Will Baby Eczema Go Away? We Asked A Pediatrician

Cold weather has begun to settle in which means winter is almost here! This change in weather can cause our skin, as well as your baby’s, to feel a little drier and itchier than normal. But how can you tell if your baby’s skin is experiencing something a bit more?

At least 1 in 10 children experience eczema, but when we asked our audience last month about their baby’s skin, we found out that many aren’t familiar with baby eczema and what it looks like. So we reached out to London-based pediatrician and mother-of-three, Dr. Kiran Rahim, to help us understand what baby eczema is, what it looks like, and how to properly care for your baby. 

Take it away, Dr. Kiran! 

What is baby eczema? 



Dr. Kiran: “Baby eczema is also known as atopic eczema and is characterised by the appearance of patchy red, sore, dry and itchy skin. It usually affects children, beginning in the first few months of life and into childhood. 



The irritated, inflamed, and itchy patches of skin can make your baby irritable and uncomfortable and be difficult for the whole family. It’s really important to understand how to treat eczema and how to keep the skin healthy. Watching your baby like this can be so difficult but it’s important to know that eczema is very common and very treatable.”

What causes eczema?

Dr. Kiran: “Unfortunately, there is no one cause for baby eczema. Eczema is thought to occur due to a combination of factors that include: an overactive immune system, a ‘leaky’ or defective skin barrier, genetics, environmental factors, and allergies. “

Baby2Body science deep dive!

When the skin suffers from eczema, there's an issue with the protein barrier of the outer layer of our skin called 'fillagrin', which helps provide a protective barrier between our skin and the environment around us. If the skin doesn't have enough fillagrin, it can have a difficult time staying hydrated and can be more succeptible to environmental irritants (leading to those dry, itchy patches).

How do genetics influence baby eczema?

Dr. Kiran: “We know that genetics plays a huge role in eczema and your baby is more likely to get eczema if both parents had it and at some point in their lives, particularly in childhood.

It’s important to understand that allergies do not cause eczema but exposure to allergens can make your baby’s skin worse. In certain families, there can be a history of atopy, which means you are more likely to develop allergic diseases as your immune system is more sensitive to allergic triggers that you might eat or breathe in. 
If you have a family history of atopy, you are more likely to develop asthma, eczema, and allergies. 
“

What environmental factors contribute to eczema?

Dr. Kiran: “Some other causes of eczema in babies include:

• Heat and sweating

• Using fragranced products

• Using products with alcohol

• Drooling


• Dry Skin

• Winter weather

• 
Harsh soaps

• Detergents

• 
Friction from clothes

All of the above could be reasons why some babies get eczema and others don’t.
“

How is baby eczema different from dry skin? 

Dr. Kiran: “Not every baby that has dry skin will have eczema. Dry skin is a feature of many skin conditions, including eczema. 

Dry skin is characterised by rough, tight skin which can become red and flaky. It doesn’t have a pattern and can happen all over the body, or parts that are exposed to water/harsh weather conditions more, such as the face and hands. 


Eczema, as above, is the presence of dry, red, sore skin that is itchy. It generally has a characteristic pattern in babies, usually starting in the cheeks and then progressing to the arms, legs and sometimes body. It also occurs in the areas that babies sweat most e.g. neck, groin and underarms. It often occurs in the folds of the elbows and knees. 

Babies can have dry skin AND eczema or another skin condition. The dry skin will make the eczema worse and this is why adequate treatment is important.”

What does eczema look like on babies and toddlers? 



Dr. Kiran: “Eczema in children can look different for different age groups. According to the National Eczema Society, babies up to six months of age are more likely to develop eczema on their face — mainly the cheeks, chin, forehead and also the scalp. When babies are teething, or learning to self-feed the area around their mouth that is exposed to drool and food can become more red and sore. 



In some babies, particularly in winter months or if they are over-dressed you may note eczematous patches in the folds of their necks, underarms and in the groin/nappy area as they are exposed to heat and sweat more. 

Once infants begin to crawl, you may note that the areas of eczema are worse on the areas that are exposed to friction such as the knees. 



Unlike babies, toddlers are able to scratch, vigorously, so their skin might have lots of scratch marks and thickened skin. Typically eczema in toddlers occurs in the folds of knees, elbows and around the ankles. 

