When To Seek Medical Advice
See a GP if you have symptoms of atopic eczema. Theyll usually be able to diagnose atopic eczema by looking at your skin and asking questions, such as:
- whether the rash is itchy and where it appears
- when the symptoms first began
- whether it comes and goes over time
- whether theres a history of atopic eczema in your family
- whether you have any other conditions, such as allergies or asthma
- whether something in your diet or lifestyle may be contributing to your symptoms
Typically, to be diagnosed with atopic eczema you should have had an itchy skin condition in the last 12 months and 3 or more of the following:
- visibly irritated red skin in the creases of your skin such as the insides of your elbows or behind your knees at the time of examination by a health professional
- a history of skin irritation occurring in the same areas mentioned above
- generally dry skin in the last 12 months
- a history of asthma or hay fever children under 4 must have an immediate relative, such as a parent, brother or sister, who has 1 of these conditions
- the condition started before the age of 2
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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.
What Causes Eczema To Wax To Flare
Different triggers can make eczema worse. For infants, these can be irritants such as wool, certain detergents or extreme temperatures, or other immune triggers, such as food allergies and asthma, and even pet dander.
Most kids with the condition have the hardest time in winter, when the air is cold and dry. A small percentage has a harder time in the summer, when it is hot and humid.
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How Does Baby Eczema Differ From Dry Skin
Dry skin is a symptom of eczema. Your pediatrician can diagnose eczema by examining your baby’s skin. He or she may send you to a pediatric dermatologist for confirmation and treatment if the condition is severe.
In general, dry skin can be handled at home with some moisturizer and isnt as bothersome as eczema. However, babies with darker skin tend to have drier skin than those with lighter skin making moisturization even more crucial.
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.
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Why Did My Child Develop Eczema
The exact cause of eczema is unknown. Researchers do know that children who develop eczema do so because of a combination of genes and environmental triggers. When something outside the body switches on the immune system, skin cells dont behave as they should causing flare ups.
We also know that children who come from families with a history of atopic dermatitis, asthma, or hay fever are more likely to develop atopic dermatitis.
Is There A Cure For Childhood Eczema
Eczema is a genetic condition, much like dust or food allergies. That means there is no cure. You can treat the symptoms , but the condition will never go away completely. As your child gets older, though, their skin will mature and their hydrolipidic layer will thicken, thus reducing the likelihood that a flare-up will occur.
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Help Your Child Avoid Personal Irritants
Some substances can irritate skin and start the cycle of itching and scratching. If you notice that your childs eczema gets worse after being exposed to something, help your child avoid it. Irritants are not the same for all children. If a common trigger does not bother your child, there is no reason to avoid it. Here are some examples of possible triggers that can cause eczema flare-ups in some children.
Perfumes and fragrances, including the skin care and bathing products that contain them
Harsh soaps
Bath salts or bubble baths
Rough clothing, including wool fabrics
Temperature extremes, including hot and cold, dry air
Skin Infections
Children with eczema often have more bacteria on their skin. Even when it does not cause an infection, the bacteria can make the skin more irritated and can make the eczema worse, so keeping clean is important.
Babies and children with eczema are also prone to skin infections. Infections make the eczema even worse and need to be treated by a doctor. An oral antibiotic, antibiotic cream or very small amount of bleach added to bath water might be prescribed. Bleach should not be added to bath water without guidance from your childs doctor. Signs of possible infection include: increased pain, tenderness or swelling, hot skin, fever, pus, or red streaks extending from the affected skin.
Stress
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What You Can Do
You can help reduce your child’s discomfort by:
- keeping their fingernails short to reduce the damage to their skin from scratching
- washing them with aqueous cream instead of soap – ask your pharmacist about aqueous creams and always follow the instructions on the product
- using non-biological detergent and a double rinse cycle when washing their clothes or bedding
- avoiding herbal, ‘natural’ or alternative creams – these can make eczema worse, as they may contain bacteria or high doses of steroids
- rinsing and drying them well after swimming
- dressing them in cool, breathable fabrics like cotton
- keeping them away from anyone with a cold sore – as the cold sore virus can cause eczema to become infected
- using extra moisturiser on areas your child scratches a lot
- avoiding anything you know that causes your childs eczema to get worse
Around 6 out of 10 children with eczema will grow out of it by the time they’re teenagers.
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Precautions To Keep In Mind
Because shea butter comes from a tree nut, it might stand to reason that allergies would be a concern. But in reality, there are no documented cases of shea butter allergies.
