Baby eczema on face

Contents

Signs And Symptoms Of Eczema

Eczema – What Does It Look Like?

The appearance of eczema can vary from mild forms, when skin looks dry and flaky, to severe forms, when skin can be extremely irritated and red. The most severe forms of eczema can make your skin crack and ooze. Even if your skin does not look dry, flaky, or red, it needs consistent care and protection.

It’s important to remember that eczema happens in cycles – at times, your skin may feel okay. Other times, it will feel itchy, and scratching leads to red, rashy, and/or leathery skin. Eczema tends to flare up when you’re exposed to triggers, which are substances or conditions that aggravate your eczema. These can include irritants, rough fabrics such as wool, emotional stress, heat and sweating. When you’re experiencing a flare, you’re more likely to scratch, which can aggravate already irritated skin and make the condition worse. NEOSPORIN ESSENTIALS® Products are for people with mild to moderate eczema.

Eczema most frequently appears on the face, arms, and legs, but it can show up in other areas, too.

Pictures of Eczema:

Mild Eczema

Moderate Eczema

Severe Eczema

Since there are varying levels of severity within eczema, it may be hard to know if you just have dry skin, or if you have eczema. Normal dry skin is usually a temporary problem, and does not tend to be very itchy or inflamed. If your dry skin turns into an itchy rash that appears frequently, it could be eczema. You may want to see a physician to confirm whether or not you have eczema, or to find out how severe your eczema is. NEOSPORIN ESSENTIALS® Products are for people with mild to moderate eczema.

With the proper management and product solutions, you can begin living your life with fewer interruptions from eczema.

In babies and children, eczema is seen in differing severity and different places on the body depending on age. Head, face and/or feet are more common areas for flares in babies and young children than adults.

Atopic Dermatitis in Children

What is atopic dermatitis in children?

Atopic dermatitis is a long-term (chronic) skin condition. It causes dry, itchy skin. It’s a very common condition in babies and children. It usually first appears between ages 3 and 6 months.

What causes atopic dermatitis in a child?

The exact cause of atopic dermatitis is not known. But some things are linked to it. They include:

  • Genes. This skin problem can be passed on from parents to a child.

  • Immune system. An immune system that isn’t fully developed may affect how much protection the skin can give.

  • External factors. These include being in winter weather, using hot water for bathing, using soap, and being in dry, hot temperatures.

Which children are at risk for atopic dermatitis?

A child has a greater chance of having atopic dermatitis if he or she has:

  • Family members with atopic dermatitis

  • Allergies

What are the symptoms of atopic dermatitis in a child?

Symptoms may come and go, or occur most or all of the time. Any area of the body may be affected. In babies, symptoms usually affect the face, neck, scalp, elbows, and knees. In children, symptoms usually affect the skin inside the elbows, on the back of the knees, the sides of the neck, around the mouth, and on the wrists, ankles, and hands.

Symptoms can occur a bit differently in each child. They can include:

  • Dry, scaly skin

  • Severe itching

  • Redness and swelling

  • Thickened skin

  • Pale skin on the face

  • Small, raised bumps that may become crusty and leak fluid if scratched

  • Rough bumps on the face, upper arms, and thighs

  • Darkened skin of eyelids or around the eyes

  • Skin changes around the mouth, eyes, or ears

  • Raised, red areas (hives)

The symptoms of atopic dermatitis can be like other health conditions. Make sure your child sees his or her healthcare provider for a diagnosis.

How is atopic dermatitis diagnosed in a child?

The healthcare provider will ask about your child’s symptoms and health history. He or she may also ask if you or other family members have atopic dermatitis, asthma, or nasal allergies such as hay fever or allergic rhinitis. He or she will also ask about allergy symptoms in your child. The healthcare provider will examine your child, looking for signs of atopic dermatitis. There is no specific test for atopic dermatitis. Testing is usually not needed, but it may be done. Tests may include:

  • Blood tests. Your child’s blood may be checked for levels of immunoglobulin E (IgE). IgE is released by the body’s immune system. It’s high in most children with allergies and with atopic dermatitis. Other blood tests may also be done.

  • Skin tests. Skin tests may be done to check for allergies or other skin conditions.

How is atopic dermatitis treated in a child?

Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is. There is no cure for atopic dermatitis. The goals of treatment are to ease itching and inflammation, add moisture, and prevent infection.

Treatment of atopic dermatitis includes:

  • Staying away from irritants, as advised by your child’s healthcare provider

  • Bathing with a gentle cleaner or body wash advised by the healthcare provider

  • Keeping your child’s fingernails short, to help prevent scratching that can cause skin irritation and infection

  • Using moisturizing lotion advised by the healthcare provider

Your child’s healthcare provider may also prescribe medicines. They may be used alone or together. The following are most commonly used to treat atopic dermatitis:

  • Corticosteroid cream or ointment. The cream or ointment is put on the skin. This is to help ease itching and swelling.

  • Antibiotic medicine. Your child may need to take liquid or pills by mouth to treat infection.

  • Antihistamine. Your child may need to take this medicine before sleep to help ease itching and improve sleep. It comes in liquid or pills and is taken by mouth.

  • Calcineurin inhibitor cream or ointment. Cream or ointment is put on the skin. This is to help ease itching and swelling.

  • Ointments that change the immune system. The provider may prescribe crisaborole cream to put on the skin.

  • Phototherapy (light therapy). Light therapy may be done in the healthcare provider’s office or at home.

  • Immunomodulatory medicine. This is a liquid or pill taken by mouth that affects the immune system. It may be used when other treatments don’t work well. This medicine may have side effects. Your child will have regular blood tests to check for side effects.

  • Biologic medicines. In severe cases, your child may need a new medicine such as dupilumab. This medicine is injected.

What are possible complications of atopic dermatitis in a child?

Atopic dermatitis can cause thickened skin, bacterial skin infection, and other allergy-related skin inflammation (allergic dermatitis). It can also cause poor sleep because of intense itching. And it can lead to depression. Overuse of steroid creams can lead to thinning of the skin and tissue beneath the skin.

How can I help prevent atopic dermatitis in my child?

The skin condition is usually passed on from parents to children, so it may not be possible to prevent it.

How can I help my child live with atopic dermatitis?

Atopic dermatitis has no cure. But it will usually get better or go away as your child gets older. There may be times when your child has few or no symptoms. And he or she may have times when symptoms get worse. This is called a flare-up. To help prevent flare-ups, make sure your child:

  • Stays away from triggers. Common triggers include irritants such as wool, soap, or chemicals. Other triggers include allergens such as eggs, dust mites, or pet dander. Stress is also a trigger.

  • Doesn’t scratch the skin. Try to keep your child from scratching. It can cause symptoms to get worse. It can also cause infection.

