Your baby has developed patches of dry or scaly skin, or a rash and is itchy and uncomfortable. You and your baby are unhappy. Your baby may have eczema.
Eczema is a common skin problem and can affect up to one in four babies. It is the most common skin condition in babies and can also affect older children and adults. Eczema is not contagious. Your baby did not “catch” eczema from someone and cannot spread it to you or to other people. It is also not caused by not keeping your baby clean. In fact, washing your baby too much with a harsh soap can make eczema worse.
Eczema looks like patches of dry, crusty, rough, or flaky skin that can occur anywhere on your baby. However, the usual places for it to occur are your baby’s face, arms, torso, and legs. In older children, the patches tend to be behind the knees and on the insides of the elbows.
The patches can range from very mild to very severe. Mild eczema doesn’t interfere with normal activities. Moderate eczema causes itchiness that can interfere with sleep or makes your baby cranky both from poor sleep and the itchiness. Severe eczema has large patches that are very red and dry, and the skin may crack and start to ooze a clear liquid. In severe eczema, the itching is constant and makes your baby miserable.
If your baby has severely red and cracked patches on the skin and bad itching, see your pediatrician. He or she may refer you and your baby to a dermatologist.
In babies with light skin, patches of eczema can look pink or red and they look and feel dry. In people of color, however, eczema can look purple, dark brown, or even gray.
There are several types of eczema, but the most common type in babies is called atopic dermatitis and is an inflammation caused by a combination of factors. It tends to run in families and frequently the people who have it also develop asthma and allergies, especially food allergies. About 30% of babies who have eczema also have food allergies, most often to cow’s milk.
Although it has a genetic component, eczema is also “triggered” by things in the environment. According to the National Eczema Association, the immune system triggers inflammation that damages the skin, leaving it prone to forming itchy, rough patches. Your baby may be fine and then suddenly flare up in patches after exposure to a trigger.
Triggers can include certain foods, very dry weather, or things that touch your baby’s skin. Certain fabrics such as wool or polyester; skin lotions, soaps, laundry detergents, or shampoos; perfumes; smoke; pollen; or latex items can all be triggers. Some babies react to animal hair and dander. Although eczema shares some traits with allergies, these reactions to triggers are not considered to be allergic reactions.
Breastfeeding is best for all babies but can be especially important for babies with eczema. In addition to its perfect nutrition for a growing baby, breast milk passes along to the baby some of its mother’s immune system and can help make the baby’s immune system less sensitive. Even so, some babies may react to the mother’s breast milk if she has eaten certain foods, notably cow’s milk or eggs.
If your baby has eczema and you need to use baby formula, talk to your pediatrician about the best types of formula. Some baby formulas are based on milk, but some are made with hydrolyzed proteins, which may be less likely to create a reaction in your baby. You may need to try different formulas to find one that works best for your baby.
Because of triggers, your baby’s eczema can seem to get worse or get better, or even come and go completely. For many babies, eczema gets better and may completely go away as they get older.
Try to identify the triggers for your baby’s eczema. If you can identify what causes your baby’s skin problems, you can try to eliminate it or avoid it as much as possible. For example, if a certain item of clothing seems to make your baby itch, don’t put it on for a couple of weeks. If your baby reacts when he or she wears it, that piece of clothing is a trigger. It can be difficult to identify triggers, especially since your baby may have several.
The best way to treat a baby’s eczema is to treat the skin gently. You don’t need to give your baby a bath every day since this can dry out the skin and make eczema worse.
Bathe your baby in lukewarm water and keep baths shorter than ten minutes long. Use soap only on the baby’s diaper area, and hands and feet, and use warm water on everything else. Avoid scrubbing. Use soap and laundry products that don’t contain perfumes or scents. Avoid antibacterial or deodorant soaps and bubble bath products because these may be too harsh for your baby’s skin.
Right after the bath, apply a fragrance-free moisturizer on your baby’s skin. In addition, moisturize your baby’s skin twice a day. Thicker creams or ointments may provide more protection to the skin than thin lotions. Apply moisturizer right after a bath. On dry patches of skin, you can also apply a thin layer of petroleum jelly.
If your baby has mild eczema, talk to your pediatrician or healthcare provider at the next checkup. If your baby is extremely uncomfortable, call your healthcare provider’s office as soon as possible.
A severe patch of eczema can become infected. If you notice any signs of infection on your baby’s skin, such as blisters, sores, or pus, and if your baby is running a fever, call your healthcare provider immediately.