Even so, its best to do a test on a small patch of skin before slathering it all over your baby. If you notice any redness or irritation in the test area, go with an alternative that doesnt contain shea butter.
Also, know that most dry skin in babies resolves on its own after about the first month or so. If your little ones dry skin persists, dont just reach for the shea butter or baby oil talk to your pediatrician. There may be a more serious issue that requires medical treatment.
Some oils containing the same fatty acids as shea butter for example, olive oil have been the subject of research into whether they can actually cause atopic eczema. More research is needed, but keep this in mind and watch for any skin changes in your baby.
The Possible Dangers Of Eczema In Children
Although this may seem like a relatively tame skin condition that is rather common and can be handled easily, there are some serious dangers if left untreated.
Its important to know that children with eczema are much more susceptible to other bacterial skin infections, especially in the areas where the rash is the worst. Scratching can also cause thickened, darkened, or scarred skin over time. If untreated, the rash can be unsightly, so it may present a social challenge for a child, too.
The biggest concern is an infection called impetigo. Though your child may try to get relief by scratching with his hands or by rubbing his face against the sheet during sleep, this scratching and rubbing can further irritate or inflame the skin and make matters much worse. Scratching can cause infection to set in. Signs that this is occurring are increased redness of the skin around the rash and a honey-colored fluid oozing from the rash or forming a crust over the rash.
Be sure to give the doctor a call if your child develops a fever or other signs of an infection, such as the area being warm to the touch, oozing, or having a yellow crust. These are signs that your child needs immediate attention by a professional.
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Are There Likely To Be Any Complications Of Eczema
It’s important to control your child’s eczema – uncontrolled eczema can lead to poor sleep which can have long-term effects on learning and behaviour.
Children with eczema are more likely to get skin infections.
Eczema makes the skin dry and cracked and increases the chance of infection by bacteria and viruses . Infected eczema may be wet, crusted or painful. See your doctor for treatment.
If your child’s eczema gets worse or becomes infected, you will need to take them to your doctor. Sometimes, a hospital stay may be necessary.
It’s important to control your child’s eczema. Uncontrolled eczema can lead to poor sleep which can have long-term effects on learning and behaviour.
The Areas Of The Body Most Commonly Affected By Contact Eczema
Contact eczema is an allergy . A product or object comes into contact with the skin and triggers an inflammatory reaction. Where the redness appears is thus a key indicator of what caused the allergy. If you have contact eczema on your earlobes, for example, you will suspect an allergy to your costume jewelry over your toothpaste. Some connections are less obvious, however: you may have a reaction on your neck from a product in contact with your hands, due to our tendency to touch our neck. You can even have an allergic reaction to a product transferred onto your skin from the hands of another person , an item of clothing or even the air!
The following are the most common causes of contact eczema according to the area of the body:
Scalp: Hair dye , perms, shampoos, other hair care products
Face: Cosmetics , personal care products, topical medicines, sunscreens , airborne allergens
Eyelids: Eye drops, cosmetics, nail polish, airborne allergens
Lips: Cosmetics, medicines, toothpaste, musical instruments
Ears: Jewelry, topical medicines
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When To Visit A Doctor
Theres often no need to visit a doctor or pediatrician at the first sign of an eczema flare-up. In most cases, applying an emollient cream or balm multiple times throughout the day should be enough to treat the flare-up. Its also important to inspect your childs environment to see if any triggers are present.
Does a new piece of clothing rub the wrong way or is it too rough? Is it time to give your childs room a thorough cleaning? Identifying and removing these triggers can help decrease the duration of the flare-up.
If the eczema flare-up is still present after seven days despite using an emollient product, or if you notice a yellow or light-brown crust or blisters on top of the flare-up, call your doctor as soon as possible.
This could be a sign that your child has a bacterial infection. In these cases, your doctor may prescribe an antihistamine or an antibiotic. These medications will reduce the swelling, irritation, and itchiness that are causing your child so much discomfort. With the flare-up gone, your child will feel better, sleep better, and be happier overall.
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Causes Of Baby Eczema
The exact cause of baby eczema is not known. However, it is suggested that genetic and environmental factors play critical roles in the development of skin inflammation .
Eczema may often be associated with a lack of filaggrin, which is a skin barrier protein. Filaggrin protects the skin from environmental irritants and bacteria by preventing their entry into the skin. Many children who have eczema usually have too little of this strong barrier protein in their skin .