  • Always has short fingernails. Trim or file your child’s nails to keep them short and prevent scratching.

  • Takes baths or showers with warm, not hot, water. Air dry or gently dry the skin afterward.

  • Uses moisturizers. Put creams or ointments on after bathing.

  • Wears soft clothing. Don’t dress your child in wool or other rough fabric.

  • Keeps cool. Try to keep your child as cool as possible. Getting hot and sweating can make him or her more uncomfortable.

  • Doesn’t get the smallpox vaccine. It’s not a common vaccine, but people with atopic dermatitis should not get the smallpox vaccine.

Talk with your child’s healthcare provider about other ways to help your child’s skin condition.

When should I call my child’s healthcare provider?

Call the healthcare provider if your child has:

  • Symptoms that get worse

  • Signs of a skin infection, such as increased redness, warmth, swelling, or fluid

  • New symptoms

Key points about atopic dermatitis in children?

  • Atopic dermatitis is a long-term (chronic) skin condition. It’s common in babies and children.

  • A child with allergies or family members with atopic dermatitis has a higher chance of having atopic dermatitis.

  • Itching, dryness, and redness are common symptoms.

  • The goals of treatment are to ease itching and inflammation of the skin, increase moisture, and prevent infection.

  • Staying away from triggers is important to manage the condition.

  • It usually gets better or goes away as a child gets older.

Next steps

Tips to help you get the most from a visit to your child’s healthcare provider:

  • Know the reason for the visit and what you want to happen.

  • Before your visit, write down questions you want answered.

  • At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.

  • Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.

  • Ask if your child’s condition can be treated in other ways.

  • Know why a test or procedure is recommended and what the results could mean.

  • Know what to expect if your child does not take the medicine or have the test or procedure.

  • If your child has a follow-up appointment, write down the date, time, and purpose for that visit.

  • Know how you can contact your child’s provider after office hours. This is important if your child becomes ill and you have questions or need advice.

Understanding Your Child’s Eczema

What is eczema?

Eczema (eg-zuh-MUH) is the name for a group of conditions that cause the skin to become red, itchy and inflamed.

There are several types of eczema. Atopic dermatitis, contact dermatitis, dyshidrotic eczema and seborrheic dermatitis, also known as “cradle cap” in infants, are the most common types that affect children. Eczema, especially atopic dermatitis, often appears in the first six months to 5 years of a child’s life.

Eczema is not contagious. You can’t “catch it” from someone else.

For most types of eczema, managing flares comes down to these basics:

  • Know your child’s particular triggers to avoid exposure
  • Implement a daily bathing and moisturizing routine to protect skin and lock in moisture
  • Use OTC and prescription medication consistently and as prescribed to curb symptoms

There is no cure for eczema but there are treatments and more are coming. These include over-the-counter (OTC) remedies, prescription topical medications, phototherapy, and immunosuppressants.

Eczema, especially atopic dermatitis (AD), may look and act very differently as your child gets older. It’s important to understand which type of eczema they may have and also their symptoms and triggers so that you can better treat and manage it as they grow and change. The only way to be sure what type of eczema your child has is to make an appointment with your doctor.

Get the info you need to manage your child’s eczema

NEA has the tools to help you help your child in the classroom, at home and beyond

  • Learn what you can do to help your child manage eczema
  • Understand the importance of communicating with your child’s teachers, so they can help your child better cope in the classroom
  • Get tools and tips to manage your child’s “itch-scratch cycle” so that your entire family gets more restful sleep
  • Download NEA’s “Eczema Basics for Children” so that your child has everything they need to understand and manage their eczema

Sign up to learn more about eczema and your child

And you’ll also get the NEA “Eczema Basics for Children” booklet

Why did my child develop eczema?

The exact cause of eczema is unknown. Researchers do know that children who develop eczema do so because of a combination of genes and environmental triggers. When something outside the body “switches on” the immune system, skin cells don’t behave as they should causing flare ups.

We also know that children who come from families with a history of atopic dermatitis, asthma, or hay fever (known as the atopic triad) are more likely to develop atopic dermatitis.

Is eczema different for infants or toddlers, than it is for older children?

A painful, itchy rash on a baby’s face, torso or body (but usually not the diaper area) may be eczema

Eczema looks and acts differently in infants and toddlers than it does in older children. The location and appearance of eczema changes as they grow, so it’s important to know what to look for during every stage of your infant or toddler’s life.

Infants (first 6 months)

Eczema usually appears on the face, cheeks, chin, forehead and scalp. It can also spread to other areas of the body, but not usually in the diaper area, where moisture protects the skin. The skin at this stage also tends to look more red and “weepy.”

Babies (6-12 months)

At this stage, eczema often appears on your baby’s elbows and knees — places that are easy to scratch or rub as they’re crawling. If the eczema rash becomes infected, it may form a yellow crust, or very small, “pus bumps” on the skin.

Toddlers (2-5 years)

Atopic dermatitis frequently affects the face in children. It can appear as red patches with small bumps as shown here.

Around the age of two, your toddler’s eczema is more likely to appear in the creases of the elbows and knees, or on their wrists, ankles and hands. It may also appear on the skin around your toddler’s mouth and the eyelids. Your toddler’s skin may start to look dry and scaly at this stage and become thick with deeper lines — this is called “lichenification.”

Children (5 years+)

Eczema usually appears in the folds of the elbows and/or knees. Sometimes, it’s only on a child’s hands — at least 70% of people have had hand eczema at some time in their life. Redness and itchy patches behind your child’s ears, on their feet or scalp, may also be a sign of atopic dermatitis. But these could also be symptoms of another condition, like seborrheic dermatitis, which can exist with eczema.

What triggers my child’s eczema or causes it to get worse?

Some of the most common eczema triggers include:

Even your baby’s stuffed animals may be a trigger for eczema

  • Dry skin
  • Irritants
  • Heat and sweating
  • Infection
  • Allergens such as pet dander, pollen or dust

Your child’s eczema may be worse in the winter when the air is dry. Saliva from drooling can also cause irritation on your baby’s cheeks, chin and neck.

The best way to manage your child’s eczema is by getting to know their symptoms and triggers so that you can help keep it under control.

Learn more about common eczema triggers.

What’s the difference between eczema and atopic dermatitis in children?

Eczema is an umbrella term for a group of conditions that cause the skin to become dry, itchy and inflamed. Dermatitis – literal meaning: skin inflammation – is another word for eczema.

Atopic dermatitis is one of the most common types of eczema, affecting 13% of all children under the age of 18 in the United States. Atopic dermatitis is considered a chronic, inflammatory condition that is a result of an overactive immune system response to triggers inside and outside the body.

