May 2016

Treating Baby Eczema

There are several means in which the condition can be treated. But taking care of the skin of your baby is the very first step, especially for mild cases.

Use of Moisturizers

It should not just be any moisturizer. The product you need to use should be one containing ceramides. Such products can be purchased over the counter and by prescription. Petroleum jelly is also a good option along with other moisturizers that are fragrance-free. Daily application of this helps in retaining the natural moisture of their skin. It is best to apply it after giving them a bath.

Lukewarm Bath

Giving them a lukewarm bath helps in hydrating and cooling their skin. It is also good in reducing itching. You can ask your baby’s physician about using antihistamine to relieve skin itching.

If it is a severe case, the treatment for eczema can include antibiotics for infected rashes or ultraviolet therapy.

Preventive Measures

These are not the only ones available for baby eczema treatment. Be reminded that scratching is inevitable in this condition, which can further worsen the rash causing it to get infected. You can avoid it by trimming the nails of your baby frequently. If it can be done, use a file in taking the edges off. Slipping your baby’s hands with scratch mittens also helps. When bathing them, make sure to use mild and unscented body soap since anti-bacterial and perfumed soaps are not good for their sensitive skin. When getting them dried, just pat their skin. Do not rub it. Applying moisturizer is also best done when their skin is still wet.

Adding oatmeal-soaking products to their tub can help in reducing the itchiness on their skin. However, you need to consult your doctor first before doing it. Make sure to dress them in loose clothes to minimize irritation on their skin, which is the case if their clothing keeps on rubbing against it. Remember not to put too many blankets on them because it will only make them sweaty causing eczema flare.

Finding their baby suffering from this skin condition may be frightening for parents, especially for the new ones who might not know how to deal with it. But the information above on how to treat baby eczema can certainly help guide new parents on what to do.

 

Who does eczema affect?

We see eczema occurring more in those with a familial history of eczema and other allergic conditions like asthma and hay fever. Eczema together with the latter two conditions are a part of a bunch of conditions called the “atopic trio”. To give you an idea why these conditions are part of a gang, it is not common to find close relatives who also have these conditions in the family of a child who has eczema. Kids who have eczema are more likely to come down with allergic conditions however, it should be known that having eczema will not cause an allergic condition like asthma and vice versa.

 

Eczema in babies, how are they different from those in toddlers and children.

 

There are several ways eczema in babies differs from those in older kids.

  • The first is in terms of distribution: in babies, eczema tends to occur more on the scalp, forehead and cheeks. In fact, it can affect most other parts of the body, however, what is striking is that the area covered by the diaper is spared. At 6-12 months of age when the child is crawling, eczema is most prominent in the parts of the body involved in crawling that is the knees and elbows. The distribution also changes by the age of 2, when the condition spreads to involve the elbow and knee creases, as well as the hands, wrists and ankles. It may also involve the perioral and circumorbital skin. In older children and adolescents, the only places that may be involved are the hands.

 

  • A second difference is the physical presentation of the eczema: in babies, the eczema tends to be erythematous (red) and may ooze fluid out, a condition described as weepy. On the contrary, in older kids and toddlers, it tends to be drier, perhaps even scaly. The lines of the skin may become more obvious as the skin thickens.

 

What can cause an outburst of eczema in my child?

An outbreak or an exacerbation of eczema can occur under the following conditions:

  • When the skin is very dry.
  • when the skin is infected
  • When the skin is in contact with irritants.

In addition the weather is also known to contribute to this a worsening of the condition, specifically eczema tends to be improve in the summer time when there’s more moisture in the air and worsens in the winter when there’s less moisture in the air.

One source of irritation in babies can be seen from drooling saliva, as such eczema tends to occur in the areas saliva drools to and from like the cheeks, chin and the neck particularly the skin creases of the neck. If this is the case, preventing direct contact of saliva with the skin by the use of ointments like Vaseline can reduce the irritation. If the skin is infected, seeking a consultation with your dermatologist or pediatrician is important. Your specialist will be able to prescribe appropriate medication or antibiotics.

You should also be aware that there may be several triggers and these triggers vary depending on the child. Examples of such triggers include carpet, pets, scented products like detergents and perfumes.

 

Can this condition be cured?

Sadly, there is no known cure for eczema. Thankfully, the condition does tend to regress over time. One pleasant thing to note though is that eczema can be managed successfully.

 

What is the treatment for infantile and toddler eczema?

If you recall, we said on one of the possible conditions that worsens eczema is if the skin is infected and where the skin is excessively dry. To combat the dryness, developing a bathing plan is of great value. In the case of infections, a common thing that occurs is the inflammation of the skin. The use of steroidal creams that can be applied on the skin can be very helpful in combating the inflammation. This should be under the guidance of your doctor. In some severe cases, oral anti-inflammatory medication is used.

 

Bathing your child with eczema, a how to.

It is imperative that kids who have eczema must undergo bathing every day. Instead of just showering. The baths should not be long, lasting maximum 10minutes, it is also important that they be warm not hot. Hot baths are a big no no.

