At around 3 months of age, my daughter developed a thick, rough, scaly patch of skin on the side of her neck. Not thinking much of it, I mostly ignored it, only making sure to keep it clean and dry. I hoped it would go away on its own, but it spread to the back of her neck as well. I soon noticed that my little baby had learned to scratch the itchy spot, and it only worsened from there. After a trip to the pediatrician, we discovered this was a patch of baby eczema. With an understanding of her eczema triggers and how to manage her scratching and treat the irritation, we were able to get the issue under control. If you suspect your baby has eczema, read on to discover the symptoms, causes, triggers, and treatments to consider.
Eczema is a chronic condition or allergy of the skin that causes itchy, dry patches. An overactive immune system reacts to outside triggers, causing skin inflammation on various areas of the body.1,2 Eczema can also be called atopic dermatitis, and it can present itself as a rash on a baby’s face, head, neck, torso, and limbs. Due to moisture, the only area that eczema typically doesn’t typically affect is the diaper region.1
Baby eczema typically starts as a rash or irritation somewhere on the baby’s face or head, and it may eventually spread or pop up in other areas of the body, such as the chest or back, and then elbow or knee joints when they’re older.1 Specific skin symptoms associated with baby eczema include:1,2
- Dryness
- Itching
- Cracking
- Redness
- Weeping or oozing
- Crusting
- Blisters
- Skin breakdown
- Scaly patches
- Skin thickening
We don’t fully understand the exact cause of eczema, but it likely occurs because of a combination of genetics and environment. Let’s explore these potential causes:1
Genetics can predispose a baby’s skin to a defect in a protein called filaggrin, which leads to their skin holding onto less moisture, therefore becoming dry more easily.16 A baby’s immune system may also overreact to skin triggers, causing eczema flare-ups.1 Due to the genetic link, having a parent or sibling with eczema puts a baby at higher risk for developing eczema themselves.3
Dryness in the air makes it more difficult for the skin to retain moisture, which weakens the skin barrier, leaving the skin more susceptible and vulnerable to environmental and topical allergens and other triggers.3 Exposure to these irritants can turn on a baby’s immune system and cause an overreaction in the form of eczema inflammation.1
Despite having a higher risk of developing eczema if someone else in your immediate family and household has eczema, the answer is no — eczema isn’t actually contagious.3 It can’t be caught, transmitted, or given to someone else.1 But while babies with eczema can’t spread it to anyone else, they may be more prone to infections from bacteria, viruses, and fungi. This is because their dry skin can break open more easily and let germs in.4
Because eczema worsens as a response to environmental factors, certain things can cause or trigger it:1
Anything that touches your baby’s sensitive skin can cause irritation. Even products that say “hypoallergenic” can still cause inflammation, depending on what irritates your baby’s skin.12 Some examples of topical triggers include:1,3,5
- Cleansers
- Soaps
- Shampoo
- Ointments
- Bubble bath
- Fabrics such as wool or polyester
- Detergents
- Fragrances
- Baby wipes
Potential allergens can be found in the air or environment. Anything that comes in direct contact with the skin, or even substances ingested in the body, can cause an allergic reaction manifesting as eczema.1 Some common allergens that can cause eczema include:3
- Dust mites
- Pet dander
- Pollen
- Mold
- Foods
A baby’s skin conditions can also be affected by the air and weather around them. Most of the time, dry winter weather is harsher on eczema.4 Some climate-related triggers for eczema include:1,4
- Cold weather
- Dry air
- Wind
Body Conditions
Finally, the emotional and physical state of your baby’s body can trigger eczema flares.6 Body conditions that may exacerbate eczema include:1,6
- Illness
- Stress
- Sweating
- Drooling
Baby eczema treatment relies on keeping the skin moist with barrier creams, minimizing or avoiding triggers to prevent flare-ups, and caring for eczema patches that do pop up:
Because soaps and shampoos are common eczema triggers, bathe your baby daily in lukewarm water, targeting the use of gentle soap on only the dirty areas. Pat the skin dry, making sure to avoid vigorous rubbing, and moisturize with a barrier cream immediately after bathing to lock in moisture. Thick, unscented baby eczema cream or emollient, such as petroleum jelly-based ointments, tend to work better and last longer on the skin than lotions and oils. Apply this at least twice daily and more as needed.5