Will My Baby’s Eczema (Atopic Dermatitis) Improve Or Even Disappear?

When you finally identify those dry, red, itchy patches on your little one’s skin as baby eczema or atopic dermatitis, a lot of your worry and stress goes away. That’s because this form of eczema is very common (it affects one in every five children, ref: gosh.nhs.uk) and can be very easily treated without a prescription.

But often, knowing your baby has eczema (atopic dermatitis) can raise even more questions, like:

  • What causes baby eczema?
  • Can eczema (atopic dermatitis) be cured?
  • Can your baby’s eczema (atopic dermatitis) improve or even disappear?
  • What factors affect eczema (atopic dermatitis) flare-ups?
  • When will eczema (atopic dermatitis) first appear?
  • What is the best treatment for this skin condition?

Mustela is here to help. This article will answer those questions and help you see why, if you treat it correctly, eczema (atopic dermatitis) isn’t anything to worry about.

What Causes Baby Eczema (Atopic Dermatitis)?

If your little one is suffering from baby eczema, you’re probably wondering where it comes from. While environmental factors and your baby’s immune system probably have something to do with eczema, the short answer is that eczema is a genetic condition.

That’s right — it’s passed on from parents to children. If you or your partner have eczema or are prone to dry skin, you might pass it on to your little one. But don’t be discouraged. When it comes to dealing with eczema, preventing flare-ups is the name of the game.

So, realizing early on that your baby might develop eczema allows you to take action to reduce the risk of flare-ups.

While genetics is the cause of eczema-prone skin, various factors can lead to flare-ups (which appear as red, dry, rough, and itchy skin). This is when you really notice that your baby suffers from eczema.

Every baby’s delicate skin is sensitive to different things, so you’ll need to figure out what triggers your baby’s eczema specifically. For many infants, flare-ups can be caused by:

  • Dry skin (think extra-dry skin thanks to winter weather or dry climates)
  • Irritants like dust, air pollution, soap, lotion, laundry detergent, shampoo, and cleaning products
  • Heat (in the summer or from too many layers of clothes)
  • Diet (your baby’s diet or yours if you’re breastfeeding)
  • Poor gut health

Now that you know what causes eczema, you’re probably wondering if this frustrating condition can be cured.

Can Baby Eczema (Atopic Dermatitis) Be Cured?

The simple answer is no, eczema (atopic dermatitis) cannot be cured. This form of eczema is encoded in your baby’s genetic makeup and can never be removed completely. The red, itchy patches that flare up on your baby’s skin are caused by a combination of:

  • Atopic-prone (dry) skin
  • A reaction to some allergen(s) in your baby’s environment

As bad as that may sound, eczema does not pose a threat to your baby’s long-term health or happiness. Because eczema (atopic dermatitis) is essentially an allergy like the hay fever that most adults suffer from, that means there is relief that can improve your baby’s comfort level and temperament.

Unlike you, your baby can’t take an allergy pill. Instead, they just need a little TLC in the form of a daily application of an emollient cream. When your baby’s body reacts to the allergens, it’s with inflamed, itchy skin instead of with sneezing and a runny nose. When put that way, it doesn’t seem like such a major thing anymore, does it?

Can Your Baby’s Eczema (Atopic Dermatitis) Improve or Even Disappear?

Yes! Your baby’s eczema (atopic dermatitis) will get better, and will even disappear completely if treated properly. Again, that doesn’t mean your baby is cured.

Your child will always be prone to eczema (atopic dermatitis) outbreaks, even into adulthood, because of their atopic-prone skin. And those flare-ups will come and go from time to time depending on their environment and how much care is put into preventing them.

Before we talk about treatment options, it’s important to understand what factors can lead to an eczema (atopic dermatitis) flare-up, and when those flare-ups can first appear.

What Factors Affect Eczema (Atopic Dermatitis) Flare-Ups?

One of the major factors that can affect eczema (atopic dermatitis) flare-ups is your baby’s skin itself. The genetic condition mentioned earlier can result in what’s called atopic-prone skin. This is really just a fancy term for skin that is dry and easily irritated.

On a more technical note, atopic-prone skin is characterized by “holes” in the protective layer of water and oil (hydrolipidic barrier) on your baby’s skin. Those holes allow moisture to escape and allergens to get in. This combination of dry skin and irritation leads to flare-ups when conditions are right. What makes the conditions “just right”?

It all depends on the sensitivity of your child’s skin. If they suffer from extreme atopic-prone skin, every little thing may cause a flare-up. If they suffer from mild atopic-prone skin, only a very specific set of circumstances may cause a flare-up.

And those “just right” conditions also depend on your child’s environment and activities. They may be allergic to certain fabrics, the pet dander from your dog, or even something they ate. That’s why it’s so important to consult a physician to help you identify the triggers that set off your baby’s eczema (atopic dermatitis).

Another major factor that affects eczema (atopic dermatitis) flare-ups is regular daily care. As you’ll see in the care and prevention section below, the diligence with which you treat your baby’s skin goes a long way toward minimizing the itchiness and swelling of flare-ups and even keeping them at bay.

Now that we know what can lead to an eczema (atopic dermatitis) flare-up, let’s discuss when those flare-ups may first appear.

When Will Eczema (Atopic Dermatitis) First Appear?

The first signs of atopic-prone (dry) skin can appear at birth. Dry, even scaly, patches of skin can indicate that your baby may be suffering from an eczema (atopic dermatitis) flare-up.

Those flare-ups usually begin to occur when your baby is two months old, although they can appear even earlier. Flare-ups are nothing to get worked up or worried about. They will not cause any lasting damage to your baby’s skin unless they are left untreated and get infected.

From two months to one year of age, flare-ups will mostly appear on the chubby areas of your baby’s body, such as their:

  • Chin
  • Cheeks
  • Arms
  • Belly
  • Calves
  • Feet

Keep in mind that stress can also set off an eczema (atopic dermatitis) flare-up. So even if you treat your baby’s skin daily and haven’t seen an outbreak in months, when they start teething around six months, a flare-up may appear despite your best efforts.

This, in itself, is nothing to worry about. It doesn’t mean that the condition has worsened or that you did something wrong. It merely means that the stress of teething caused an extreme reaction on your little one’s skin. Keep up the treatment as we outline below, and when that initial teething pain goes away, so too will their eczema (atopic dermatitis) flare-up.

After the age of one, eczema (atopic dermatitis) may appear less on the chubby areas of your baby’s skin and more on the skin folds, such as elbows, neck, back of the knees, wrists, and even behind the ears (a particularly atopic-prone part of the body).

By the age of three or four, flare-ups will continue to appear on skin folds but will also appear on hands and around the mouth and eyes. By five or six, eczema (atopic dermatitis) usually goes away. This is thanks to a combination of treatment and your child’s development.