In addition go easy on the soap. You’ll also want to avoid other bathing additives like bubble baths or Epson salts as these can irritate the skin exacerbating the eczema. When bathing you don’t want to use washcloths and scrubbers. Apply a moisturizer immediately after bathing.

 

Can you recommend which cleansers I can use?

There are several cleansers that can be used. Examples of dermatologists-recommended ones include Stelatopia cream cleanser, and brand names like dove bar soap for sensitive skin. Do not use cleansers all over the body. Limit their use to the diaper area and any other body part that appears dirty. Unlike bathing, cleansers do not need to be used every day. You can check the seal of acceptance directory for more safe-to-use cleansers.

I have heard that bleach baths are recommended for children with eczema, what are they and why are they recommended?

Let’s answer this quickly. Bleach baths are recommended if the child has moderate to severe eczema along with a previous or present history of skin infection. They’re so recommended because their use helps prevent superimposed infections and allow for better eczema regulation.

There’s a common bacteria known as staphylococcal aureus that is a facultative organism. It normally lives on the skin of humans especially children and is gotten from their interaction with the environment. It is particularly found on the skin of kids who have eczema. Its presence causes an infection of affected skin worsening the eczema. Having bleach baths help reduce the amount of bacteria present on the skin, this can in turn lead to fewer incidences of skin infection. Having a bleach bath can be likened to swimming in a swimming pool that has been disinfected by the addition of chlorine.

 

How do I make my own bleach bath?

Very simple really. Simply add a quarter cup of bleach into a half-filled bathtub of clean water. If the child is a baby, then 1-2 teaspoons of bleach for every 4liters of water can be added to a baby tub. Ensure you dilute the bleach before allowing skin contact. This cannot be stressed enough. This is to prevent bleach getting into the eyes. And like regular bathing, you must immediately moisturize afterwards. You do not have to carry out bleach baths every day. They can be done a couple of times every week.

 

You talk about moisturizing after taking a bath? How do I do this for my child?

There are generally two forms of moisturizers that are approved when treating eczema:

Creams and Ointments.

There’s another form of moisturizer and that is a lotion. However these are not recommended as they’re mostly water. Ensure that within 3minutes of bathing, the moisturizer is applied. This is to keep the water from bathing within the skin keeping it moist. Also when applying moisturizer, do so in a thick layer at least twice daily. Creams and ointments due to their less water content trap water within the skin, pretty much the same way your plastic wraps seal the moisture in your food. This is the reason why lotions are not recommended. To find out more recommended moisturizers, you can consult the seal of acceptance directory.

 

Moisturizers, lotions and creams, what’s the difference?

All moisturizers contain two compounds: oil and water in varying proportions. This is what is used to class them. Generally, the more oil a moisturizer has, the more effective it is for dry skin. In order of the oil contents from the greatest to the least, you have ointments, followed by creams and lotions.

In addition, lotions and creams usually have some preservatives added in that may cause burns when applied to broken skin. Conversely ointments seldom cause any burns when applied. It is because of this reasons that ointments and ointment based topical preparations are preferred over lotions and creams. Lotions are generally contraindicated.

In the summer when there’s more moisture in the air, a cream may be used instead of an ointment to prevent heat rash which can occur following the application of ointments during this period. Ensure that any moisturizer you use, has no fragrance or any dyes. This is to prevent any irritation.

 

What if my kid complains of a stinging, burning pain on taking a bath or applying a moisturizer, what do I do?

If this occurs, then it’s advised you change to an ointment. That is if you were using a cream before. Your child is likely reacting to the added preservatives in the cream. Even when applied to broken skin, ointments don’t not usually because burning.

As for bathing, the addition of a cup of salt to the warmed bathwater is sufficient to prevent the stinging pain.

 

Are there shampoos that can be used for infants and young children who have eczema?

Yes there are. The use of regular baby shampoos are preferred. Specifically the fragrance type that is free of any dyes. Generally, the fewer the ingredients, the better it is for use. A specific example is exederm baby shampoo. You can check out the seal of acceptance product directory for more approved shampoos you can use.

 

Is there a place or need for the use of steroidal ointments for children?

Yes there is. Generally very mild eczema can be managed with regular proper bathing followed by adequate moisturizers. For mild eczema, there may be the need for the use of a low-potency steroid that is applied to the affected skin. However, most kids with moderate to severe eczema will require regular daily use of topical steroidal preparations that are in the low-to-medium strength range to get a grip on the eczema.

 

If this is so, are steroidal ointments safe to use?

Yes they are, when used in the proper manner. Some safety tips when applying them include:

  • Do not apply them on unaffected, normal skin. Restrict their use to only the affected skin.
  • As much as you can, you want to avoid applying these topical steroids to the folded areas of skin that is under the breast, the groin area, thighs and armpits for extended time periods.
  • Do not ever use these steroids on the eyelids.
  • On the face, apply only the mild steroids. Especially those your dermatologists prescribes.
  • In managing the eczema, you want to use only the lowest, most effective topical steroid that is the mildest steroid that works. There’s no need going overboard in terms of ointment strength. Your skin specialist can help you determine this.
  • Always limit the use of these agents to a maximum of 2 applications daily.

