- Canadian health experts have released a list of tips for parents who have babies with eczema.
- They note that eczema usually appears in young children as raised bumps and dry, itchy skin.
- They say it’s important to moisturize a baby’s skin on a regular basis and use anti-inflammatory treatments when needed.
More than one in 10 children in the United States will develop eczema, also known as atopic dermatitis, with many parents often at a loss as to how to control the condition.
A new article in the Canadian Medical Association Journal suggests five things parents and specialists should know to approach and manage the condition.
Eczema in infants and children typically appears as raised bumps and itchy, dry, and irritated skin on the cheeks, stomach, back, and outer limbs.
The article’s authors also note that “classic eczema” that appears behind the knees and in elbow creases might not appear until later in childhood.
And while infant eczema is not usually life-threatening, it can make life difficult for babies and their caretakers.
“My daughter is going on 15 months and she has suffered pretty severe eczema around her ankles, knees, butt, and arms since she was born. It would worsen with change in weather, allergies, or severe dry skin, which would worsen if she itched until bleeding,” Liang Zhao, a publicist, told Healthline. “We consulted pediatric urgent care, three pediatricians, five family doctors, and a pediatric dermatologist (we have a lot of doctors in the family). We got so many different opinions. It is good to be aware and be prepared.”
Regular moisturizing of the skin — ideally twice daily — is an important way that parents can help control their child’s eczema.
However, studies have shown that the type of moisturizer, whether it’s a lotion, a cream, or a gel, is less critical than simply moisturizing regularly.
So, experts say, use what works for your family.
“Sealing in moisture and avoiding allergic/irritant triggers is key,” said Dr. Rebekah Diamond, a pediatric hospitalist in New York City and an assistant professor of pediatrics at Columbia University.
“A minimalistic approach to skincare starting with fewer products and adding in moisturizers as necessary will save your pocketbook and sanity,” she told Healthline.
That said, while “any moisturizer” might work, it’s probably best to try to find those with fewer potential allergens in them.
“Unfortunately, nothing is ever simple when it comes to baby product marketing, and parents now have to wade through a sea of ‘for eczema’ products that are actually full of scents, irritants, and additives,” Diamond added. “Since babies with atopic dermatitis commonly have the type of allergic reactions that happen when an irritant touches the skin, literally anything can cause a reaction (even the lanolin in Aquaphor or Vaseline that comes with a mild fragrance).”
Atopic dermatitis in children requires anti-inflammatory treatments, the new article authors say.
However, doctors should prescribe the lowest adequate strength possible and note that a “reactive approach” to use steroidal treatments only during flare-ups among mild cases is appropriate.
“Infants mostly get eczema on the scalp and on the face, and in many cases, steroid creams are recommended or prescribed by the child’s pediatrician to help clear up the eczema rash,” Dr. Christina Johns, a pediatric emergency doctor and senior medical advisor at PM Pediatric Care, told Healthline. “It’s important to follow the prescribing instructions carefully and only put the cream/ointment on the affected area.”
This approach worked well for Zhao’s daughter.
“We were prescribed mupirocin and then topical steroid for about a month. Since we have been using mupirocin and steroid on my daughter, she is a totally different baby,” she said. “She’s a lot less fussy, and she doesn’t have to wear scratch sleeves everywhere. She is the happiest kid now.”
Antibiotics are often prescribed to treat secondary infections from eczema, but the authors say that treatment should focus on reducing the underlying skin inflammation from the condition, in part to lessen the risk of fostering antibiotic resistance.
The exception is if the infection has become systemic, resulting in a fever and other systems.
Then, an oral antibiotic is appropriate.
Finally, many parents and some experts believe that food avoidance can reduce the severity of a child’s eczema symptoms.
However, research does not bear this out.
Experts say avoiding foods might actually end up promoting allergies among infants and children.
So, they say focus on other treatments for eczema control and feed your kids normally.