Even after the symptoms disappear, continue to treat your child just like you did before to minimize flare-ups from occurring.

A Note About Facial Eczema

Many parents will panic when their baby’s eczema flares up on their face. They’re nervous because the red bumps have appeared in such a prominent place, and they fear that their baby will suffer this way for the rest of their life.

If you feel like this at the first signs of your baby’s eczema face, try to relax. First of all, it’s a normal reaction to be concerned about your baby’s well-being. Second, as we mentioned above, eczema — even facial eczema — won’t cause any lasting damage as long as it’s treated properly.

One of the best ways to treat facial eczema is with a special cream designed exactly for that, such as Mustela’s Stelatopia Emollient Face Cream. Speaking of treating eczema, let’s talk about the care and prevention of baby eczema so you can get your little one feeling good as soon as possible!

Care & Prevention Of Eczema (Atopic Dermatitis)

Understanding the causes and contributing factors of eczema helps you understand how to keep it at bay. But at the end of the day what you really need is an action plan! You want steps to take to care for your baby’s eczema.

Below, we’ve listed eight ways to soothe your baby’s eczema-prone skin. Proper care will reduce itchiness when your baby is dealing with a flare-up and also prevent future flare-ups.

At Mustela, we love natural and eco-friendly solutions and we’ve listed a few in this article, but you can read more about natural eczema treatments for your tiny tot here. Without further ado, let’s jump in.

1) Identify The Allergen

Sometimes the cause of a flare-up can be hard to pinpoint, but do your best to identify any allergen that could have caused skin irritation. This could be dust, harsh soap, dry air, tight clothes, a certain food, and a host of other things.

Ask your pediatrician if eliminating certain foods would improve your baby’s eczema. And if you’ve identified an allergen (food or otherwise), remove it from your baby’s environment if you can. This might mean putting a humidifier in the nursery, buying new clothes, or trying new lotions and soaps.

2) Keep Your Baby From Itching

Baby eczema is annoying and itchy. One of your jobs is to keep your little one from itching and scratching at their eczema — easier said than done! Keep your baby’s fingernails cut short, and put mittens or socks on their hands so they can’t scratch (which just irritates their skin even more).

3) Dress Your Baby In Natural Fabrics

Because clothing can irritate your little one’s eczema-prone skin and cause a flare-up, be mindful of the materials you dress them in. Opt for cotton, linen, and silk, but avoid wool. Think natural, smooth, and comfortable fabrics.

To calm their skin and reduce itchiness overnight, try Mustela’s Stelatopia Skin Soothing Pajamas, which deliver soothing moisture while your baby sleeps.

4) Avoid Tight Clothing

In addition to being careful about the fabric of your baby’s clothes, make sure their clothes aren’t too tight. Tight clothing can irritate your little one’s skin, trap heat near their body, and cause them to sweat — all of which can contribute to an eczema flare-up.

On cold days, dress your baby in several layers rather than tight, thick clothing. Take layers off as needed so your little one isn’t too hot or too cold.

5) Wash Clothes To Prevent Eczema

To care for and prevent baby eczema, reduce allergens and irritants when you do laundry. To do so, use a hypoallergenic laundry detergent and consider putting clothes through an extra rinse cycle in the washing machine to rinse off any residual allergens.

After, dry your baby’s clothes inside. As nice as it is to let onesies and tiny pants dry in the sun and breeze, allergens from the great outdoors could get on your baby’s clothes and then irritate their skin.

6) Use Calming Products

Think about all the products you use on or around your baby. Do they contain irritants or chemicals that could aggravate your baby’s eczema?

Consider switching to eczema-friendly products that will help, not harm, their sensitive skin. Cover all your bases, from clothing and laundry detergent all the way to diapers and diaper wipes

7) Give Your Baby A Soothing Bath

Bath time can soothe your baby’s eczema and reduce itching if you do it right! Start with bathwater that’s not too hot and not too cold. If you have a bath thermometer, shoot for somewhere between 97 and 98.6 degrees.

Then add a bath oil to the water — like Mustela’s Stelatopia Bath Oil, which is specially formulated with sunflower oil, avocado oil, and chamomile extract to soothe, strengthen and soften the skin. It’s fragrance-free and great to use every day or during an eczema flare-up.

Next, wash your baby’s delicate skin with Stelatopia Cleansing Gel and lather their hair with Stelatopia Foam Shampoo.

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Finally, don’t leave your little one in the bath for too long. As much fun as bath time can be, a long bath can dry out their skin, which is not what you want! When you get your baby out, you’ll want to apply a calming lotion right away, which brings us to our next point.

8) Apply Emollient After Bath Time (And Every Day!)

Don’t let your baby’s skin dry out after bath time. Reinforce their skin’s moisture barrier by applying Stelatopia Emollient Cream when you get them out of the tub.

In fact, the best method for treating and preventing eczema (atopic dermatitis) flare-ups is to apply an emollient product to your baby’s skin every day and to bathe them with a gentle yet protective cleanser. We recommend Mustela’s Stelatopia Emollient Cream or Stelatopia Emollient Balm for repeated application and Stelatopia Cleansing Gel for bath time.

These specially designed formulas are safe enough to start using the day your baby is born and powerful enough to use every day thereafter to prevent atopic-prone skin and eczema (atopic dermatitis) flare-ups.

Since emollients are so important for eczema care, let’s take a look at the best way to apply an emollient cream.

The Best Way To Apply An Emollient Cream

Even though an emollient cream is specially formulated for eczema-prone skin, the way you use it isn’t really any different than the way you use a regular cream. Simply apply the emollient product twice per day to your little one’s clean, dry skin while paying special attention to particularly dry areas.

Step #1

Wash your hands to remove any foreign substances like dirt, pollen, adult hand creams, and animal dander. Washing is also a great way to soften and warm your hands so that you don’t irritate your baby’s skin or give them a shock when you apply the emollient.

We recommend avoiding regular liquid or bar soaps and opting instead for a gentle, fragrance-free soap like Mustela’s Stelatopia Cleansing Gel. This will minimize the risk that you transfer an allergen to your little one’s skin.

Step #2

Remove your jewelry. As an adult, you probably don’t think about how rough and sharp jewelry can be because it doesn’t bother your mature skin. But to your little one’s eczema-prone skin, a small nick or rough edge can feel like a pinprick.

Your baby will wriggle and move while you’re rubbing their skin, so we suggest removing all jewelry from your fingers and wrists before applying an emollient product. This will ensure that nothing comes between you and your little one’s sensitive skin.

