Recognizing Eczema in Little Ones
It is important for parents to learn how to recognize the signs and symptoms of eczema early so they can properly care for their baby’s sensitive skin. Eczema shows up on the skin as a chronic itchy, dry, red scaly rash, commonly found in areas like around the eyes, the insides of the elbows, behind the knees, and back of the neck. Because the skin is so dry, it commonly develops cracks and sores, which makes hydrating the skin even more challenging. This leaves the skin barrier open to developing infections and allergies from increased exposure to potential irritants.
My son started developing an itchy dry rash first on his face around 3 months of age, and then it spread to the rest of his body, including all the usual “hot spots” for eczema. Even though I can recognize eczema from a mile away in clinic, it was still so hard as a new parent to see the little guy itchy and scratching all the time!
The following are best practices when helping parents care for their babies with eczema:
Promote good bathing habits. Babies with eczema do not need daily hot baths, which can dry out the baby’s skin and strip away the skin’s natural oils. Recommend that parents use lukewarm water to bathe their baby, and keep bath time to less than 10 minutes to avoid prolonged exposure to water. Soap should be used in moderation; parents do not need to apply soap to the entire body every single day since baby skin dries out easily, especially baby eczema skin.
Recommend choosing soaps and moisturizers carefully. Parents should look for fragrance-free moisturizing soap, which will be less likely to irritate baby’s skin. After bath time, recommend they gently pat the baby dry; and to not rub vigorously with a towel which can irritate the skin. While the skin is still moist, apply a fragrance-free moisturizer with ceramides or glycerin from head to toe. This will help them lock in the moisture! I recommend moisturizing at least twice a day in babies with eczema, since their skin dries out so quickly.
Stress the importance of avoiding potential irritants. Eczema skin is more sensitive, and can flare in response to exposure to potential irritants in the environment. We already discussed how to choose soap and moisturizer above, but parents should also be mindful of which wipes they use to clean baby’s bottom during diaper changes. Put it in perspective for them – a baby’s bottom is already sensitive from constant exposure to moisture and the pressure of wiping; it doesn’t need to be repeatedly exposed to potential irritants in the wipes themselves! For patients with sensitive skin, I recommend using hypoallergenic, fragrance-free, paraben-free wipes such as WaterWipes, which contain 99.9% water and a drop of fruit extract. These wipes are gentle enough for everyday use on sensitive eczema prone skin, and have been awarded the National Eczema Association of America Seal of Acceptance. For hot days WaterWipes are instantly hydrating and are suitable to use all over baby’s face, arms, and legs to cool them off.
Help them recognize and avoid triggers. Certain things in the environment can make baby eczema worse. Common triggers include pet dander, dust mites, pollen, tobacco smoke, sweat, and more. Certain food allergies such as peanuts and eggs can cause eczema flares as well, and the skin reaction is usually immediately after the food exposure. When parents can recognize certain triggers that irritate their baby’s skin, they can try to reduce exposures to prevent eczema flares.
Know when to recommend they see a dermatologist. I see eczema patients in my office everyday, and I sometimes wish they came to see me sooner instead of suffering at home! If a baby is constantly scratching at his or her eczema, and seems uncomfortable, then it is time to come in for an appointment, especially if the baby can’t sleep at night from scratching or if they are scratching to the point of bleeding. There are lots of tools at our disposal for eczema treatment, including topical medications to decrease inflammation, treatments to prevent and treat infections, and antihistamines to help baby with uncomfortable itching and sleep.
Do you share any of these eczema skincare tips already with your patients? We may not have a permanent cure for eczema yet, but I hope these pearls will help your patients keep their baby’s eczema under control.