Baby Eczema

Baby Eczema is more common than you think. According to the American Academy of Dermatology, Eczema affects up to 25 percent of infants worldwide, and it comes in different forms. ^[1] Babies can get eczema anywhere, mostly on their cheeks, elbows, scalps, and knees. It can appear as red, flaky splotches in infants with lighter skin and a brownish rash that looks like dead skin in babies with darker skin.

The good news? Eczema is treatable. Detecting early symptoms can accelerate your baby's healing journey, alleviate discomfort, and enhance the overall well-being of your child’s skin.

What is Baby Eczema?

Baby eczema, also known as atopic dermatitis, is a very common condition that affects 1 in 5 babies due to genetics or certain environmental situations ^[2]. It is characterized by brownish or red, crusty patches triggered by environmental or bodily changes. It can cause your little one to feel itchy and uncomfortable, leading to fussiness or crying until something soothing is applied. 

Unlike other regular baby skin conditions, eczema is commonly found on the cheeks, elbows, scalp, and knees, with the tendency to affect other body parts. However, it is not contagious. Babies with the condition can not pass it on to other people. ^[3]

Types of Baby Eczema 

While atopic eczema is the most common type, infants can also develop other forms of eczema. Each type has its own distinct symptoms, so recognizing them can help you provide the right care for your child. These include Contact Dermatitis, Seborrheic Dermatitis, and dyshidrotic eczema, all of which are very common in babies. 

Contact Dermatitis: This skin reaction occurs when the skin comes into contact with an irritant or allergen. It has two forms: irritant contact dermatitis, caused by repeated exposure to substances such as saliva or soap, and allergic contact dermatitis, a delayed reaction to allergens like certain fabrics or skincare ingredients. Common symptoms include redness, dryness, and itching, often appearing on the cheeks, neck, or diaper area ^[4].

Seborrheic Eczema: or cradle cap, appears mainly on children's scalp. It causes flaky skin on the affected area and could be mistaken for Atopic eczema. The affected area constantly creates dried, congealed, dandruff-like particles occasionally. 

Dyshidrotic Dermatitis: also known as vesicular eczema, is a skin condition that mostly affects the palms of the hands, fingers, and feet. Children with this type of eczema deal with small, dry blisters on the palms or soles of their feet, causing extreme discomfort and pain.

As scary as they all sound, all types of eczema can be treated, and their symptoms can be prevented or managed, especially in toddlers. 

Causes of Baby Eczema 

Genetic research on infants has found that mutations in the Filaggrin (FLG) gene, a crucial protein that supports a healthy skin barrier, can lead to atopic eczema. These mutations reduce the skin’s ability to retain moisture and block irritants, making babies more likely to develop eczema.

This means genetics and hereditary traits play a huge role in eczema development ^[6]. Babies with a family history of any type of eczema are at a higher risk of developing the condition. 

Studies have shown that babies with a family history of asthma or allergies are genetically more susceptible to developing eczema^[7].

While genetic mutation might be responsible for 20-30% of babies with eczema, there are other common causes of eczema in babies. They include:

Weakened Skin Barrier: occurs when your baby's skin is unable to retain sufficient moisture. Every infant's skin barrier is an integral part of their immune system, serving as a protective layer that retains moisture and prevents allergens or foreign microbial activities from entering their body. So, when it becomes dry, it automatically becomes more susceptible to irritants.

Climate change: Your newborn or infant is still very new to the temperature outside your womb. At this stage, their bodies are still adapting and adjusting to a harsher climate. Since their hormonal glands are still immature, these climate changes can affect the skin, contributing to various skin conditions, such as atopic eczema. 

Food Allergens: Atopic Eczema can result from a reaction to certain foods, such as eggs and milk, which may not be well tolerated in your baby's body, especially when transitioning from exclusive breastfeeding to processed baby milk. Some babies may require more months of breastfeeding before their bodies can tolerate a more mature type of milk. 

Skin irritants: Environmental irritants, such as prickly or tight fabrics and harsh substances like soaps and dyes, may affect your baby's skin or worsen eczema. Tight clothing can cause overheating in a child, causing a rash breakout or even eczema.

Indoor triggers: Your house represents your baby's major environment, so dust mites, pet dander, molds, cigarette smoke, and other environmental pollutants can cause eczema flare-ups ^[8]. You must always keep your house clean to ensure breathable air for your child.

Symptoms Of Baby Eczema

Eczema can appear differently depending on a baby’s age and the severity of the condition. As infants grow, symptoms may shift in appearance and location. Below are key signs to watch for at each stage:

0-6 Months (Infants)

Mild symptoms 

• Dry, crusty skin on the cheeks and scalp — areas exposed to saliva, milk, or friction from bedding.

• Red patches scattered across the face, resembling insect bites or tear stains.

• Constant fussiness and discomfort due to itching in the affected area. 

Severe symptoms

• Red, irritated patches spreading to the arms and legs, causing discomfort and restless sleep.

6-12 months (Crawlers) and Toddlers

Mild symptoms:

• Rough, dry skin on the cheeks and scalp, but it more frequently affects the body, especially where babies crawl or rub against surfaces (elbows, knees, wrists).