Step #3

Make sure your nails are trimmed. You don’t have to trim your nails every time you apply an emollient cream. That’s unnecessary. You really just need to make sure they’re short enough (so they don’t poke or scratch your baby’s sensitive skin) and that there are no sharp points or jagged edges.

Step #4

Warm the emollient cream before applying it to your baby’s skin. Cold and heat can trigger an eczema flare-up just like dust, rough fabrics, and other irritants. You don’t want to accidentally cause an eczema flare-up while you’re trying to prevent them.

To warm the emollient cream, squirt a generous amount onto the palm of your hand. Then rub your palms together for about ten seconds (like you would if you were trying to warm them on a cold day). You don’t have to apply the emollient to the backs of your hands like you would a regular hand cream, so resist the urge to rub in a circular motion.

Additionally, before you dismiss this step as unnecessary, think about it this way. Most creams are stored at room temperature. Depending on the time of year and how cool or warm you like to keep your house, that can range anywhere from 65 to 80 degrees Fahrenheit.

Your baby’s normal skin temperature is 86 to 89 degrees Fahrenheit (about six degrees less than their core body temperature). So if you keep your house at 70 degrees Fahrenheit, the emollient cream will be at that temperature too.

Imagine applying a cream that is almost 20 degrees cooler than the temperature of your baby’s skin. That would come as quite a shock to your sensitive little one. You can avoid this shock and keep your baby comfortable (and flare-up-free) by warming the emollient cream before applying it to their skin.

Step #5

Apply the warm emollient cream all over your baby’s body. Even if your baby’s eczema only flares up in certain areas (like their wrists or cheeks), it’s a good idea to apply the emollient everywhere. This helps strengthen the hydrolipidic layer on your baby’s skin.

Don’t forget especially flare-up-prone areas, like the creases behind your baby’s ears and in their elbows and knees.

Apply An Emollient Multiple Times A Day

We recommend at least twice (morning and evening), but don’t be afraid to apply emollient cream three, four, five or more times per day if that’s what your baby needs to stay comfortable.

The gentle ingredients in Mustela’s Stelatopia Emollient Cream — like Avocado Perseose and sunflower oil distillate — mitigate the drying effects of environmental conditions by enveloping your little one’s skin in a silky, hydrating barrier that protects, moisturizes, and soothes dry, itchy skin.

With repeated emollient use and as your baby’s skin begins to repair its hydrolipidic layer, the potential for flare-ups will decrease. That means you’ll eventually be able to reduce the number of emollient applications your baby needs to stay comfortable and avoid flare-ups.

Reduce Eczema Flare-Ups For A Happy, Healthy Baby

Remember, fewer flare-ups doesn’t mean that your baby has been cured — that their atopic dermatitis has gone away completely. It just means that you’ve eliminated the irritants that cause flare-ups and that their sensitive skin has gotten stronger.

But until that happens, continue to keep your little one happy and healthy. For babies with eczema-prone skin, that means fewer irritants and plenty of emollient cream.

Keep Stelatopia Emollient Cream in your diaper bag, in the bathroom, and even at grandma and grandpa’s so you’ll always have it on hand. Your baby’s skin will thank you for it!

Eczema in Children

Have you noticed a rash on your child’s arms, legs, hands or face? Eczema, also known as “atopic dermatitis,” is a noncontagious, inflammatory skin condition that is characterized by itching, redness and scaly rashes. These symptoms can be painful, and can cause changes in skincolor and blisters. The itch associated with eczema can be severe and often interrupts sleep. When kids scratch their skin, they can get an infection. Infants who have eczema may rub against bedding or other things to relieve the itch.

Get Relief

Find an Allergist

Eczema most commonly shows up before the age of 5, but adolescents and adults can also develop the condition. About 60 percent of patients will experience eczema symptoms by age 1, and another 30 percent will experience symptoms by age 5. Children born into families that have a history of allergic diseases such as asthma or hay fever are at an increased risk for eczema. Eczema is not caused by any type of allergy, but is associated with the development of food and environmental allergies. Eczema develops due to a defective skin barrier. Eczema is often inherited and infants with parents who have allergies or asthma are at highest risk for development.

Eczema is considered to be part of the “atopic march.” The atopic march involves the diagnosis of eczema during infancy, followed by food allergy, allergic rhinitis (also known as hay fever) and asthma, typically in that order.

Some young children with severe eczema benefit from food allergy testing and potential removal of certain specific foods from their diet. Peanut, egg, and milk are the most common food allergies identified in these children. It is not recommended to test all children with eczema for food allergies due to the high rate of false positive results. This leads to misdiagnosis and unnecessary food avoidance. Scientists have found that people who have a protein deficiency known as Filaggrin deficiency are at risk for developing eczema.

Children and adults diagnosed with eczema can manage the condition with the guidance of an allergist. In cases of moderate or severe eczema, an allergist may recommend prescription medication, including topical steroids and/or antihistamine. Milder cases may be treated with ointments and moisturizers. Flare-ups of eczema can be caused by any fragranced product including cosmetics, soaps, and detergents. Other triggers include harsh clothing such as dry climates, cold air, illnesses such as the common cold and stress.

No parent wants to see their child suffer with a rash. An allergist can set your child on the right track, for the long term, to handle their eczema. See an allergist for expert care and relief.

Atopic Dermatitis and Eczema Symptoms & Causes

In-Depth

If your child has atopic dermatitis, you’ve probably struggled with how you can stop her skin from itching and causing painful irritation. At Children’s Hospital Boston’s Atopic Dermatitis Center, within the Division of Allergy and Immunology, we help you every step of the way. We understand that you may want to learn more about your child’s atopic dermatitis in order to fully understand the condition and get her the most appropriate treatment.

What is atopic dermatitis?

Atopic dermatitis is a chronic and relapsing inflammatory condition of the skin. Children with atopic dermatitis often have skin barrier dysfunction which causes dry, itchy, scaly skin. They can also have associated environmental and food allergies. Of children who have atopic dermatitis, 65 percent show signs in the first year of life and 90 percent show signs within the first five years. Half of all affected children improve between ages 5 and 15. Parents with atopic dermatitis are more likely to have children with atopic dermatitis.

What triggers it?

The main triggers of atopic dermatitis are dry skin, irritants, stress, allergies, infection and heat/sweating. It’s important to note that these are triggers that worsen the symptoms of atopic dermatitis, and don’t necessarily cause atopic dermatitis.

Is my child at risk for having atopic dermatitis?

Children with a family history of allergies, asthma and atopic dermatitis are more likely to have atopic dermatitis. In research studies, mutations in skin barrier genes such as filaggrin are commonly associated with atopic dermatitis.

What does it look like?