Triggers such as irritants could activate the immune system, thus causing skin damage as a result of inflammatory response.
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What Is The Difference Between Baby Eczema And Acne
Symptoms of baby eczema and acne can look similar but there are differences between the two conditions. Baby acne causes pimples to form on your babys skin, specifically coming from the oil glands in their hair follicles. Eczema causes dry and itchy patches of skin that form a rash. Eczema can also cause bumps on your babys skin. These bumps arent filled with fluid. Some acne pimples are fluid-filled. Baby acne can resolve on its own, but baby eczema needs treatment to rehydrate your babys skin.
A note from Cleveland Clinic
Baby eczema usually affects your childs face and it can be concerning to see a rash suddenly form on your babys cheeks. Avoiding irritants and triggers and keeping your babys skin moisturized and hydrated helps improve their skins healing time and prevent future flare-ups. While your baby isnt able to vocalize that theyre itchy, you can stay a step ahead of their condition by scheduling times throughout the day to put moisturizer on their skin to keep them from scratching their eczema rash. You might also consider putting mittens on your babys hands so they cant scratch at their skin, which can make their symptoms worse.
Last reviewed by a Cleveland Clinic medical professional on 07/05/2022.
References
When To See A Doctor
You may seek your pediatricians advice if you notice any skin rashes or eczema symptoms in your baby. A doctor can diagnose the exact cause and prescribe a treatment.
Seek immediate medical care in the following situations .
l Fever and signs of a skin infection, such as redness and pus
- Baby is less than three months old
- Blisters or vesicles on the skin
- Baby cries while scratching or touching the eczema rash
Contact the doctor if you have any concerns, or if your baby is sick. The doctor can diagnose the skin rash by observation and may order some tests to identify allergic reactions. Exact diagnosis is crucial to determine the type of eczema and the subsequent management plan.
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What Are The Complications Of Eczema
Affected skin can be very itchy. The itchiness can cause sleep difficulties for your child or infant and scratching can also lead to breaking of the skin.
Broken skin may become infected with bacteria that commonly live on childrens hands. Bacterial infections may cause inflamed blisters which can weep and form crusts.
Warts and herpes can also infect eczema rash. Infection with herpes can cause serious problems and is an emergency which needs to be treated urgently. If someone has a cold sore, make sure to keep a distance from a child with eczema.
How Is Discoid Eczema Diagnosed
It is diagnosed by the typical skin appearance. If your doctor is uncertain about the diagnosis then he or she may need to exclude a fungal skin infection. For example, if there has been clearing of the skin rash in the centre , they may suggest scraping a few skin cells off a skin patch. These can then be sent off to the laboratory to look for a fungal infection. If your doctor is worried that there may be a bacterial infection of a skin patch, they may take a sample . Again, this can be sent to the laboratory to look for this type of infection.
If your doctor feels that you may have contact dermatitis, they may suggest skin patch testing. In this procedure, tiny amounts of up to 25 or more substances are applied as small patches to your skin, usually on your upper back. They are fixed on with non-allergic tape. Some days later, you return to the skin department and the patches are removed. Your skin is examined to see if there is a reaction to any of the tested substances. See the separate leaflet called Patch Testing for Contact Dermatitis for more details.
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Ways To Prevent Baby Eczema
Eczema itself cannot be prevented, but knowing and avoiding triggers can help prevent flare-ups of the condition.
Some ways to reduce triggers include:
- Keep your child out of cold, dry air.
- If they are 6 months or older, make sure your child gets an annual flu shot.
- Read labels on products to help your family avoid common irritants.
- Double-rinse your laundry to remove detergent residue.
Wash Soft Furnishings Regularly To Prevent Dust Mites
While allergies are not the primary cause of atopic dermatitis, exposure to allergens like dust mites cause allergic dermatitis and itch, so this tends to flare atopic dermatitis, says Dr. Lee. Thus dust mites can be a problem for people with allergic contact dermatitis and atopic dermatitis.
If dust mites are a problem for you, there are steps you can take to minimize your exposure to them in your home. The Mayo Clinic suggests washing bed linens and curtains weekly in hot water, opting for allergen-proof bedcovers, and thoroughly cleaning your room to keep it free of clutter and dust. You may also choose to remove carpets, upholstered furniture, blinds, and unwashable curtains from your room, as these can collect dust and harbor dust mites.
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