Rosy baby cheeks are cute, but not when they come from eczema. Also known as atopic dermatitis, eczema is a skin disorder that causes patches of red, itchy skin and, occasionally, blisterlike bumps. This common condition affects about 1 in 10 children, with 60 percent showing symptoms before their first birthday.
Cause Eczema occurs more often in babies with a family history of eczema or allergies, though the exact cause is unknown. Food is a common trigger in young children, says Michael J. Welch, M.D., editor-in-chief of the American Academy of Pediatrics' Guide to Your Child's Allergies and Asthma. The most likely culprits are eggs and cow's milkÐbased formulas.
Symptoms The calling card of eczema is its intense itch. Red, scaly patches, which may crust over, follow, first on the face, then on the trunk and limbs, usually sparing the diaper area. Though outbreaks come and go, the dry air of winter tends to bring the most discomfort, says Dr. Welch. The most serious side effect of eczema is a bacterial skin infection caused by scratching. Call your pediatrician if you notice signs of infection, such as swelling.
Diagnosis A pediatrician will first try to rule out other possible causes of the rash, such as cradle cap or psoriasis. She may recommend that certain suspect foods be temporarily removed from your baby's diet to identify a trigger, or suggest that you try a low-allergenic diet for a week. Allergy skin tests may also help with diagnosis.
Treatment In about half of affected children, eczema clears up by age 3. Until it does, your child's pediatrician will likely prescribe a topical steroid cream (such as hydrocortisone) to treat flare-ups and possibly an oral antihistamine. Note that long-term use of steroid cream can cause stretch marks, thinning of the skin, and dilated blood vessels. New steroid-free options, such as tacrolimus ointment and pimecrolimus cream may be available for use when other treatments have failed.
Prevention To keep outbreaks at bay, use a mild, unscented soap for baths, and then gently pat your child's skin dry. Follow with a moisturizer for sensitive skin such as Eucerin, Aquaphor, or Cetaphil. One new product to try is Gentle Naturals Baby Eczema Cream by Baby Orajel. Long-sleeved and long-legged clothing and pajamas, along with keeping your child's nails clean and short, will help guard against infection from scratching. Avoid irritating clothing and skip laundry detergent that contains dyes or perfumes. About 75 percent of children with eczema will develop asthma or allergies; your doctor can help you spot symptoms. For a free copy of The Girlfriends' Guide to Pediatric Eczema, call 866-545-6711.