Atopic dermatitis often causes itching which leads to scaly, bumpy, red and/or swollen skin. If chronic scratching occurs, the skin becomes thickened and or hardened. It manifests on different parts of the body depending on the person’s age. In older children and adults, atopic dermatitis tends to appear on the creases of the arms and the back of the knees. In infants, it affects the face, trunk and extremities

How serious is it?

Atopic dermatitis is not a life-threatening condition. The usual cause for concern is a severe skin infection.

Is it curable?

It is not curable, but with proper treatment and medication, the disease can be well controlled.

Is atopic dermatitis the same thing as eczema?

Physicians often use the terms eczema and atopic dermatitis interchangeably because most cases of eczema are caused by atopic dermatitis. Eczema is a general term for dry flaky inflamed skin, which can sometimes be caused by something other than atopic dermatitis.

How does atopic dermatitis relate to food allergies?

About 25 percent of children with atopic dermatitis have a food allergy.

Who does atopic dermatitis mostly affect?

Atopic dermatitis usually affects babies or very young children, but it sometimes lasts until adolescence or adulthood.

What happens if my child doesn’t stop itching affected areas?

Prolonged itching of the skin can lead to lichenification, which means the skin becomes thick and leathery. Intense itching may break the skin, and lead to infections and or permanent scars. While atopic dermatitis is not a life-threatening condition, many patients with atopic dermatitis have an underlying skin barrier defect that requires them to take special care of their skin for their whole lives.

What impact can climate have on atopic dermatitis?

Extreme levels of dry climate, or hot and humid climates can trigger atopic dermatitis. For example, the cold dry air of winter in New England can trigger an outbreak of atopic dermatitis as well as the heat and humidity of summer. We recommend that parents find ways to help their child avoid exposure to extreme weather, such as using air conditioners in summertime.

What can children do to help reduce their atopic dermatitis while playing sports?

Sports equipment can be an irritant to areas affected by atopic dermatitis. Wearing moisture wicking clothes, taking a bath right after sports and taking medicine can help.

Triggers and Symptoms

What triggers atopic dermatitis?

  • stress
  • allergies
  • sweating
  • certain soaps, cleaners or detergents
  • long, hot baths or showers
  • rapid changes in temperature
  • low humidity
  • wool or man-made fabrics or clothing
  • dust or sand
  • cigarette smoke
  • certain foods, such as eggs, milk, fish, soy or wheat
  • bacterial skin infection or colonization

What parts of the body are affected?

  • The part or parts of the body affected by atopic dermatitis tends to change as a child ages. In infants and young children, it’s usually the face, trunk and extremities. In older children and adults, atopic dermatitis tends to appear on the creases if the arms and back of the legs.

What are the symptoms of atopic dermatitis?

  • dry, scaly skin
  • small bumps
  • redness and swelling of the skin
  • a thickening and hardening of the skin
  • raw and sensitive skin

When should my child see a doctor about her atopic dermatitis?

  • child is irritable and uncomfortable
  • child has trouble sleeping
  • rash spreads
  • child has a fever
  • child has pus or yellow crusts from affected areas

FAQ

Q: What is atopic dermatitis?

A: Atopic dermatitis is a chronic and relapsing inflammatory condition of the skin. Children with atopic dermatitis often have skin barrier dysfunction which causes dry, itchy, scaly skin. They can also have associated environmental and food allergies. Usually it affects babies and young children, but sometimes it can last until adolescence or adulthood.

Q: Why is it a cause for concern, other than being itchy and uncomfortable?

A: Severe atopic dermatitis can make it very hard for your child to enjoy school and play. Too much scratching or itching can lead to a severe skin infection. Additionally, the discomfort of atopic dermatitis can ruin sleep, which can affect your child.

Q: Can other children contract my child’s atopic dermatitis?

A:No. Atopic dermatitis is not contagious; however, if an allergen is a source of your child’s atopic dermatitis, it is important to avoid it.

Q: If my child has atopic dermatitis, will he be OK?

A: Although there is no cure for atopic dermatitis, it can be treated with bathing, emollients, prescription ointments and other treatments. Many children with atopic dermatitis get better as they grow older.

Q: Can stress cause atopic dermatitis?

A: No. Stress does not cause atopic dermatitis, however it can worsen the symptoms.

Q: Can atopic dermatitis leave permanent scars?

A: Yes. If your child suffers from a chronic case of atopic dermatitis and itches excessively, this can lead to permanent scarring.

Q: Can atopic dermatitis affect my child’s mood?

A: Yes. Atopic dermatitis is very uncomfortable, and can limit your child’s sleep, which may impact her mood, just as anyone would be affected by a lack of sleep.

Q: Can my child still swim in chlorinated pools?

A: Yes. Prolonged exposure to chlorine can make your child’s atopic dermatitis worse. However, if your child applies fragrance-free, hypoallergenic sunscreen before swimming, and quickly rinses off and applies moisturizer after getting out of the pool, her atopic dermatitis should not be aggravated.

Q: Should my child bathe daily even if he has atopic dermatitis?

A: Yes. It’s important for your child to bathe daily, moisturize and hydrate the skin afterward.

Q: If I prevent my child from being exposed to allergens, will her atopic dermatitis go away?

A:Most children have an underlying skin disorder, and their atopic dermatitis will not go away even if you limit exposure to allergens.

Q: What’s the difference between eczema and atopic dermatitis?

A:Physicians often use the terms eczema and atopic dermatitis interchangeably because most cases of pediatric eczema are caused by atopic dermatitis. Eczema is a general term for inflamed, itchy skin, which can sometimes be caused by something other than atopic dermatitis.

Questions to ask your child’s doctor

After your child is diagnosed with atopic dermatitis, you may feel overwhelmed with information. It can be easy to lose track of the questions that occur to you.

Lots of parents find it helpful to jot down questions as they arise- that way, when you talk to your child’s doctors you can be sure that all of your questions are answered. If your child is old enough, you may want to suggest that she writes down what she wants to ask her health care provider too.

  • How could the medication or treatments interact with my child’s current medication regiments?
  • How could creams or ointments interact with other creams or sprays, such as suntan lotion or bug repellent?
  • Are there any dietary restrictions my child needs to follow while taking atopic dermatitis medications?
  • What treatments and medications are covered by my insurer?
  • What are some things I can do to help my child’s itching and scratching?
  • How can I find out if any of the products, substances and foods around the house triggers my child’s atopic dermatitis?
  • How will atopic dermatitis impact my child’s social life?
  • What resources are available to help my child cope with the stress of having atopic dermatitis?
  • How could atopic dermatitis impact my child’s experience in the classroom?
  • How will Children’s Hospital Boston coordinate with my child’s school nurse to continue care at school? Managing food allergies at home

    About 25 percent of children with severe atopic dermatitis have food allergies. As many athletes know, having a game plan is crucial to winning. In managing allergies, it’s even more important. Learn new strategies for helping your child manage and cope with food allergies. Join the discussion on Children’s Thriving blog.

