Eczema is the name given to a wide range of non-infectious skin conditions that can affect people of any age. Although the appearance of the skin can vary according to the severity, it is generally itchy and dry. In severe forms of eczema the skin can crack and bleed. If you think your child may have eczema take her to the doctor for her condition to be diagnosed, so it can be treated effectively.
Atopic or infantile eczema
This is the most common form of eczema in infants and usually appears at 2-6 months of age. The good news is that the condition clears up in half of those affected by the age of 18 months.
Atopic eczema tends to run in families. It is linked to hay fever, asthma, and other allergy-related disorders, so if anyone in your family has these conditions there is a possibility that your child may develop atopic eczema.
In infants the first sign of atopic eczema is usually an itchy rash, most commonly on their cheeks. This can then spread to the scalp, arms, trunk and creases of the legs.
This rash is the result of the skin having an allergic reaction that makes it become inflamed. This inflammation causes the skin to become itchy and scaly. The child should be encouraged not to scratch the skin because scratching causes the skin to crack and then it can become infected and weep.
The cause of eczema is unknown, but changes in temperature and humidity can often aggravate the eczema.
Diagnosing atopic eczema
Atopic eczema is easily confused with other skin conditions so always consult your doctor. Your doctor will usually be able to diagnose atopic eczema simply by examining your child's skin closely. However, in some cases, the doctor may want to make further investigations.
Treating atopic eczema
The treatment that your doctor advises you to apply to your child's skin will vary according to the exact appearance of your child's skin - whether it is cracked and weeping, dry and scaly, or dry and thickened.
However, whatever the appearance of the skin, the first thing that your doctor will recommend is that your keep your child away from anything that could make the eczema worse.
Dust mites may aggravate eczema symptoms, so vacuum regularly to keep dust mite numbers down. Some foods will also aggravate symptoms, so if you are weaning your baby watch carefully for any changes in the skin with new foods.
Avoid biological washing powders and fabric conditioners because this can also help to reduce eczema symptoms if your child has an allergic reaction to them. Stress and sweating can also aggravate symptoms, so try to keep your child at a constant temperature.
Wool will aggravate the itching of eczema, so do not dress your child in clothes containing wool. Use cotton clothing and bed linen, rather than those made from synthetic fabrics or wool, because they will allow the skin to breathe more easily, reducing the itching.
To prevent your child scratching their skin raw, keep their nails short and put them in cotton mittens at night.
If these tactics do not clear up the eczema, your doctor will recommend you apply a treatment to your child's skin. If the skin is cracked and weeping, your doctor is likely to suggest a soothing lotion or wet wrapping (enclosing the skin in lotion followed by bandages soaked in warm water). A mild antipruritic lotion or low-strength steroid cream might be suggested to soothe irritated, dry and scaly skin.
Corticosteroid creams are occasionally used to treat eczema but should only be used under the supervision of a doctor. Side effects are extremely rare with low potency corticosteroid creams, but it is still important to only apply these creams thinly and not use creams prescribed for someone else.
Success of treatment
Atopic eczema usually resolves with appropriate treatment in most infants before they reach the age of 3-4 years. However, atopic eczema is a chronic condition, so the skin condition can persist or return in later life.
Infantile seborrhoeic eczema or 'cradle cap'
This is a very common condition in babies under 1-year-old and its cause is unknown. It generally starts in the scalp or nappy area and quickly spreads. The skin becomes flaky and looks rather unpleasant, but luckily it is not itchy so does not cause the baby any distress. Massage your baby's scalp with olive oil, or baby oil and leave it on overnight. Shampoo the oil off in the morning and rub your baby's head gently with a towel. Cradle cap usually clears up within a few months, but if it hasn't, speak to your health visitor.