You can also use topical nonsteroidal anti-inflammatory meds like protopic ointment. It’s approved for use in kids older than 2years. Though it is commonly use differently especially in combination with topical steroids in infants.

 

What are the ideal times to use a topical steroid on a child?

Like we said earlier, these ointments should not be applied no more than twice a day. The first should be done immediately after bathing. After applying the steroid, remember to apply a moisturizer over the steroid. If the skin is inflamed, reddened and itchy, apply the steroid ointment till the redness and itchiness subsides. Till the redness clears up, the skin may look lighter in color. You should be aware of this. Don’t worry. This is entirely normal and will improve as time goes passes.

 

Exactly how much steroidal ointment should I be applying?

The short answer is enough. You want to apply enough ointment such that immediately after application, the skin feels slightly sticky. In a few minutes after application, everything will be absorbed through the skin. Like we already said, do not apply topical steroids to normal skin, restrict its application to inflamed, itchy skin.

 

 

Apart from the use of steroids, are there other treatments for eczema in infants and young children?

Yes there are. Apart from the important treatments we’ve summarized above like the use of moisturizers and topical steroids along with gentle skin care. You can also use tar mixtures.

Preventing the infection of the skin by bacteria is vital. This can be done through the use of bleach baths. See the previous section on how to make up this bleach bath.

If an infection gets in, it should be managed with antibiotics-either systemic or in ointment preparations. To help with the itchy feeling, antihistamines are extremely helpful. However, you should be aware it causes drowsiness as a side effect predisposing children to prolonged episodes of sleep.

In some rare cases, some eczema do not respond to the usual treatment plan we’ve outlined in this page. Such cases are best handled with systemic anti-inflammatory medication that can be wither in oral or injectable form. Your kid’s skin specialist will help you determine whether this kind of treatment is needed.

 

I want to change my child’s diet. Will it help?

There are a lot of parents who believe that eczema is the manifestation of an allergy to a particular food and as such assume that removal of that food will result in the resolution of the eczema. This is not entirely true. The fact is a most cases of eczema do not have anything to do with eczema in any way. As a matter of fact, you are more likely to cause more harm if you remove food from your child’s diet in an attempt to get rid of the eczema.

If you child’s skin improves with the routine we’ve outlined above (use of topical meds and proper skin care) then it’s not likely there’s any food allergy involved. While it is true that some children develop eczema with food allergies, the argument that food allergies are responsible for eczema is not true. The development of red, swollen skin bumps that itch (those bumps are not at all like those seen in eczema) soon after consumption of a particular food usually within an hour is a sign your child is allergic to that particular food. You should avoid this food till you see your pediatrician.

I am breast feeding and/or giving infant formula. Could this be responsible?

Like we earlier answered, most cases of infantile eczema have nothing to do with a food or diet. This also applies even if you are breast or bottle feeding. If your child has eczema and you’re breast or bottle feeding your child, do not stop until you’ve consulted with your pediatrician. A lot babies who have eczema have been incorrectly tagged as being allergic to milk. Using the techniques of topical steroids and appropriate skin care will see a vast improvement in the condition of the skin.

 

Do I need to do allergy testing for my child?

Allergy testing is not usually recommended. This is because as stated earlier, most eczema cases have nothing to do with a child’s diet. Besides the current allergy tests can not accurately tell you what the eczema triggers are or will be. That being said, you should consider allergy testing if the following occurs:

  • your child develops any rash after consuming a particular food
  • The conventional eczema treatments outlined here does no result in any improvement in your child’s eczema.

Should is press on with the usual childhood vaccinations?

Yes you should. The only modification maybe that your pediatrician may recommend your child take attenuated vaccines (vaccines that are not live) if your child is on an anti-inflammatory medication.

 

Can my kid go swimming?

Yes. Your child can carry on with his/her normal childhood activities including swimming. The only thing is that your child may not be able to stay in the water for long periods especially swimming pools (which contain chemicals) because of the drying effect on the skin that can result. Before entering and exiting a pool that has been chlorinated, you should rinse and apply moisturizer on your child.

 

I noticed that my child’s skin appears lighter after the eczema cleared. Why is this so?

There are cells called melanocytes present in our skin. These cells are responsible for the color of our skin. Because of the inflammation in eczema, the action of these cells are impeded. Fortunately this effect is only temporary. Your child will recover her normal skin color when the cells regain full function.

 

Is there anything that can be done to prevent eczema from ever happening?

Sadly, there is no known way to prevent eczema from happening. There are certain things that can be done to reinforce the skin against any irritants:

  • Regular proper and gentle skin care with the use of a moisturizer twice daily.
  • Try as much as you can to know what the triggers of eczema in your child are and ensure you avoid them as much as you can.
  • Lastly be quick to respond to any patches of eczema as soon as possible. Its way easier to treat small patches than generalized diffuse rashes.