Eczema is an umbrella term for several skin conditions that cause areas to become red, itchy, and inflamed. Eczema in young children is usually the type called atopic dermatitis.
It’s believed to affect at least 10 percent of children in the United States, according to a 2014 report from the American Academy of Pediatrics (AAP). In 85 percent of cases, it develops before the age of 5, but in more than half it appears in the first year of life.
In infants (under the age of 12 months), eczema usually affects the:
Older children and adults typically have more flare-ups on their hands and feet, though knees and elbows are also quite common. Eczema is very itchy and uncomfortable. The discomfort can interfere with quality of life, interrupting sleep and daily activities.
Eczema results from an overreaction of the immune system. There isn’t one exact known cause. Instead, doctors believe that many different things can lead to it and that it’s most likely a combination of genetic and environmental factors (such as living with a pet).
Babies with a family history of asthma, allergies, or eczema itself are more likely to develop it. Theories about the causes and triggers of eczema include various allergens, bacteria, and even genetic variations and mutations.
Between 20 and 30 percent of people with eczema have a genetic variation that compromises the outermost layer of the skin. This makes it harder for the skin to retain moisture and to keep out foreign substances. This is just one of many genes likely involved in eczema.
According to the AAP, the four main goals to treating eczema are:
- Maintenance skin care. This is the most important, as it can help repair and maintain a healthy skin barrier, as well as potentially prevent future flare-ups.
- Anti-inflammatory skin medications. These help reduce the inflammatory response during a flare-up. (They may not always be appropriate or necessary for babies.)
- Itch control. Scratching generally increases the severity of the itch.
- Managing triggers. Avoiding or managing triggers helps reduce flare-ups.
Keeping those four goals in mind, here are five ways you can treat your baby’s eczema at home.
Giving your baby a short warm bath is one of the most effective things you can do to treat and manage eczema at home. A daily warm bath for no more than 5 or 10 minutes is usually beneficial, as long as you immediately apply moisturizer to the baby’s skin after the bath.
Use lukewarm water in the bath. Stay away from any synthetic soaps or cleansing agents that are harsh or perfumed. Every child is different, so you should pay attention to how your infant’s skin responds to the frequency of baths. Some babies may respond better to baths every other day.
It’s important to gently pat your baby dry after their bath, leaving a little moisture on their skin. Then apply moisturizer to their damp skin to help prevent the skin from drying out.
Your baby may object to the greasy feeling of skin ointment, as opposed to lighter moisturizing lotion. But studies have found that skin ointments are more effective for treating eczema because they keep more moisture in. Thicker creams are also helpful.
You should choose the most natural formula available, as fragrances and preservatives can be irritating for babies with eczema. In general, prescription creams have not been found to be more effective than over-the-counter moisturizers for eczema.
Save your money and choose the moisturizing ointment or cream that works for your budget.
One of the most important things you can do for your baby’s eczema is to look for things in your environment that seem to trigger your baby’s flare-ups or make them worse. Products in your home could be causing or contributing to the problem.
In babies, the most common triggers are things that touch their skin. Rarely, environmental allergens like mold or pollen might be a trigger. Other known triggers that are rare in babies are infections and stress. Common triggers for babies are:
- harsh soaps and detergents
- rough or nonbreathable clothing fabrics
- excess saliva
If your baby is having a particularly severe eczema flare-up, ask your pediatrician about doing a wet dressing, or wet wrap therapy. This treatment is sometimes used with prescription steroid cream under close medical supervision.
The wrap helps ensure that topical treatments stay moist and get better absorbed into the skin.
How to apply a wet dressing:
- Give your baby a bath, and gently dry the skin.
- Apply cream or moisturizer.
- Wet gauze or cotton clothing with clean, warm water, and apply to the affected area.
- Cover the wet layer with another light layer of dry clothing, and leave the dressing on for three to eight hours.
You can continue applying the wet dressing for 24 to 72 hours or overnight. Continue for a maximum of one week.
Before using wet wrap therapy, always discuss it with your pediatrician.
Itching is one of the hardest things about eczema. For parents of babies and young children, it might seem impossible to stop them from scratching the affected areas. Scratching that injures the skin can allow bacteria to enter and cause an infection.
Keeping your baby’s skin covered with loose, cotton clothing may help prevent them from scratching.
Be aware that applying an antihistamine cream, such as diphenhydramine hydrochloride (Benadryl), directly to the skin can make the eczema worse.
Giving your baby an oral antihistamine can help decrease the sensation of itchiness. The “non-drowsy” antihistamines, such as loratadine (Claritin) and cetirizine (Zyrtec), don’t help with itchiness. The type that does help, diphenhydramine (Benadryl) and other older antihistamines, will usually make babies sleepy.
This may be helpful, especially at night, but antihistamines shouldn’t be given to children under 2 years old without a doctor’s recommendation.
Eczema is a fairly common skin condition in young children, but the specific causes and triggers for your baby may be difficult to figure out. Work with your pediatrician to develop the best treatment plan. The good news is that eczema typically gets better or goes away entirely as your child gets older.
Chaunie Brusie, BSN, is a registered nurse with experience in labor and delivery, critical care, and long-term care nursing. She lives in Michigan with her husband and four young children, and is the author of the book “Tiny Blue Lines.”