Severe symptoms: 

• Restlessness, leathery skin, and insomnia from constant itching.

• If left untreated, affected areas can become severely infected, leading to yellow, crusty bumps on the skin.

Does Baby Eczema Cause Food Allergies?

Baby eczema and food allergies are closely linked, often creating a vicious cycle where each condition can worsen the other. Infants with a family history of allergies are more likely to develop eczema, and research shows that babies with eczema have a higher risk of developing food allergies, especially to common triggers like peanuts and eggs ^[10].

The skin needs moisture to flourish, resist unwanted penetration, and protect the body from toxins, hence the skin barrier. Skin barrier dysfunction promotes dryness, which is a major stimulator of eczema symptoms, including itching and inflammation. Since eczema most likely indicates a weakened skin barrier, food substances like peanut dust can penetrate the skin, causing it to react even before the child consumes it. 

When the skin is not adequately hydrated or moisturized, especially in babies, irritants and external microbes can find their way into the body, causing the immune system to react.

This reaction can contribute to producing hormonal proteins, which can encourage inflammation. The immune system's inflammation reaction can further damage the skin barrier, worsening Atopic dermatitis and allowing viral and bacterial infections to thrive. 

How Is Eczema Diagnosed?

If you see a rash or unusual patches on your baby’s skin that don’t clear up with regular lotion, it could be a sign of eczema. When unsure about what you’re seeing, it’s best to consult a dermatologist. 

They’ll carefully examine your baby’s skin for any signs of rash, dryness, or redness. They will ask when you first noticed the blotches and whether anything triggers your baby’s itching or irritation. To get a fuller picture, your doctor will also ask about your family history of asthma or food allergies.

In severe cases, the doctor may recommend specific tests to confirm the diagnosis of eczema. These tests are conducted to determine if symptoms are consistent with a diagnosis of eczema. 

The results of these tests inform the doctor whether secondary issues beyond eczema are present. 

Common baby eczema tests include:

Skin Examination: Skin examination is the most common test dermatologists perform. They carefully check your little one’s skin for visible signs of eczema or flare-ups and may gently feel the skin to assess dryness or crustiness. This helps them determine the severity and recommend the best care for your baby.

Allergy Tests: Doctors use this test to determine if a substance or a physical trigger causes your baby's skin reaction. To conduct this test, the doctor places the baby in a controlled setting, along with possible or suspected triggers, while monitoring the baby's reaction. 

Allergy Blood Tests: If your dermatologist can’t confirm eczema through a skin exam, they may check your child’s blood for immunoglobulin E (IgE) levels. Higher-than-normal IgE could indicate an allergic reaction rather than eczema.

Skin Biopsy: A skin biopsy is typically a last resort when symptoms worsen and the cause remains unclear. A small skin sample is taken to examine under a microscope, which helps identify infections or other issues causing the symptoms.

How To Treat Baby Eczema 

To effectively manage your baby's eczema, it is essential to incorporate intentional strategies into your daily routine. Focus on your baby's hygiene and comfort, and seek medical help when necessary.

• When bathing your baby, use lukewarm water, clean the dirty parts gently, and avoid scrubbing their skin thoroughly.

• Moisturise your baby's skin constantly. Use thick ointments rather than regular lotions.

• Avoid heat, and keep your house warm and free of dust.

• Use small quantities of prescribed medications only on the affected areas.

Baby-Safe Natural Remedies for Eczema

Some natural remedies are safe for your baby’s skin when treating it, but getting advice from a professional helps you choose the best and safest option.

• Coconut oil possesses anti-inflammatory properties and serves as a versatile remedy for various skin issues. Coconut oil can prevent redness and dryness in your baby's skin. Rub it 1-2 times a day on the affected area.

• Aloe vera gel also possesses anti-inflammatory properties that gently soothe the skin, giving it a healthy and robust appearance. To help reduce your baby's discomfort, lightly apply raw aloe vera gel to the affected areas. 

• A mother's breast milk does wonders for her child; this is no exception. The milk soothes the skin and reduces redness. Apply cotton wool to a small amount of breast milk, let it air dry, and then apply it to the affected area. ^[12]

• Oatmeal is a good relaxing agent, especially for babies. It rejuvenates the body and helps with itching. To relieve your baby, pour grounded oatmeal into the bath water. Place your baby in the water for 12-15 minutes. Moisturize immediately.

If eczema symptoms persist even after all these applications, get professional help, as there may be an underlying issue.

How To Prevent Baby Eczema 

The first step in tackling baby eczema is to destroy its foundation, which is dry skin. Baby eczema would only thrive if your baby's skin is without moisture, which is why you must follow the simple steps below:

• Moisturize your baby's skin immediately after bathing. Leave a little wetness after bathing and quick moisture to optimize hydration.

• Avoid using scented lotions and soap on their skin.

• Avoid sponge or any other hard scrub when bathing your child.

• Avoid clothing that makes your child uncomfortable. 

• Keep your home clean and free of disturbing substances.

• Use only gentle and medically approved body products on your baby.