Eczema (Atopic Dermatitis) in Babies and Children

Eczema (Atopic Dermatitis) in Babies and Children

What is eczema

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Eczema is a common skin condition and may begin in infancy or early childhood.

  • Eczema causes patches of skin that can be:
  • red, swollen and irritating
  • scaly, dry and itchy
  • oozy/weepy
  • infected.

In babies it may affect the skin on their face and neck, scalp, outsides of the arms and legs and the trunk.

From two years onward, eczema may occur in the knee and elbow creases, the skin of the neck, wrists and ankles. Sometimes the inflammation may lead to weeping and crusting.

Who is affected by eczema

Eczema affects 1 in 5 children under two years of age. It usually improves with age, but it can still occur in older children and adults. Eczema is not contagious.

What is known about eczema

The reasons why babies and children get eczema is not well understood. It can be genetic. It is common to have other allergies (e.g. hay fever, asthma, food allergy, dust mite allergy) and eczema.

The areas of skin affected by eczema do not keep moisture in and the skin dries out. The body releases chemicals which makes the skin itchy. Scratching can make the skin feel itchier. This sets up a ‘itch, scratch, itch’ cycle.

Circle showing itch, scratch, itch and scratch cycle

What makes eczema flare up

An ‘eczema flare’ is when eczema worsens. An eczema flare is usually caused by more than one trigger.

Triggers vary from person to person. Sometimes a cause for a flare up is not obvious.  It is not possible to avoid all these possible triggers. For example, it’s hard to keep young children away from sandpits but if they wear long trousers, this will help reduce exposure to a trigger. When possible try to avoid known triggers and irritants.

Common triggers include:

  • Dry skin.
  • Scratching.
  • Saliva (dribbling, sucking fingers, dummies) may aggravate eczema around the mouth.
  • Infections (viral or bacterial).
  • Contact with irritants these can include perfumes, soap, bubble bath, chemicals, woollen or synthetic fabrics, some types of carpet, chemicals in swimming pools (like chlorine), sand (especially from sandpits), grass, house dust mites, animal fur and saliva.
  • Allergens that you can breathe in, such as pollen allergy (these can cause eczema to worsen in spring/summer).
  • Contact with or eating foods that your child is allergic or intolerant to. This includes artificial colours and preservatives.
  • Temperature changes such as heat, or overly warm rooms.
  • Stress (doesn’t cause eczema but can make it worse).

In most cases, eczema is not triggered by food. If you think your child’s eczema might be food-related, seek medical advice before removing any foods that your child usually eats. A dietitian can help assess your child’s growth and nutrition needs.

What can help

The best way to manage eczema is to moisturise often and treat eczema flares quickly.

  • When the skin becomes affected by eczema, treat it straight away. Use creams or ointments prescribed by your doctor or pharmacist in the amounts recommended.
  • During flare ups apply a moisturiser all over your baby or child twice a day (including soon after a bath).
  • Some allergy experts recommend avoiding food-based moisturisers to reduce the risk of developing a food allergy. Using a non-food based moisturiser may be worth considering especially when there is a family history of food allergy. This may mean avoiding moisturisers that contain nuts, coconut, avocado, seed oils or olive oil for example.
  • Eczema is prone to infections (bacterial or viral) so treat these through your GP as soon as they occur.
  • When the skin is very inflamed, applying cold compresses or wet wraps may reduce itching and provide relief. It is important to think about how this will feel for your baby or child, as it will cool the body. Place wet bandages over ointments or creams for 30 minutes. You can buy special bandages designed for eczema management. Alternatively, you can use a damp singlet or cotton t-shirt for the body, a damp bandanna for the scalp and a damp scarf for the neck.
  • Clipping finger nails and wearing night gloves may help babies and young children avoid scratching.

Where to go for help

If you think your child has eczema, see your GP or child health nurse. Seek the help you need from them to help manage your baby or child’s eczema.

References

Australasian College of Dermatologists 2019 www.dermcoll.edu.au/atoz/atopic-dermatitis/

Raising Children 2018  www.raisingchildren.net.au/guides/a-z-health-reference/eczema

The Royal Children’s Hospital Melbourne 2010 www.rch.org.au/uploadedFiles/Main/Content/derm/Wet_dressings_A3.pdf