggs, dust mites, or pet dander. Stress is also a trigger.
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Doesnt scratch the skin. Try to keep your child from scratching. It can cause symptoms to get worse. It can also cause infection.
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Always has short fingernails. Trim or file your childs nails to keep them short and prevent scratching.
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Takes baths or showers with warm, not hot, water. Air dry or gently dry the skin afterward.
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Uses moisturizers. Put creams or ointments on after bathing.
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Wears soft clothing. Dont dress your child in wool or other rough fabric.
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Keeps cool. Try to keep your child as cool as possible. Getting hot and sweating can make him or her more uncomfortable.
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Doesnt get the smallpox vaccine. Its not a common vaccine, but people with atopic dermatitis should not get the smallpox vaccine.
Talk with your child’s healthcare provider about other ways to help your childs skin condition.
What Are The Signs & Symptoms Of Cradle Cap
Babies can develop seborrheic dermatitis when they’re between 2 weeks and 12 months old. It usually starts with cradle cap. A baby with cradle cap will have slightly red scaly or crusty yellow patches on the scalp. It may also start on the face or diaper area and spread to other parts of the body.
Seborrhea looks:
- red and moist in skin creases and folds
- yellowish with greasy patches or crusts
- scaly or flaky
Seborrheic dermatitis might look uncomfortable or irritating to the skin. But it usually isn’t itchy and doesn’t seem to bother infants.
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How Is Cradle Cap Treated
Cradle cap and seborrheic dermatitis in infants usually clears up on its own in weeks or months. In the meantime, you may want to loosen and remove the scales on your baby’s scalp:
- Wash your baby’s hair once a day with mild, tear-free baby shampoo.
- Gently remove scales with a soft brush or toothbrush.
- If the scales don’t loosen easily, apply a small amount of mineral oil or petroleum jelly to your baby’s scalp. Let the oil to soak into the scales for a few minutes to several hours, if needed. Then use a soft brush or toothbrush to remove scales. Shampoo your baby’s hair as usual.
If regular shampooing doesn’t help, your doctor may recommend a mild steroid cream or antifungal shampoo.
For seborrhea on other parts of the body, your doctor may recommend a mild steroid or antifungal cream.
Do not use over-the-counter steroid or antifungal creams or anti-seborrhea shampoos without checking first with the doctor.
Treatment For Seborrheic Dermatitis In Children
If the seborrheic dermatitis is mild, an OTC topical antifungal cream or medicated shampoo with ketoconazole, selenium sulfide, coal tar or zinc pyrithione, may be enough to control symptoms. It is OK to leave mild seborrheic dermatitis untreated if your child is not uncomfortable.
A seborrheic dermatitis rash on an infants head, neck and torso.
In more severe cases, a provider may prescribe topical steroids or TCIs to calm the inflammation. Oral antifungal agents may also be used.
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Elsewhere On The Body
- Bathe your baby every day with a medical emollient as a soap substitute, or add an emollient bath oil to the water, which will help loosen scales and moisturise dry skin. Take extra care when lifting your baby out of the bath as their skin will be slippery!
- Use a medical emollient rather than cosmetic baby products , which may contain fragrance and other ingredients that can irritate the skin. Moisturising the skin with an emollient will help prevent further skin flaking and infection. Please see National Eczema Societys Emollients factsheet for more information on emollients.
- If the skin looks sore, your doctor or health visitor may prescribe a mild topical steroid cream apply it very thinly once or twice a day, as prescribed, to the sore areas of skin only.
- A good time to apply emollient is after bathing. After applying the emollient, wait at least 10 minutes before applying a topical steroid. It is important to leave a gap between the two treatments to avoid diluting the topical steroid and/or spreading it to areas unaffected by eczema.
- Keep the nappy area clean and dry. Check nappies frequently while the skin is sore and change as soon as they become wet or soiled.
- At each nappy change, apply a water-repellent emollient as a barrier to help protect the skin . Dont use plastic pants over cloth nappies as these can make the problem worse.
Progression Of Eczema In Infants And Children
Baby eczema is most prominent on the cheeks, forehead, and scalp of an infant within the first few months of life, and often tends to make the skin look more red and weepy than at other ages.
The eczema can appear on other parts of the body as well, including the diaper area.
When the infant begins to crawl, usually between 6 and 12 months, eczema will typically affect the elbows and knees, which rub on the ground. The eczema rash can become infected, resulting in a yellowish crust or tiny bumps of pus.
When the child is around age 2, eczema may begin to appear on the inside of the elbows and behind the knees, as well as on the wrists, ankles, and hands. It may also appear around the mouth and eyelids.
This eczema tends to be drier, scalier, and thicker .