Types of Eczema & Dermatitis

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Eczema and dermatitis are common conditions that cause skin inflammation. This inflammation can affect people of all ages and may result in redness, bumps, dryness, cracking, or a scaly texture. Often, skin affected by eczema and dermatitis is so intensely itchy that people may not be able to resist scratching, especially at night.

Eczema and dermatitis are neither contagious nor life threatening. But skin inflammation may cause physical and social discomfort. Rashes may develop anywhere on the body but can be especially uncomfortable when they appear on the face and hands.

Understanding the types of eczema and dermatitis can be difficult; sometimes, the terms “eczema” and “dermatitis” are used interchangeably in casual conversation. Our dermatologists differentiate between them because treatments may differ.

Atopic Dermatitis

Atopic dermatitis is often called “eczema” and is sometimes also called “atopic eczema.”

Atopic dermatitis tends to run in families, and it’s more often seen in babies and children under the age of five years than in people in other age groups. Atopic dermatitis can appear at any age but often appears before a child is a year old.

The most common symptom of atopic dermatitis is an itchy rash in the skin folds of the arms, legs, and face. Sometimes, itching occurs before redness appears; that’s because the immune system releases substances under the skin that cause itching before the rash is evident.

Atopic dermatitis may also appear before or at the same time as hay fever, food allergy, or asthma—the term “atopic” indicates a tendency for these allergic conditions to develop together. These other medical conditions are not caused by atopic dermatitis, nor do they cause it, but doctors have noted that they often develop after skin irritation forms. The reasons for this are unclear and are being researched.

In infants, rashes may appear as red, scaly patches. They frequently develop on the face, especially the cheeks, but can emerge anywhere on the body. In children, the inflammation tends to appear in the crooks of elbows, behind the knees, and on the wrists and ankles. Atopic dermatitis rarely develops for the first time in adults, but many children who have it experience symptoms into adulthood. When adults develop atopic dermatitis, the itchy rashes can appear anywhere on the body.

Contact Dermatitis

Contact dermatitis occurs when your skin comes into contact with an allergen or irritant, and the body’s immune system responds with inflammation, which leads to redness, swelling, itching, cracking, and sometimes blistering. There are two distinct types of contact dermatitis: allergic dermatitis and irritant dermatitis.

Allergic Dermatitis

Allergic dermatitis occurs when your skin has a physical reaction after coming into contact with a substance to which your body is allergic. There are thousands of possible causes of an allergic reaction, including certain ingredients and fragrances in soaps, shampoos, and detergents; preservatives in moisturizers and cosmetics; chemicals in hair dyes; metals such as nickel, cobalt, or gold in jewelry; and chemicals in certain plants, including poison ivy and poison oak.

Allergic dermatitis can affect people of any age, male or female, and your doctor can identify which substances you are allergic to using a patch test.

Rashes caused by allergic dermatitis appear at the location of contact and often appear within hours or days—such as when poison ivy comes into contact with the skin. If you are allergic to nickel, for instance, and wear earrings containing the metal, a rash with crusting or oozing may develop on the earlobes a few days after you started wearing them. Sometimes a rash can take as long as a week after contact to develop.

Irritant Dermatitis

Irritant dermatitis occurs when something interferes with the normal barrier function of the skin and causes inflammation but not an allergic reaction. This happens to most people on occasion, as a result of routine exposures to irritating substances or to the environment. Common examples include chapped lips, dry hands in the winter, and diaper rash.

A person may develop irritant dermatitis as a result of repeated exposure to sports equipment such as shin guards or a helmet or frequent hand washing with harsh soaps. Acidic substances or harsh chemicals in the workplace can also cause irritant dermatitis when they come into contact with skin.

Unlike the rashes in other forms of dermatitis, the rash caused by irritant dermatitis can appear immediately at the site of exposure. Irritant dermatitis can also develop more slowly when the skin is repeatedly exposed to a trigger. The surface area, location, appearance, and itchiness of irritant dermatitis depend on the irritating substance and how much contact it has with the skin.

Nummular Dermatitis

Nummular dermatitis appears as raised, red patches that are often very itchy. These patches are often circular, or coin-like, which is what the word “nummular” means. This type of rash can appear anywhere on the body and may last for weeks or months.

Nummular dermatitis appears most frequently in people older than age 50 but may be seen in children and adolescents too. The cause of nummular dermatitis remains unclear.

How eczema might lead to asthma

“Scientists believe they have found what triggers many children with eczema to go on to develop asthma,” BBC news reported. It said that allergies and asthma often develop in the same people, and that 50-70% of children with atopic dermatitis (severe allergic skin problems) subsequently develop asthma. It said a recent study has shown that, in mice, a protein called thymic stromal lymphopoietin (TSLP), which is made in damaged skin, “triggered asthma symptoms”. The researchers reportedly hope that treating the skin rash early and blocking production of the protein might stop young people with eczema from developing asthma.

This study in genetically engineered mice identified a protein that could be part of the link between atopic dermatitis and asthma. However, this link is likely to be complex and involve various other proteins. Further research needs to determine whether TSLP is also elevated in humans with atopic dermatitis and plays a similar role in asthma risk, and to identify other proteins involved in this process. This type of research may eventually lead to the development of drugs to block the development of asthma in people with atopic dermatitis, but such a development will take time.

Where did the story come from?

The research was carried out by Dr Shadmehr Demehri and colleagues from Washington University School of Medicine. The authors received grants and support from the National Institute of General Medical Sciences (one of the US National Institutes of Health), Washington University, the Toyobo Biotechnology Foundation and the Japanese Society for the Promotion of Science. The study was published in the open access, peer-reviewed scientific journal PLoS Biology .

What kind of scientific study was this?

This animal study looked at the relationship between atopic dermatitis (also known as allergic eczema) and asthma. In allergic asthma, exposure of the surface of the lungs to a foreign substance (an allergen) provokes an immune response, resulting in inflammation of the airways, which makes it difficult to breathe. Atopic dermatitis is also the result of inflammation in response to exposure of the skin to allergens. Asthma is much more common in people who have had severe atopic dermatitis than in the general population. This is called atopic march. Researchers think that if they can understand the relationship between the two conditions, they may be able to stop asthma developing in this susceptible population, that is, to stop the atopic march.

There are several theories about this link. One theory is that if the skin’s protective external barrier against the environment has defects, this could lead to the immune system producing an allergic inflammatory response to any allergens present on the surface of the body, including the surface of the airways in the lungs. The researchers in the current study investigated this possibility using mice.

