What is eczema?
Eczema, also known as atopic dermatitis, is a common rash occurring in people of all ages. It is particularly common in children. Eczema can start early, during the first few months of life. The rash of eczema is red, dry, and itchy. Some children grow out of it, while others can have sensitive skin and a rash for years. Eczema tends to come and go, and may get worse during certain times of the year, such as the colder, drier winter months.
What causes eczema?
Eczema is caused by a combination of genetic and environmental factors. Our skin should be a tight barrier – keeping moisture inside the body and the rest of the world outside. We now know that people who have eczema have differences in the proteins that make up the skin barrier – and that barrier becomes leaky. They lose moisture more easily, leading to dry skin. Additionally, people with eczema are more sensitive to environmental triggers that can worsen rashes. In eczema, the skin is prone to developing infections. Infants often have rash on their cheeks caused partially by drool – our saliva is great at breaking down food, and it also breaks down our skin proteins, leading to increased redness and sometimes difficult to control eczema on the cheeks.
What other things go along with eczema?
Eczema is part of a group of conditions called the ‘atopic triad.’ The atopic triad includes eczema, allergies, and asthma. We know that people with eczema are at higher risk to develop allergies (including food allergies), as well as asthma. People with known allergies may notice that their eczema worsens if they are exposed to something they are allergic too, including foods or pollens, but they are usually not the root cause of eczema.
Can we cure eczema?
Unfortunately, there is no cure for eczema. It tends to come and go, and predicting flares can be difficult. Kids do often outgrow some of their eczema, but they may continue to have rashes or sensitive skin for life. Our goal as dermatologists is to provide the tools and education to manage eczema and make it less impactful on the life of your child.
When should I be concerned?
I recommend seeing your doctor or a dermatologist when rash and itching continues despite moisturizing the skin – this is the first step in treatment, and sometimes mild eczema will improve with just moisturizing alone. If rash stays despite moisturizing, medicines may be needed to treat inflammation in the skin. In addition, if you are concerned your child may have a skin infection or if the itching is impacting their sleep or daily life, it is time to seek help.
How is eczema treated?
The first thing we do when treating eczema is to try to help the skin act as a better barrier. We use moisturizers to help with this. All moisturizers should be fragrance-free, since fragranced products can be very irritating to people with eczema. The best moisturizers are thick, greasy ointments like petroleum jelly. Next best are thicker creams that are scooped out of a tub. The best time to apply moisturizers are immediately after a bath, which seals in that great moisture. Ideally, moisturizers should be used several times a day. For infants, I recommend keeping a tub of cream at the diaper changing area and putting on moisturizer whenever you do a diaper change.
What are common triggers of eczema rashes?
Fragrances are common triggers for those with eczema. Eliminate all fragrances from personal care products. Soaps, detergents, and all other personal products should be fragrance-free. For infants, only use soaps on visibly dirty areas – often bathing in just water is okay.
How often can I bathe my child?
You can bathe your baby as often as you like. As long as you always moisturize afterwards, there is no ‘too much’ or ‘too little’. Infection can also be a trigger for the rash of eczema. We often utilize tools like weekly diluted bleach baths (which makes the bathtub like a swimming pool) to combat bacterial growth on the skin and prevent infection.
When are medications used?
When red, itchy rash is present, we often will need to use anti-inflammatory medicines to help reduce the active inflammation in the skin. This is where getting a doctor’s help is useful in determining the right strength of medicine, and how to use it correctly to avoid any side effects from its use.
With all of these tools, we can help your child to have less rash, less itching, and reduce the severity of any eczema flares. We are always happy to help develop a personalized plan for your child’s eczema that works for you and your family.
- Eczema is common, and occurs when the skin becomes a ‘leaky’ barrier instead of a fully protective one.
- Moisturizing and avoiding triggers are important first steps.
- Anti-inflammatory medicines are useful tools to treat the active rash of eczema.
- Eczema can’t be cured, but with the right tools, it can be managed. Our goal is to help your child have healthy skin and minimize the impacts of any outbreaks.
To schedule an appointment or to learn more, visit our Dermatology page.