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Be Willing To Try Different Things
Experiment with different ways to stop scratching and learn a few methods that work for your child. Keep in mind that whatâs helpful one day may not work on another. So have backup strategies ready.
Show Sources
Lawrence Eichenfield, MD, chief of pediatric dermatology, Rady Children’s Hospital, San Diego professor of pediatrics and medicine, University of California, San Diego School of Medicine.
FamilyDoctor.org: “Eczema: Tips on How to Care for Your Skin.”
National Eczema Association: “Bathing and Moisturizing.”
EczemaNet: “Wet Wraps Can Relieve Severe Eczema,” “Preventing Flare-Ups.”
Asthma and Allergy Foundation of America: “Atopic Dermatitis.”
What Is Infant Eczema
Infant eczema is red patches of dry and itchy skin. They are normally rough to touch and can become inflamed and raised.
Babies can suffer from infant eczema all over their body but it mainly affects their knees, joints, armpits and other sweaty areas of the body.
Eczema happens when the body makes too few fatty cells called ceramides. If you dont have enough of them, your skin will lose water and become very dry. The treatment is to replace lost moisture daily.
Baby eczema is often confused with Atopic Dermatitis which is totally different. Baby and infant eczema often disappear without warning after a year or two. Treatment should be to moisturize their skin daily and remove any irritants like the ones listed below to help reduce the itchiness.
- Wool and other hot materials, keep your childs skin cool
- Stress and tiredness
- Cigarette smoke
- Damp and mold
If you are worried about your child having any form or eczema then please visit our website where we have hundreds of helpful eczema articles written by us and other parents coping with this skin condition.
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Will My Baby Grow Out Of Eczema
Sadly, it is impossible to predict whether your baby will have eczema for life or for just a short time. So far, there is no cure for eczema. Eczema is a chronic condition with periods of flare and periods of remission, and most people with a history of eczema still have problems with dry and itchy skin. If your child has a difference in their filaggrin gene, they will not grow out of it. Even if your baby appears to grow out of their eczema, it may return during the teenage years or in adulthood.
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:
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Dry, scaly skin
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Pale skin on the face
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Small, raised bumps that may become crusty and leak fluid if scratched
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Rough bumps on the face, upper arms, and thighs
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Darkened skin of eyelids or around the eyes
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Skin changes around the mouth, eyes, or ears
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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.
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What Else Is Happening At Johns Hopkins Today
We go out of our way to provide the comprehensive care our patients with eczema need. On a case-by-case basis, we communicate with one another whether in allergy, dermatology, psychology or infectious disease to put together the best course of treatment for each child.We are optimistic that future therapies and approaches to care for those with even severe eczema are going to be greatly improved with more research and that the creation of the Eczema Day Treatment Unit will help us conduct cutting edge research and answer questions we face every day seeing and treating patients.
Did My Baby Develop Eczema Because I Couldnt Breastfeed
As eczema is caused by genetic factors, bottle-feeding a baby definitely cannot cause eczema. In fact, current research is divided, with some studies showing positive effects of breastfeeding and others showing no significant effects at all.
Neither is there enough evidence to advise pregnant or breastfeeding women to avoid specific foods to protect unborn children from atopic eczema or any other atopic condition.
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Which Is The Best Emollient For My Baby
Emollients treat dry skin by providing a surface film of oils. This increases water in the upper layer of the skin, restoring and providing a robust skin barrier, to prevent the entry of environmental agents or triggers.
Emollients soften the skin and reduce itch. If they are used regularly to maintain skin hydration, they can reduce the frequency of eczema flares. Leave-on emollients include lotions, creams,ointments and gels.
The emollient advised or prescribed for your baby should prevent dry skin and not cause irritation. You might need to try several products until you find the right one. Apply leave-on emollients regularly, throughout the day for example, at every nappy change and after bathing.
Use the product liberally . To apply the product, dot it all over the skin, and then smooth it in, using a gentle, downward, stroking motion rather than rubbing in.
Seborrheic Dermatitis In Children
Seborrheic dermatitis on an infants scalp is known as cradle cap.
Seborrheic dermatitis occurs in areas of the body where there are a lot of oil-producing glands such as the scalp, nose and back. In infants, seborrheic dermatitis usually appears on the scalp and is commonly known as cradle cap. In older children and adults, seborrheic dermatitis on the scalp is typically called dandruff.
The exact cause of seborrheic dermatitis is unknown, but it is believed to be a combination of factors including genes, yeast that lives naturally on the skin, stress, chemical irritants and/or dry, cold weather that causes the skin to overproduce oil. In infants, researchers believe seborrheic dermatitis is triggered in part by hormones from the mother.
Unlike other forms of eczema, seborrheic dermatitis is not the result of an allergy.
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