Patches of red, scaly skin on your baby may be as unwelcome as a 3 a.m. diaper change, but they’re about as typical. Up to 30% of children under age 2 have atopic dermatitis (eczema), says pediatric dermatologist Joan Tamburro, DO.
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Most children outgrow the condition, although flare-ups (flares) can recur throughout life. And dry, sensitive skin may always be a concern.
Eczema or just dry skin?
“Eczema can start as dry skin, but it’s more than dryness,” says Dr. Tamburro. “It’s a red, extremely itchy rash that can ooze or become even more red and itchy when scratched. Sometimes scratching can cause the rash to bleed, crust and scale over.”
Eczema can appear anywhere on the body, she says, but location often changes with age. It’s usually on the:
- Face and scalp in infants.
- Arms and legs in toddlers.
- Elbows, wrists, creases of hands, knees, ankles, feet and neck in teens and adults.
While dry skin can trigger flares, so can environmental factors, including:
- Allergens, like pollen and pets.
- Skin irritants, like laundry detergents, dyes, fragrances and other chemicals.
- Clothing fabrics.
- Heat and sweating.
In addition to avoiding triggers, good skin care is the best way to prevent the dry, itchy skin that can provoke eczema flares. Dr. Tamburro recommends parents help children with eczema:
- Bathe daily. “People used to think that bathing less was better for dry skin, but that’s no longer true,” says Dr. Tamburro. “Today, soaps, cleansers and washes are more mild and don’t strip skin of hydration.” Use lukewarm (not hot) water and mild soaps or products that are “fragrance free,” “hypoallergenic” or “for sensitive skin.”
- Slather on moisturizing cream. Do it immediately after bathing to seal in the most moisture, and then reapply moisturizer two or three times throughout the day. Studies show that moisturizing creams with ceramides — oils that reinforce the outermost layer of skin — are most effective.
- Stop itches from intensifying. Itching begets scratching, which begets more itching, which begets more scratching, which begets…. Ward off scratching before it gets out of hand with over-the-counter hydrocortisone ointment or antihistamine medication. Finding things to keep your child’s hands and brain busy also can help distract from the itch.
While it’s not curable, eczema can be controlled, says Dr. Tamburro. Those who have had flares, even as infants, need to protect their skin for the rest of their lives.
“Some parents are aggressive at treating other health problems but disregard their child’s eczema, thinking skin problems are no big deal,” says Dr. Tamburro. “When children are itchy every day of their life, it is a big deal. Kids suffer with it. Eczema needs to be treated.”