Eczema in babies and children

What is infantile eczema?

Eczema in babies and children is not uncommon. It varies enormously in severity and is characterised by an intensely itchy, dry inflammation which has periods without symptoms and outbreaks where the condition flares up.

Closely related to asthma and other allergies (such as hay fever or dust/animal sensitivity), most children with infantile eczema will outgrow the condition though some may continue to suffer from it all their lives.

Causes

Nobody knows what causes baby eczema, but for 75% of sufferers either eczema, asthma or hay fever run in the family.

The disease usually becomes apparent before the child reaches the age of five, and most frequently appears when the child is between two and six-months old.

Symptoms

The rash will usually show itself for the first time on the baby's cheeks, then spreads to the rest of the face and neck, diaper area and arms and legs. The child will probably be upset by it, the irritation and itching being worse at night. However, with consistent skincare a number of the more serious complications can be avoided.

Complications

The eczema can in some cases become infected with bacteria in which case there will be some discharge of pus. If this occurs it is important to see a doctor or dermatologist without delay.

At the age of around 18 months to two years, the disease begins to resemble adult eczema and follows a more typical distribution on the body; the rash appearing behind the knees, in the bends of the arms, wrists, ankles and neck.

Pre-conception advice

If you or your partner suffer from eczema it is thought that a change in diet might help reduce the risk of passing on the condition to your children if you consult your doctor and begin to make changes before conceiving your child.

If you have a child with infantile eczema:

* Make sure your child wears cotton clothes - not woollen or synthetic items, which will cause sweating and skin irritation.
* Wash clothes in perfume-free soap. If your water is hard, add household vinegar when rinsing.
* Apply plenty of moisturiser several times a day. In the summer, this should be a relatively thin lotion, whereas in the winter a thick cream should be used. Use non-soap based cleansers when washing the skin, for example aqueous cream.
* If the eczema begins to suppurate - ooze pus - or small yellowish blisters appear in the eczema, consult a doctor at once. The eczema is probably infected and will need medication. * If your child has any allergies, make sure you get treatment and try to avoid things or situations you know make the allergy worse. These could include stress.

Treatment for infantile eczema

The aim of treatment for baby eczema is to recognise and avoid triggers which start the rash and cause a flare up of an existing condition. Keeping the skin well moisturised with emollients helps soothe itching and inflammation and prevent excessive dryness, cracking and flaking.

Eczema that can’t be controlled with just moisturisers will normally need treatment with a steroid cream that your doctor or dermatologist will prescribe. Steroid creams are prescribed by your doctor to reduce the skin inflammation. They are safe when used correctly. The stronger the cream and the longer it is used, the higher the small risk of side effects. These should be discussed with your doctor.

If you suspect that your baby or child has infantile eczema you need to get a correct diagnosis from your doctor as soon as possible to develop ways of managing the condition.

Cradle Cap

Real name Seborrheic Dermatitis, cradle cap can, if severe, be responsible for cases of eczema in small babies.

What is Cradle Cap?

Cradle cap is a disease of the scalp in babies, characterised by greasy, yellow, scaly patches on the skin of the scalp. It looks a bit like dandruff as it dries and flakes off. The scaling can develop into quite a thick, unsightly layer but the baby is not in any discomfort or distressed by it. It does not hurt or itch.

The cause is unknown but cradle cap is not brought about by infection, allergy or inadequate washing. There is a theory that it is a result of hormonal changes which stimulate secretions from the oil glands in the skin.

It usually disappears on its own within a few months of birth, but can persist or recur in patches for longer.

Cradle cap will eventually clear up on its own but the most common home treatment is to massage a little baby oil or olive oil into your baby's scalp at bedtime, then in the morning gently wash the hair and massage gently with your fingers or a soft baby toothbrush to loosen scales. Several applications might be necessary.

Cradle Cap Eczema

In rare cases, the condition can spread to the face, or to the body, where it can cause eczema in the nappy region (the groin) and the armpits. If the cradle cap appears to be spreading it is best to consult a doctor who may choose to treat it with hydrocortisone or medicated shampoo.

Severe cases are usually referred to a skin specialist.