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Rashes are part of childhood: heat rashes, diaper rashes, allergic reactions — you name it and parents have probably seen it. Eczema is one of the more common rashes of childhood.

This article describes how eczema can look on a child’s face, what can trigger an eczema flare, and what can be done to prevent and treat the condition.

In babies, eczema often appears on their cheeks and scalp. Up to 60 percent of people with eczema first have symptoms as babies and up to 90 percent first develop the condition before age 5, per 2017 research. Eczema is not contagious. It cannot be passed from one person to another by touching.

Eczema on a child’s face often looks like irregular dry patches or a scattering of tiny red bumps. On Black and Brown skin, eczema often looks like darker brown or purple patches.

Read this article for more information about eczema in People of Color.

Sometimes pustules or whitish bumps can appear on both light and dark skin tones. Eczema patches may also look scaly and thicker than healthy skin.

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Eczema on a child’s face.
Kaufman, BP, Guttman-Yassky, E, Alexis, AF. Atopic dermatitis in diverse racial and ethnic groups—Variations in epidemiology, genetics, clinical presentation and treatment. Exp Dermatol. 2018; 27: 340– 357. https://doi.org/10.1111/exd.13514

You can usually see eczema on a baby’s face. It often looks like:

  • red, brown, purple, or grey patches on cheeks and on the scalp
  • raised bumps that are red or whitish
  • dry, scaly areas that sometimes weep or ooze clear fluid

In addition to the face, eczema can also appear on the outsides of arms and legs on babies and toddlers. It can sometimes be found on the abdomen and chest, but that isn’t very common.

In teens, rashes may show up on elbows, hands, necks, and feet. Eczema on the face is rare among older children and teens.

Eczema is very itchy. In some cases, the itching can be so severe that it disrupts a child’s sleep and makes them irritable. They may also feel embarrassed about it.

Eczema is an inflammatory condition. The cause is linked to a gene mutation that affects the skin. Many things can make eczema worse, such as food, pollen, and other allergens.

Conditions that may lead to eczema include:

Problems with the skin barrier

Your skin has a thin protective layer meant to keep invaders out and water in. One of the most important elements in your skin barrier is the protein filaggrin.

People with eczema may not make enough filaggrin. As a result, too much water escapes, and too many irritants and germs get in.

Immune reactions

Your immune system helps protect you from illness and heal from injuries. In people with eczema, the immune system may react too strongly to allergens and things that are irritating. It may send out a surge of antibodies that cause a lot of inflammation in your skin.

The National Eczema Association estimates that 9.6 million children in America have eczema, which is also known as atopic dermatitis.

Doctors and other healthcare professionals usually diagnose it by looking at the rash and asking questions about triggers and other symptoms like itching.

It’s possible that allergy testing, such as skin prick or scratch tests, may be needed to make sure the rash isn’t caused by an allergic reaction.

Treatment for facial eczema in babies and children ranges from simple at-home changes to bathtime routines to prescription medications, according to 2017 research. What your child needs will depend on the severity of the condition and your child’s age and overall health.

Here are some common treatment options:

Moisturizers

To relieve dry skin and repair the skin barrier, you can use emollient-rich moisturizers daily. It’s a good idea to talk with your child’s pediatrician about how often to moisturize and which brand to use.

Many pediatricians recommend lotions with ceramides and other ingredients that build up the skin barrier.

Short daily baths

Many health experts recommend quick daily baths (around 10 minutes) in warm water. If you use a cleanser, make sure it is free of fragrances and irritating soaps. After the bath, pat gently with a soft, clean towel and apply moisturizer.

Light therapy

Sunlight and narrow band ultraviolet (UV) light have been used to treat eczema successfully. You’ll need to speak with your child’s doctor to decide whether light therapy, which is also called phototherapy, would be a good way to treat eczema on your child’s face.

Here’s more information about how phototherapy is used to treat eczema.

Corticosteroids

Your child’s healthcare professional may prescribe a cream, gel, or foam that contains steroids to reduce inflammation.

Steroid treatments should not be used long-term because they can make the skin thin and more vulnerable to damage. If you’re using a corticosteroid cream, make sure you’re only dabbing it on the areas directly on eczema lesions, not on the whole body.

Biologics

Biologics are treatments options made from natural substances. Dupixent (dupilumab) is a biologic medication that may be prescribed to help treat severe eczema. In 2019, the Food and Drug Administration (FDA) approved the use of Dupixent for children 6 years and older.

Researchers have found that several factors are associated with a higher risk of developing eczema as an infant, toddler, child, or teen. These include:

  • having a family history of eczema or allergies
  • having certain genes
  • having food allergies
  • having asthma
  • having respiratory allergies, such as hay fever
  • living in dry climates
  • living in cities

There’s a lot of overlap in several of these conditions.

For example, researchers know that eczema tends to get worse during times of the year when hay fever happens, per a 2021 study. Eczema symptoms for people with darker skin tones also tend to get worse during outdoor allergy seasons.

Eczema on a child’s face may go away, but it is likely to flare up from time to time throughout childhood and even into the adult years. For many people, eczema is a lifelong inflammatory condition.

Later in childhood and in the teen years, it will probably show up on hands, wrists, and skin covering joints. In people of African ancestry, eczema often affects skin that extends, such as the backs of elbows, according to 2021 research.

Treating eczema early in childhood can lead to better outcomes later, argue the authors of a 2021 article. It’s also important to treat eczema symptoms because it can become infected with a secondary bacterial infection if a child scratches too much and causes open wounds in the skin.

Eczema is a chronic skin condition that often shows up on the cheeks and scalp in babies under 1 year old.

On darker skin, facial eczema can look like purple, brown, or gray patches. On lighter skin, the rash looks red. Broken skin might ooze a clear fluid. Eczema is itchy on all skin types.

Treating eczema early is important because it could reduce the severity of the condition later on. Try short, warm, daily baths followed by lots of moisturizer. Avoid harsh soaps and ingredients that can dry out the skin even more.

Your child’s healthcare professional could also prescribe medicated creams to help heal irritated patches. Light therapy could also help.

Eczema may come and go as your child gets older. It probably won’t show up on the face after infancy, but during flare-ups, it could appear on hands, elbows, knees, necks, and feet.