The researchers used genetically engineered mice that lack the gene with the instructions for making a protein called RBP-j in their skin, and so do not develop a normal skin barrier. The researchers observed the mice to see whether they developed skin symptoms.

They also exposed these mice and a group of normal mice to an allergen called ovalbumin (initially by injection and then through their noses) to see if they would develop allergic asthma-like symptoms. They then investigated whether a protein called thymic stromal lymphopoietin (TSLP) played a role in this process. TSLP is an immune-system-activating protein that is produced in greater amounts by skin with barrier defects (including in mice lacking RBP-j), and which has been suggested to play a role in both atopic dermatitis and eczema. They investigated TSLP’s role by further genetically engineering the mice lacking the RBP-j protein to block the effects of TSLP. As TSLP is present in the blood stream and moves around the body, the researchers thought that it might be sensitising the lungs to the development of asthma.

Finally, the researchers wanted to investigate whether high levels of TSLP alone were able to make mice sensitive to developing asthma-like symptoms in response to allergens. To do this they genetically engineered mice to produce high levels of TSLP in their skin (without lacking RBP-j). They exposed these mice and normal mice to allergens and looked at whether they developed asthma-like symptoms. They then repeated these experiments, but blocked the action of TSLP, to see if this had an effect. They also repeated these experiments in mice that were genetically engineered to have high levels of TSLP, but did not show any skin symptoms.

What were the results of the study?

The researchers found that genetically engineered mice that did not form a skin barrier because they lacked the RBP-j protein in their skin developed atopic dermatitis-like skin inflammation. If these mice were exposed to an allergen through their noses after an injection sensitising them to the allergen, they developed more severe allergic asthma-like symptoms than normal mice treated in the same way.

The RBP-j-lacking mice produced high levels of the immune-system-activating protein thymic stromal lymphopoietin (TSLP) in their skin. Mice that were genetically engineered so that the effects of TSLP were blocked developed less severe asthma-like symptoms in response to allergen exposure. However, their immune systems still had signs of activation, they had some skin-barrier problems and their skin still became inflamed when it was exposed to allergens. This suggested that other proteins similar to TSLP might play a role in these skin symptoms.

Mice that had been genetically engineered to have high levels of TSLP but no skin symptoms also developed severe asthma-like symptoms when they were exposed to the allergen, but normal mice did not.

What interpretations did the researchers draw from these results?

The researchers conclude that blocking the action of TSLP might be important in treating skin-barrier defects, and “may be the key to blocking the development of asthma in patients”.

What does the NHS Knowledge Service make of this study?

This animal study has identified a protein (TSLP) that may play an important role in the link between atopic dermatitis and asthma. The link between atopic dermatitis and asthma is likely to be complex and involve various other proteins. Further research will now be needed to determine whether TSLP levels are increased in humans with atopic dermatitis, whether it plays a similar role in asthma risk and to identify other proteins involved in this process. This type of research may eventually lead to the development of drugs to block the development of asthma in people with atopic dermatitis, but such a development will take time.

Analysis by Bazian
Edited by NHS Website

Links to the headlines

BBC News, 26 May 2009

Links to the science

Demehri S, Morimoto M, Holtzman MJ, Kopan R.

Skin-Derived TSLP Triggers Progression from Epidermal-Barrier Defects to Asthma.

PLoS Biology 2009; May: Open Access

Further reading

Abramson MJ, Puy RM, Weiner JM.

Allergen immunotherapy for asthma.

Cochrane Database Syst Rev 2003, Issue 4

Common questions about eczema

What is eczema? The word eczema simply means dermatitis, which is an inflammation of the skin. There are different types of dermatitis or eczema. The most common type of eczema in children is atopic eczema. The terms “atopic eczema” and “atopic dermatitis” mean the same thing. The child with eczema has sensitive skin, which is irritated very easily. Their sensitive skin often is itchy (the medical term is pruritus), and the eczematous rash results from the scratching or rubbing of the extremely itchy skin from which these children suffer. While it is apparent from observing a child with atopic eczema that the rash is very itchy, it may be more accurate to say that atopic dermatitis is “the itch that rashes.” Why does my child have eczema? Atopic eczema is believed to be a genetic disorder resulting in sensitive skin. It tends to be associated with the predisposition to become allergic to foods and substances in the air such as pollens, molds, animal danders, and dust mites. Some children with eczema develop severe allergic reactions to foods and many develop asthma and hay fever symptoms as they get older. Often there is someone else in the family with eczema, asthma or hayfever (allergic rhinitis), but this is not always the case. There are many external factors which may influence eczema on a day to day basis; some are irritants and some may be from allergy. Will my child “grow out” of eczema? The tendency for sensitive skin may remain even into teenage years or beyond. However, in most cases your child’s eczema will gradually improve as they get older. The age at which eczema ceases to be a problem varies. Many are better by the age of 3 years, and most will have only occasional trouble by the time they are teenagers. It is estimated that about 2/3 of children “outgrow” their eczema, although they may always have a tendency for dry skin. Only a few continue to have troublesome eczema in adult life. Is eczema due to an allergy? No, atopic eczema is not caused by any specific allergy. But atopic eczema may be worsened in some children from allergy to foods. Since this is the case only for some children, restricting diets as a general treatment of atopic eczema is not useful. However, when allergic antibody is demonstrated to a specific food by skin testing or a special blood test (which is often called a RAST for radioallergosorbent test although that test has been largely replaced by an ELISA for enzyme-linked immunosorbant assay), the possibility that the food can worsen atopic eczema should be investigated by a food challenge under medical observation. This is done by first withdrawing the food from the diet for two weeks and then giving the child that food while under medical observation. The most frequent observation that demonstrates the possibility that the food is worsening the eczema is the presence of redness and itching, particularly at the site of the eczema, within an hour (and usually sooner) after ingestion of the food. Of course, a food challenge of this sort is only done if the food has not previously been observed to cause a severe allergic reaction. When there are multiple foods to which allergic antibody is demonstrated, the most important ones to consider are those that are frequently in the diet. There is no need for concern about foods to which tests for allergic antibody are negative. Will allergy tests help my child’s eczema? Allergy tests identify the type of antibody that can cause allergic reactions. Children with atopic eczema are prone to make allergic antibody to many things that they eat, contact, and inhale. Some, but certainly not all of the allergic antibodies developed in a child may cause clinical problems. Allergy tests provide information that may or may not help the child’s eczema, depending on what is found from the tests, a careful medical history, and in some cases observations during exposure to a suspected food to which a positive allergy test is found. Allergy tests can also provide information about the risk of severe anaphylactic reactions (generalized hives with or without difficulty breathing), allergic rhinitis (runny or stuffy nose, sneezing), allergic conjunctivitis (itchy red eyes), or asthma.

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