Atopic dermatitis, the most usual form of eczema, is very common in babies and small children. It often goes away as they grow, but about 1 in 4 kids do suffer from it when they’re little.
It looks like rash in the knee or the elbow flexures. There are areas of thickened skin, sometimes lighter in color, or sometimes darker. Some kids let little bumps, that leak if they’re scratched. Babies tend to get their rashes on the cheeks and scalp.
Nobody’s completely sure what causes any of this. This kind of eczema almost certainly has a hereditary component. And it’s got something to do with immune response. Things trigger it. In this respect, it’s related to allergy (though atopy and allergy are not, strictly speaking, the same thing).
Anyway, it’s miserable, and if you’ve got an itchy little kid in the house, you’ll want to do something to help.
Step one is to visit your dermatologist. There isn’t exactly a cure, but there are treatment plans, that may involve prescription medications, moisturizers, or small lifestyle changes to avoid triggers. These things help a great deal.
Step two is to consider things you can do, at home. There are several ways you can help. And the sooner you start them, the better your dermatologist’s care plan will work.
Four ways you can help
1. Be a better baby-bather. Little kids like to get dirty. That can irritate atopic skin. So, naturally, you want to toss them in the tub and get them clean. But go easy on this. Bathing, itself, can be hard on sensitive skin. Consider washing your kids only where they’re dirty. Keep the whole bath experience short, too, like 5 or 10 minutes. Don’t scrub, either – just clean as gently as you can. Keep the water tepid as well. Hot water may feel yummy, but it can be another trigger. If you’re using soap, try switching to a mild cleanser instead. Choose one that’s fragrance-free. You don’t need to add emollients to the bathwater, incidentally. Recent research has shown, to many people’s surprise, that these don’t actually do very much. Right after the bath, put on a moisturizer. Then put on more in a little while.
2. Figure out the triggers. Be watchful and you might be surprised at the number of things that cause your baby’s eczema to flare. It can be practically anything. Animal dander is a common one. So are smoke and pollen. Really dry air can be another. So can fabrics, laundry detergents, and shampoos. Even baby powder and wipes can cause trouble! Find these things, and take them away. One trigger you can’t take away is saliva. There is a ‘lip-smacking dermatitis’ that kids get around their mouths. For that, put on a little Vaseline before feeds and naps.
3. Steroid cream. Ask your dermatologist if one of the topical corticosteroid preparations is a good idea. They come in a lot of forms, so they’re easy to use, and they do help bring down inflammation and itching. They generally go on right after the bath, before the moisturizer.
4. Bleach baths. It may sound dreadful, but some kids with eczema find relief from very diluted bleach in their bathwater. Your dermatologist will tell you how to go about it safely. It seems to reduce the bacteria count on the skin, and it may help with the inflammation by changing the pH of the skin as well. We’re not sure. But this is something you can consider asking about. There are parents who swear by it.
The key is to be gentle with that sensitive skin. It’s very prone to infection, especially during flare-ups, by the way. You’ll know when that’s happening because you’ll see sores, yellow-orange crusts, or blisters. See your dermatologist then.