Having a baby with dry, red and itchy eczema skin can be heart-breaking. Especially when they scratch because it is so itchy. I’ve been there with our little one with severe eczema. Unsettled, not sleeping, scratching at his face and head whenever his hands were free. It was a steep learning curve, but after getting the help we needed from our doctor and specialists I’ve learnt a lot about how to help baby eczema and get this itchy skin condition under control. And some really practical things you can do to help your baby (and you).
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What is eczema?
Eczema is an inflammatory skin condition that causes skin to become dry and itchy. Problems with the skin barrier mean that it lets moisture out and irritants and allergens in.
Experts aren’t exactly sure what causes eczema (also called “atopic dermatitis”), but it is more common in people with allergies. It’s thought to be partly genetic and partly environmental.
Up to a third of children in Australia have eczema, and it can can have a big impact on the whole family1,2.
How do you know if you baby has eczema and what does baby eczema look like? Babies often develop eczema on the face first. It looks like patches of dry, scaling red skin. Our baby started with patches on the face, a very itchy scalp (bad cradle cap) and then itchy red patches on his tummy, arms and legs. Other places eczema can affect are behind the ears and at skin ‘flexures’ (the bends at the ankles, elbows and wrists).
Should you take your baby with eczema to the doctor?
If you think your baby has eczema, it’s definitely a good idea to make an appointment with your doctor to get a diagnosis and talk about treatment options. Your doctor might also refer you to a skin specialist (dermatologist) or an allergist.
When our baby developed eczema, we first saw our general doctor who gave us some general information on caring for his skin and also prescribed some topical corticosteroid creams to help. Unfortunately the eczema continued to get worse, so we did then go and see a dermatologist who was able to give us a lot more advice about management. Our dermatologist also changed the steroid creams to thicker ointments. After our baby was diagnosed with food allergies, our allergist became our go to for eczema advice as well. And the allergy nurse at the practice was a wealth of information.
Don’t hesitate to go back to your treating doctor at any time if your baby’s eczema is not improving, is getting worse or if you think it might be infected.
What treatments help baby eczema?
Moisturiser and emollients
Moisturiser is the most important thing to use for your baby with eczema. People often underestimate how important this is, or how often and how much moisturiser they should be using.
Our allergy nurse recommends using at least 250g of moisturiser a week for children. That’s quite a lot! We applied moisturiser in the morning before getting dressed and always after a a bath. It’s easy to see how you can go through 250g in a week if you are moisturising twice a day.
Which moisturiser is best for baby eczema?
Moisturisers can be runny lotions, creams or greasy emollients. We tried everything at first. Products recommended by the pharmacy, and products we read about online. Lots of the creams actually hurt due to some of the ingredients. Especially things like sorbolene.
Then we moved on to the thicker, white paraffin based greasy emollients. These were so much better and had a much bigger impact on our baby’s skin. However, some were just so greasy that they stained my clothes, the bedding and everything else. Finally our allergist recommended Epaderm. This is a thick 3 in 1 emollient made with white paraffins and a small amount of wax, which stops it being as greasy as some other products. You can read about the different brands we tried and why we still use Epaderm in our post: Our search for the best eczema moisturiser.
All of our favourite eczema products are also listed on our Shop page.
Ultimately, the best moisturiser for you to use is the one that feels good for you and you are happy to use as often, as as much, as you should. Be careful about using anything that contains food ingredients like goats milks, nut oils or other possible allergy causing foods. Not just if your baby already has diagnosed allergies. It is possible to become sensitised to food ingredients if they are used on broken skin, so it’s best to avoid food ingredients if you can.
Corticosteroids for red, itchy and inflamed eczema
Your doctor might recommend or prescribe topical corticosteroid creams or ointments to use on your baby’s eczema. They may prescribe a different strength to use on the body and a lower strength one to use on the face. Some people worry about whether it is safe to use steroids on young children. Or they may be scared to use them as often as they should. You should talk to your doctor about any concerns you have. Corticosteroid ointments were essential for us to help reduce the redness and itchiness or eczema flares. Used in the correct amount on the “bad patches”, they made a huge difference. Once the flare had subsided, we could usually go back to using moisturiser only.