Once you’ve identified your baby’s eczema triggers, you can make efforts to minimize or avoid them. For instance, skin contact with certain foods or with baby drool around the mouth can cause eczema. So, if you notice this issue, consider using Aquaphor or Vaseline as a barrier around baby’s mouth before feeds and naps.5
If you suspect that a particular shampoo or detergent is contributing to your baby’s eczema, consider switching to a gentler, fragrance-free product.5 Try using a humidifier in your little one’s bedroom if the dry air is drying out their scaly skin, but you should keep the humidity below 40% to prevent dust mite growth.4,6
Dietary changes may be necessary if your baby has a food allergy triggering their eczema. If you’re breastfeeding, some doctors may recommend that you cut out the allergen, too, but this is less common. Other allergists suggest keeping it in your diet because continued small-dose exposure, while worsening eczema, can prevent the development of severe food allergy.7
While you can manage many cases of eczema with proper trigger elimination and skincare routine, sometimes topical or oral medications may be necessary:6
Steroid creams applied directly to problem areas can help decrease skin irritation.6 However, even mild over-the-counter steroids like hydrocortisone should be used under the supervision of a medical professional and for short periods of time (usually less than two weeks). This is to prevent side effects such as skin thinning and discoloration.8
Antihistamine medications like diphenhydramine (Benadryl) can help decrease the itching associated with eczema. They can also minimize eczema caused by allergic triggers. Many antihistamines can cause drowsiness, and you should only use them in babies at the recommendation and supervision of a doctor.8
It may seem counterintuitive to wrap your baby in wet clothes, but that is exactly what helps some kids keep the moisture in their skin. After applying any topical medication and ointments, put a cotton jammies onesie in warm water and wring out the excess. Place this on your baby first, then put dry jammies on over it. Make sure the temperature in the room isn’t too cool.13
Also called “pool baths,” bleach baths can help decrease the inflammation and bacterial load on the skin, decreasing eczema flares and keeping them at bay. Ask your doctor or dermatologist how to prepare bleach baths.17,18
Research is ongoing to investigate whether consuming probiotics (live good bacteria and fungi) is beneficial to a baby with eczema. So far, data shows that probiotics may help prevent eczema in high-risk babies whose mothers take probiotics during pregnancy and administer probiotics to their newborns. However, probiotics don’t seem to treat eczema once symptoms have developed.9
What To Do About Itching and Scratching
Eczema patches can be itchy and miserable for a baby. My daughter would scratch the patch on her neck until it was bleeding! Here are some interventions to prevent severe itching and scratching to this degree for your baby:
- Have baby wear mittens over their hands or pajamas to keep their fingernails covered and make them unable to scratch.1
- Keep baby’s fingernails short and less able to damage their inflamed skin.10
- Keep problem areas covered with clothing so they can’t scratch directly on their skin.10
- Choose natural fibers such as cotton, bamboo, or silk to allow their skin to breathe and air out.10
- Apply a cold compress to provide cooling relief to the itching sensation.10
- Soak baby in a lukewarm colloidal oatmeal bath for 10-15 minutes, then apply moisturizer and proceed with their skincare routine.10
- Distract baby from itching with things like play, a snack, a toy, or a story.10
- Gently pinching near (not on) the itchy patch can decrease the itching sensation briefly.10
- Hydrocortisone and other steroid creams decrease the inflammation and the itching sensation for your baby’s eczema.14,15 However, hydrocortisone isn’t recommended for children under 2 years of age.15
- For severe eczema flares, ask your doctor if a dose of Benadryl at night might be helpful while you get it under control.
There’s no cure for this condition, but many babies with eczema see it improve as they grow.6 If your child has a strong family history of eczema, severe eczema, early age of onset, and other associated conditions such as food allergies and asthma, they’re less likely to grow out of eczema completely.11
Eczema can persist into adulthood, but the condition may ebb and flow depending on the environment, triggers, and other factors.11 Awareness of eczema’s causes and your baby’s triggers, as well as proper and prompt management/treatment of flare-ups, can relieve your child’s discomfort, help you get ahead of worsening rashes, and get baby on the road to skin recovery.5