As children grow older, the eczema tends to localise to the elbow folds and knee folds but can occur in other areas. 



Eczema can be much harder to spot in babies and children with darker skin. The skin can look brown, purple or grey instead of red, and can be much drier and look scalier. 
Eczema is more likely to occur around the eyes in brown and black babies, leading to them rubbing their eyes and having ‘dark circles’. “

Does baby eczema go away? 



Dr. Kiran: “Eczema is a chronic condition that is characterised by periods of flare ups and periods of healthy skin. Whether it will ever go away depends on many things like family history, or whether you have concurrent illnesses such as asthma or food allergies. 



Whilst many children grow out of eczema — 50% will by age 7 — it’s important to remember that there is no cure, and so treatment aims to control rather than cure the eczema. If your baby has eczema at an early age, their skin may remain sensitive even if the eczema doesn’t recur in childhood.”

Can you prevent baby eczema? 


Dr. Kiran: “There is no ‘one way’ to prevent baby eczema and the best thing you can do to prevent flare ups is to follow a good skin routine for your baby AND seek medical attention early.
“

Best treatments for baby eczema

Dr. Kiran: “Since each child’s skin and trigger is different, their skin treatment needs to be tailored to them. Some therapies work better for some and don’t for others. It’s important to trial and error to find what suits your baby and their skin. 

The basics of eczema management are based on a combination of three things:


1. Daily Bathing. A daily bath with an oil and emollient can help soothe the eczema and reduce dry skin and itching in your baby. An emollient will also act as a cleanser, remove dirt and protect your babies skin barrier. 
General recommendations for bathing are:

• A 15 minute lukewarm bath. Avoid baby washes, bubble baths or fragranced products

• Use a bath oil

• Use a soap-free cleanser (an emollient wash product)

2. Emollients. These are essentially moisturises that soften the skin and maintain hydration by providing a surface film of oils. Emollients increase water content in the layers of the skin, repairing your baby’s skin barrier and preventing flare-ups. They can come as oils, gels, creams, or ointments and vary in their ‘greasiness’, and should be used twice a day. They’re very safe to use and you cannot ‘overuse’ them. You might need to experiment with a few types and combinations to see what works best for your baby. For example you may use a cream in the day and an ointment or gel at night.

3. Steroids
. Topical steroids are first-line treatments for babies with eczema and are perfectly safe to use. We have been using them for decades and they reduce the inflammation and help further damage to the deeper layers of skin. They need to be applied cautiously to active eczema and usually for a set period of time.”

What should I do if I think my baby has eczema?

Dr. Kiran: “Remember, if you think your baby has eczema, early recognition and treatment is best. 
It’s important not to try and use home-based remedies before you seek advice from a healthcare professional. These can make eczema worse and more difficult to manage. 

The mainstay of treatment for eczema is daily bathing, steroid therapy, and regular emollient use.”

More tips for managing eczema

• Keep babies room cool, heat can exacerbate eczema and lead to sweating


• Loose cotton clothing, this will reduce friction between the cloth and the skin.

• Reduce scratching by keeping babies nails short (I highly recommend the nail snail baby trimmer) and put on anti-scratch mittens


• Avoid using toothpaste, corn starch, olive/coconut oils on the baby’s skin


• If using wipes, make sure they are non-fragranced and alcohol free

• Avoid dietary triggers, as some foods such as cows milk and eggs can trigger eczema symptoms. Its important you discuss making ANY dietary changes in your babies diet with your GP first.

Finally, having a baby or child with eczema can be extremely worrying and hard work. Please remember you are not alone! If you are unsure of how to use the treatment or anything else, talk to your health visitor or GP.

If you live in the UK, you can also access the National Eczema Society Helpline on 0800 448 0818.

If you live in the US, you can call the National Eczema Association at 415.499.3474 or toll free 800.818.7546.

This post was created in collaboration with Dr. Kiran Rahim

Dr. Kiran Rahim is a Paediatric Doctor in London. She graduated from Barts and the London School of Medicine in 2011 and completed her foundation training in London. She is a passionate advocate for child health, health promotion in BAEM communities and supporting women to pursue higher education and leadership roles. She uses her social media platform, @themunchingmedic, to talk about key issues relating to women and child health, providing tips and medical advice in an empathetic and non-judgmental way.

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