Depending on which creams or ointments your doctor prescribes, and which moisturiser you use, you may need to apply the corticosteroids before or after the moisturiser. (For example, we had to use the steroid creams before the thick Epaderm, otherwise it wouldn’t penetrate to where it was needed). Ask your doctor or eczema nurse about this too.
Wet dressings or wet wrapping for eczema is a brilliant way to help sooth your baby’s hot and itchy skin and to improve eczema at the same time. It can also help reduce the amount of steroid ointments you need to use.
There are a couple of different ways to do wet dressings. The first involves applying corticosteroid creams and moisturisers, covering with wet towels and then wrapping in a crepe bandage or appropriate dampened clothing over the top. The other method is to using wet elasticated tubular bandages (like Tubigrip or Tubifast) over the top of the creams. RCH Melbourne has great illustrated instruction sheets for both methods, showing how to use wet dressings properly and everything you’ll need to do this: see Wet Dressings for Eczema (crepe bandages) and Wet Dressings for Eczema (elasticated tubular bandages).
As our baby’se czema started to get worse on his arms and legs, particularly the ankles and behind the knees, our dermatologist recommended wet wrapping. The doctor recommended (and we preferred) the Tubigrib as we could easily use it on eczema on ankles and wrists which were our main problem areas.
As well as helping improve eczema, wet dressings actually bring a lot of relief from the itching too. Especially if your child wakes up in the night due to itching and scratching. Wet wraps can be quite calming and soothing, and you can make it fun wrapping your little one up like a mummy before bed. Usually it’s best to use wet wrapping at night time while your baby is sleeping, but we sometimes also did this during the day when the eczema was flaring badly.
Be sure not to leave the wraps on after they dry out (if your baby isn’t asleep) as this will irritate and scratch the skin more.
For eczema on the face, cool compresses made (using disposable towels or even a baby facewasher) can help relieve itchy hot skin too. We would use these often for the face and sometimes for the hands too. Just wet some disposable paper towels in a bowl of cool water mixed with a bath oil (like QV) and hold the cool towel on the affected area for up to 10 minutes. When you’ve finished, apply some moisturiser. There are instructions for cool compresses on the RCH information sheets on wet wrapping linked above.
Because eczema causes dry skin that can crack, and scratching can break the skin barrier, skin infections can be a problem. If your baby’s eczema gets infected, you should seek medical advice as soon as possible. Your baby might need antibiotics and you may need to change your management (for example, not using steroid creams until the infection has cleared up). Signs of infection could be eczema looking redder and itchier than usual, or developing blisters or weeping fluid (which could be yellowish). We’ve had infections with staphylococcus aureus (“staph”) and Group B streptococcus (“strep”) which have needed treatment with antibiotics.
You might have also heard about “bleach baths” for eczema, Some doctors recommend this for children who often get infections in their eczema. This sounds scary, but uses very diluted bleach to help reduce bacteria on the skin that causes infection. You can read more about bleach baths for eczema from DermNet NZ and the Royal Children’s Hospital Melbourne. This is definitely something you should only do if recommended by your doctor and after you’ve been taught how to do it safely.
Avoid eczema triggers
One of the most important things you can do is try to avoid eczema triggers that cause your baby’s eczema to flare.
What can make your baby’s eczema worse?
We discovered that a lot of different things were eczema triggers for our little one, some which we learned by trial and error along the way. Many of these eczema triggers are still a problem now that he is older.
Eczema and allergies often go hand in hand. You may have heard of the ‘allergic march” or the “atopic march”. Babies with eczema may develop food allergies, asthma and hay fever (allergic rhinitis) as they get older. Our baby went on to have all of these allergic conditions.
In our experience, food allergies had a big part to play in our baby’s eczema. Even allergens in breastmilk would cause his skin to get worse. After the food allergy diagnosis, eliminating those foods from mum’s diet as well as his made a big difference. However, you shouldn’t remove foods from your baby or mum’s diet without reason and without discussing with your doctor first. We also had to contend with multiple environmental allergies including to dust mites, mould, animals and different types of grass and tree pollen. Exposure to all of these things could cause an eczema flare as well.
If your baby has allergies, careful allergen avoidance can help eczema too.
