Eczema
My baby has scaly red patches on his skin. They seem to be very itchy. What is this ugly rash?
It sounds like eczema (also called atopic dermatitis), a skin rash that most often crops up sometime between 2 months and 2 years of age. Eczema usually appears on a baby’s forehead, cheeks, or scalp, though it can spread to his arms, legs, chest, or other parts of his body. Your baby’s rash might show up as dry, thickened, scaly skin, or it might be made up of tiny red bumps that can blister, ooze, or become infected if scratched. And because it’s intensely itchy, scratching can be a problem.
What causes eczema?
No one knows for sure, but we do know that eczema is often inherited. So your baby is more likely to have it if you or some other close family member has either had eczema, or had asthma or allergies. Eczema is not an allergic reaction to something, but it can be provoked by allergens in your baby’s environment or diet, or in your diet if you’re breastfeeding. Eczema can also be aggravated by heat, by irritants that come in contact with your baby’s skin (like wool or the chemicals in some soaps, lotions, or detergents), by changes in temperature, and by dry skin.
How common is eczema in babies?
While 3 to 6 percent of the population has eczema, about 10 to 20 percent of babies have it in the first year of life. Many improve or are no longer troubled by eczema by the time they’re 2 years old.
What can I do to treat my baby’s eczema?
Taking good care of your baby’s skin is crucial if he has eczema. Here are some tips:
• Try to keep your baby’s skin from becoming too dry. Talk with your child’s doctor about how often to bathe him. Many experts now believe that daily bathing can be helpful for babies with eczema. Just don’t make the water too warm, because very warm water dehydrates the skin faster than lukewarm water. Use mild soaps, and wash and shampoo your baby at the end of bath time so he isn’t sitting in soapy water. As soon as you get your baby out of the tub, pat his skin dry and then apply plenty of moisturizing ointment, cream, or lotion right away (within two to three minutes).
• Allow your baby’s skin to breathe (and not overheat) by dressing him in natural fabrics like cotton. Avoid wool and other scratchy materials, though, because these can irritate his very sensitive skin.
• Switch to mild, fragrance-free soaps and shampoos, or those made for sensitive skin. Use mild, fragrance-free detergents for sensitive skin when laundering your baby’s clothes and bedding, too.
• Rapid changes in temperature can make eczema worse, so try not to let your baby get too hot and then cool quickly, or vice versa.
• Pollen, dust mites, and animal dander can also trigger or worsen eczema. You might want to consult an allergist, who can provide tips on how to reduce allergens in your home. These tips may include more efficient ways of vacuuming and dusting, using air filters, and possibly getting rid of carpets and upholstered furniture.
• Help your baby avoid scratching. He may try to get relief by scratching with his hands or by rubbing his face against his crib sheet when he sleeps. But scratching or rubbing can further irritate or inflame his skin and make matters much worse. Use the softest sheet possible in his crib, and keep his nails short. Put him to bed with cotton mittens or socks on his hands. If your baby has a lot of trouble sleeping because of eczema, talk with his doctor. She may suggest a baby dose of an antihistamine that will cut down on the itchy feeling and make your baby more drowsy, too.
Could my baby’s eczema be caused by a certain food?
Eczema is not a specific allergy, but in some children, certain allergenic foods can trigger eczema or make it worse. If you or your doctor suspects that your baby’s eczema is affected by certain foods — the mostly likely culprits being cows’ milk and eggs, followed by soy, wheat, peanuts, and fish — then you could try eliminating them from your baby’s diet, if he’s started on solids, and from your own diet if you’re breastfeeding. (Note that your baby shouldn’t drink cows’ milk until his first birthday, but if he’s prone to eczema you might want to delay giving him milk and other potential allergens for even longer.)
Eliminate suspect foods one at a time, and give each test a couple of weeks, because it can take that long to get it completely out of your breast milk and his system. If you’re using formula, your doctor may suggest that you try switching to a soy-based variety. This isn’t always the solution, because some children who are allergic to milk are allergic to soy as well, but it’s worth a try.
Keep in mind that while food may be a trigger in as many as 30 percent of children with eczema, it’s the main trigger in only about 10 percent of eczema cases. You’ll still want to be conscientious about other factors, like skin care.
Does breastfeeding help?
Maybe. Studies show that breastfeeding from the get-go does help prevent eczema in babies who are prone to get it (because their parents have it). Whether or not it helps a baby who already has eczema is controversial, but experts agree that it doesn’t hurt.
What should I do if the rash doesn’t get better?
Talk with your child’s doctor or a pediatric dermatologist. If the rash doesn’t get better from following the suggestions above, your doctor might suggest trying mild topical steroids (in cream form), which can be purchased over the counter. Applying this cream sometimes works wonders to help break a stubborn cycle of eczema. A short course of oral steroid medication can also help get eczema enough under control that the other relief methods you try work more effectively. Researchers are developing new drugs, like topical immunomodulators, to help eczema sufferers, so if your baby continues to struggle with the condition, ask his doctor to keep you up to date on remedies.
Will my child always have eczema?
Maybe. Most babies with eczema outgrow it by their teens, but there’s no way to tell ahead of time. The good news is that the condition usually becomes less severe with age. And there are ways to manage it. By following the measures mentioned above and treating any flare-ups immediately, you can help keep your child’s eczema under control.
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