How Do I Know My Baby Has Eczema?
Eczema (or atopic dermatitis) is a chronic condition that causes the skin to become dry, itchy, and inflamed, and it’s especially common in infants and young children. In babies, eczema often appears as a red, dry rash on their face, but it can also develop on the scalp and on their neck, arms, legs, and trunk.
At what age do kids get eczema?
Eczema commonly starts around 2 months of age, and often gets missed as it can resemble (normal) newborn acne. The key difference is that eczematous skin is very dry to touch, almost like sandpaper.
Babies aged 6-12 months are more prone to flare-ups, especially while teething which can often appear on their chin, elbows, knees, and ankles. You may notice dryness, redness, or scaly patches in these areas, and your little one may scratch them. If severe, the dry skin will eventually start to crack and bleed, leading to a risk of infection.
When mild, most children will outgrow their eczema by the age of 5 years. Certain things can cause flares of eczema, like allergens (food, pet hair, pollen, etc), excessive heat, stress or having a cold.
Eczema can run in the family
No one knows exactly what causes eczema. But it tends to occur in families, especially when there is a history of atopy – this means a tendency to sensitivity (eczema, asthma, allergy or hay-fever). If you had eczema, there is an 80% chance your child could be affected too.
How to Treat Eczema
1. Avoid Irritants
It may take time to work out what is making your child’s eczema flare up. Things that cause eczema to get worse are called irritants.
Some common skin irritants are:
- dummies, dribbling or food around the mouth
- prickly materials like woollen or acrylic clothing, bedding, and car seat covers
- detergents, soaps, bubble bath liquid and antiseptic washes
- toothpaste (use a product without the ingredient ‘SLS’)
- environmental triggers like pet fur, pollen and dust mites.
If dummies, dribbling or food trigger your child’s eczema, try applying a thick moisturiser around their mouth. After your child eats, wash their mouth with a soft, wet towel and reapply moisturiser. You can also apply a barrier ointment around their mouth before they eat to protect their skin from contact with food.
2. Moisturise the skin
The best way to care for skin with eczema is to keep it moisturised. Apply a thick, plain moisturiser with no fragrance on your child’s skin once or twice a day – even if they do not have any eczema patches. Some children will need moisturiser applied more often.
Thick creams tend to control eczema better than lotions.
It is also best to:
- Use fragrance-free and soap-free products in the bath or shower.
- Avoid creams that contain plant and food products like coconut, milk and almonds.
3. Keep your child cool
Heat is the most common eczema trigger.
Keep your child cool by:
- dressing them in one or two thin layers of cotton clothing
- removing doonas and woollen blankets from their bed and using a cotton blanket or sheet instead
- setting your house temperature under 20°C during the day and their room at or below 15°C overnight
- telling their teachers or childcare educators how to dress them suitably.
If you can, try bathing your child at least once a day in a cool bath – no hotter than 30°C. Add one or two capfuls of plain, fragrance-free bath oil or wash to the water.
4. Control the itching
Eczema can be very itchy, but scratching only makes it itchier and can cause infection.
There are several great ways to help relieve your child’s itching:
- Apply a soft, cool, and wet towel to your child’s itchy areas and leave it on for five to 10 minutes. Then, remove the towel and apply a thick layer of moisturiser.
- Put a wet dressing on your child’s itchy areas at bedtime. This is usually only needed for three to five nights while the eczema is flaring up.
- Dress your child in a wet t-shirt or singlet underneath a thin layer of cotton clothing – both during the day and overnight. Wet clothing also helps with redness.
- Spray your child’s itchy areas with a mineral salt spray from the pharmacy.
- Keep your child’s fingernails short and clean.
- Try to distract your child when they are itching.
Eczema and diet
Children with eczema may develop food allergies, just like they may develop hay fever and asthma in the future. This is a pre-disposition called ‘atopy.’ It is important to note, however, that food allergies are not the cause of the eczema, and these present in a different way. Food allergies cause immediate symptoms after eating a food, such as hives, swelling, vomiting, and in severe cases, difficult breathing or coughing. If your child has these symptoms after eating a food, then you should speak to your doctor as you may need to see an allergist.
Older children may have skin reactions in contact with acidic foods and preservatives, which can cause eczema breakouts around the mouth. However, contact skin reactions are not food allergies.
It is best to consider all foods ‘safe’ for your child to eat until proven otherwise. Cutting out foods or food groups is ineffective in treating most eczema and may affect your child’s growth. Speak with your child’s doctor, an allergist or a dietician before restricting any foods.
All of our GPs at Sage Medical are experienced in diagnosing and managing eczema. If your child has widespread eczema and does not get better with any treatments your GP prescribes or suggests, they may need to get a referral to see a specialist, such as a dermatologist, paediatrician or allergist.