Heat and sudden changes in temperature can both aggravate eczema. You can help baby eczema by dressing your baby in the same types of clothes you would wear for the weather. Don’t be tempted to add extra layers. And don’t let your baby overheat in their car seat or pram with too many clothes or blankets. Also don’t make baths too hot.
Baby soaps and shampoos
So many baby soap and shampoo products on the market are designed to entice new parents into using them. They might be marketed as “sensitive”, “natural” or scented with lavender or other soothing fragrances said to help your baby sleep. Do you know what? New babies don’t really need to use soap. There is nothing wrong with bathing your baby in just warm water without anything added. If your baby has eczema, you should definitely avoid using any soaps or baby shampoos. Don’t use anything that foams. A better idea is to use a simple emollient or bath oil to add moisture to your baby’s skin. Epaderm ointment can be used in the bath. We also used QV Bath Oil for many years. Just be careful as these products can make the bath (and your baby!) a little bit slippery!
If you do need to use a cleanser of some sort (and we all know that sometimes babies can get very messy), use a soap free cleanser. You can use Epaderm as a cleanser as well (another of it’s handy 3 in 1 uses). We save the Epaderm for moisturiser and use Dermeze moisturising soap free wash as a cleanser, which is an Australian brand.
Definitely don’t use bubble bath. The same goes for bubble mix: our boy had terrible reactions to bubble mixture as a toddler, which is essentially soapy detergent.
As your baby grows and needs to learn to wash hands, use the soap free wash for this too.
Clothing and rough surfaces
The best baby clothes for babies with eczema are smooth cotton ones. The worst offenders for irritating already sensitive skin are wool, non-breathable synthetics like nylon or polyester and anything too textured, like fluffy fleece. I had a gorgeous little cotton hooded jumper for my boy, but the inside was lined with fleece and made him incredibly itchy, so it had to go. Watch out for wool or fleecy blankets and toys or comforters too. Even car seat covers can be soft and fleecy polyester. We used to use a simple cotton wrap over the top before placing our baby in the car seat, especially in summer.
It’s not just your baby’s clothes to consider either. You might need to watch what you are wearing yourself while nursing or carrying your baby. A woollen jumper for example might be fine for us, but not against your eczema baby’s skin.
Another surface texture we had trouble with was our woollen carpet. We weren’t in a position to replace it when our baby was little, so we just had to be very careful when letting him have floor or tummy time. I used to use a cotton playmat, or when he was a little older and rolling around more, I would just spread a large cotton sheet out on the floor where he was playing.
Dust can also be a trigger, especially if your baby has allergies.
Overly fragranced or chemical laden laundry detergents can irritate sensitive eczema skin. I used to wash all of our baby clothes, cot sheets and wraps separately in a sensitive laundry detergent. (We still use sensitive laundry detergent for the whole family today as we all have varying degrees of allergy and sensitive skin.)
Saliva and food
Some babies dribble a lot. Ours certainly did. Some babies dribble more when they are teething too. The constant moisture and wet necklines on clothes can also make eczema worse. If your baby has eczema you need to be even more careful about changing bibs or wet clothes. Also gently wiping baby’s face after eating as foods can be a trigger too.
As your baby gets older and is exploring the world more, dirt and sand can become more of an issue. Sand can be an eczema trigger for a few reasons. Obviously it’s gritty texture can irritate sensitive eczema skin and even be abrasive. Sand left on the skin after playing can also scratch. Sand often retains moisture. It can harbour bacteria and germs that can aggravate eczema too.
In our experience we found that beach sand wasn’t quite as bad as sand at playgrounds or homes with sand pits. This is probably because it was usually “cleaner” than sand box sand.
A lot of doctors recommend avoiding sand, but I must admit I didn’t want my boy to miss out on the fun of playing in, building with and squishing sand between his toes. We just knew that a trip to the beach or a play in the sand pit at a playground with friends would mean wiping off sand straight afterwards and a bath and lots of moisturiser as soon we got home.
It’s obviously best to keep little babies out of the sun altogether. If you need to protect your little one from the sun outdoors, stay in the shade and use a hat and longs sleeves. Babies with eczema shouldn’t get too hot anyway. Once your baby is a bit older you might need to start considering sunscreen as well.
