Eczema, also known as atopic dermatitis, is one of the most common skin conditions we see in children at our Hollywood dermatology clinic. It’s a chronic inflammatory disorder that causes dry, itchy, red patches of skin. While eczema can be frustrating for both children and parents, understanding its causes, triggers, and treatment options can make a huge difference in managing the condition and improving your child’s comfort.
Recognizing Eczema in Your Child
The most noticeable sign of eczema is persistent itching. Often, children will scratch so much that their skin becomes red and inflamed. In babies, eczema tends to appear on the face, especially the cheeks and scalp. In toddlers and older children, you’ll usually find eczema in the folds of the arms and legs, behind the knees, or on the neck. One important point to remember is that eczema can look different depending on skin tone. In children of color, eczema patches may appear lighter or darker than the surrounding skin, rather than simply red.
Because eczema is so itchy, children may scratch before you even see a rash. The scratching can lead to skin damage, cracking, and sometimes infection, which makes treatment more complicated.
What Causes Eczema in Babies?
Eczema is often connected to a child’s immune system reacting abnormally to environmental factors. Many children with eczema have what we call an “allergic tendency” or “atopic” profile. This means they, or their family members, may have other allergic conditions like asthma or allergic rhinitis (hay fever).
There are several common triggers that can worsen eczema:
- Irritants: Fragrances, soaps, detergents, and certain fabrics like wool can irritate the skin.
- Heat and Sweat: Overheating can cause flare-ups.
- Dry Skin: When the skin barrier is compromised, it becomes more vulnerable.
- Foods: While the link is controversial and varies by child, some kids react to certain foods like dairy, eggs, or nuts.
Can A Child Outgrow Eczema?
Eczema can improve or even resolve as children get older. Some kids “grow out of it,” while others may see their eczema change in appearance or location over time, for example, shifting from the folds of their knees as kids to their hands or face as adults. However, for some, eczema remains a lifelong condition requiring ongoing management.
Pediatric Eczema Treatment Approaches
When a child comes to our clinic with eczema, we first take a detailed history to understand potential triggers and previous treatments. We ask about family allergies, the skincare products they use, and environmental factors at home. Then, we develop a treatment plan tailored to the child’s needs.
The cornerstone of eczema treatment is topical therapy. Most commonly, this includes:
- Topical Steroids: These reduce inflammation and itching. We generally use milder steroids for children because their skin is more delicate, starting with the lowest effective potency.
- Non-Steroidal Topicals: Options like calcineurin inhibitors can be used in sensitive areas or for long-term management.
- Antihistamines: These are often helpful in children to reduce itching and improve sleep, especially if itching disrupts rest.
- Moisturizers: Keeping skin hydrated is crucial. Thick, fragrance-free creams or ointments help restore the skin barrier and prevent flare-ups.
Sometimes, eczema skin gets infected or colonized by bacteria, making it harder to heal. In these cases, we may add antibiotics, topical or oral, to the treatment plan.
For severe or persistent eczema, newer treatments called “biologics” are available. These injectable medications target specific parts of the immune system and can provide significant relief for children with difficult-to-control eczema.
Daily Care and Prevention
Beyond medications, prevention focuses on reducing triggers. We recommend:
- Using gentle, fragrance-free skincare products.
- Avoiding harsh soaps and detergents.
- Dressing children in soft, breathable fabrics.
- Keeping nails short to reduce skin damage from scratching.
- Maintaining a regular moisturizing routine to keep the skin barrier intact.
Eczema in children can be a challenging condition, but with proper diagnosis, trigger management, and treatment, most kids can achieve significant relief. Early intervention, attention to skin care routines, and working closely with a dermatologist near you are key to helping your child live comfortably with eczema.