Sunscreens for very sensitive, eczema prone skin can be very difficult to find. Just because it says “sensitive” or “baby” on the package doesn’t necessarily make it a good choice. For babies a very simple mineral (zinc) based sunscreen without food ingredients or fragrances is a good option. If you do need to use a little sunscreen, still keep the exposed areas that need it to a minimum by dressing appropriately with long sleeves or a rash shirt. You can read about the sunscreens we use here: Choosing the best sunscreen for sensitive skin, eczema or allergies.
Chlorinated swimming pool water can cause eczema to flare. If you take your baby to early swimming lessons or just a dip in the pool with you, make sure you rinse of the chlorine straight away and apply lots of moisturiser afterwards. While seawater shouldn’t be as much of a problem in theory, we find that it definitely hurt quite a lot and a wash and lots of moisturiser was necessary after the beach too.
There are many more things that might make your baby’s eczema worse, and a lot of them are hard to control. Being unwell with a cold or illness or being stressed can make eczema flares worse. And scratching – which creates a vicious cycle of making the eczema worse, more itchy, and harder not to scratch!
How to stop your baby from scratching itchy eczema
If you’ve suffered with eczema yourself, you will know that it can be incredibly itchy. And that it is hard to resist scratching to bring some relief. Scratching can of course make it worse, irritate the skin more and even lead to infections in broken skin.
Babies can’t control their urge to scratch at itchy eczema, so as parents we need to think of creative ways to try and prevent it. Our poor itchy eczema baby used to scratch his face and head until it bled when he first developed eczema.
Practical tips to prevent scratching
Some practical steps you can take to stop your baby from scratching incude:
- keep nails short without any sharp edges. You can use special baby nail trimmers, scissors or nail files to do this – like the ones in this gorgeous baby nail kit from Yiveko.
- use cotton mittens. (Obviously not all of the time, as your baby needs to explore with his or her hands and fingers when they are awake. I found that even just using a mitten on the hand that wasn’t holding on to a toy was helpful).
- use a cotton hat or bandanna. (Weather dependent of course, as you don’t want baby to get too hot, but it can be helpful if you baby has a very itchy scalp).
- put your baby to bed in a sleepsuit or bodysuit with enclosed hands. (Some baby all-in-ones have sleeves which can be folded open during the day and then folded over to make mittens during the night to help stop scratching).
Of course if your baby likes being wrapped or swaddled to sleep, this can make it a lot easier to prevent night itching too.
The wet wrapping or wet dressings already mentioned are also a really good tool to prevent scratching and itching.
As your baby grows, you can start to use distraction and keeping busy to prevent scratching. When they are older, you can teach your toddler to “pat and rub” any itchy spots instead of scratching.
Hopefully some of these practical tips to help baby eczema will lead to less itching, scratching and a more peaceful nights sleep for you baby, and for you. Although it can seem never-ending, fortunately many babies will outgrow their eczema as they get older.
If you have any worries or concerns about your baby’s eczema skin, be sure to speak to your doctor.
References and more information:
For more information about eczema diagnosis and management, make sure to check out these additional resources that we’ve referred to in putting together this post:
- Allergy & Anaphylaxis Australia’s Eczema (Atopic Dermatitis) page;
- This fantastic article about Atopic Eczema Management by Eczema Nurse Educator, Ms Derryn Thompson BN, MN, PC Allergy Nursing, PhD Candidate;
- Australian Society of Clinical Immunology and Asthma’s factsheet – Eczema (Atopic Dermatitis);
- Eczema Association of Australia website.
1Mullins RJ et al. The economic impact of allergic disease in Australia: not to be sneezed at. ASCIA/Access Economics Report. Nov 2007
2Martin, PE, Koplin, JJ, Eckert, JK, Lowe, AJ, Ponsonby, A‐, Osborne, NJ, et al 2013, ‘The prevalence and socio‐demographic risk factors of clinical eczema in infancy: a population‐based observational study’, Clinical & Experimental Allergy, vol. 43, no. 6, pp. 642-651.
*Disclaimer: Allergy Spot does not provide medical advice. You should always consult a suitably qualified medical practitioner in respect of your own medical conditions, symptoms or concerns. See our Website Terms for more details.