Eczema

Also known as dermatitis, this common skin rash affects both adults and children. However, babies are also affected.

Many babies develop this in their first year of life. Around 8 out of 10 cases of eczema occur before a child reaches their fifth birthday.

These high numbers of cases show how common this condition is. It is no respecter of age, gender or ethnicity, and severe forms of this condition can have a traumatic effect on day to day living. Baby eczema is common and appears in two forms:

• Atopic eczema
• Contact eczema

Atopic eczema usually occurs for genetic reasons which mean that if you or someone in your family suffers from this then it is more than likely that your baby will do so. This also applies to conditions such as hay fever and asthma. Contact eczema develops as a form of a reaction to allergens present in specific products. In other words it is NOT an allergic reaction; rather it is a reaction to certain substances which may trigger an abnormal response. So your baby may find that he/she has a flare up of eczema when he/she is given cow’s milk or wears a woolly jumper. Potential allergens include yours and your baby’s diet (may be triggered by certain foods), wool and certain types of chemicals in fabric softeners, washing powders, soaps and lotions.

Symptoms of eczema

Symptoms are the same for both atopic and contact eczema and include:

• Red, inflamed or dry patches of skin
• Itchy patches of skin
• Sore, weeping or bleeding patches of skin

The rash usually starts as a series of red spots which then become sore and inflamed and turn into fluid filled blisters. These blusters then weep which can become infected if picked or scratched. This rash first appears on the baby’s scalp, forehead and face but then spreads to other areas of the body such as the arms and legs or chest.

You may find that your baby’s eczema is either the dry, crusty and very itchy sort, or is the inflamed, weeping, blister variety which can become infected.

Eczema is not contagious but the worst thing about it is the itchiness. It is extremely itchy which mean that it is tempting to scratch it to relieve this. But, scratching it will cause it to bleed and can lead to open sores. It is difficult to stop your baby rubbing or scratching his/her eczema but it is important to do so. Put mittens or socks over his/her hands to prevent him/her from doing so.

Causes of eczema

Not easy to say but the main causes appear to be genetic factors (eczema does tend to run in families), known allergens in certain foods and substances, changes in temperature (e.g. heat) and dry skin. Fabrics such as wool can also trigger an outbreak.

Treatment of eczema

The main issue here is to avoid a flare up of eczema which is extremely unpleasant. A flare up will result in hot, itchy and swollen skin which will contain fluid filled blisters that will ooze, especially when scratched.

There are a few steps you can take to minimise this which include:

• Ensure that your baby’s skin does not become too dry.
• Bath your baby on a daily basis. Use warm (but not HOT water) and a mild soap. After washing, shampoo your baby and then rinse so that he/she is not surrounded by soapy water. Pat him/her dry but don’t rub and apply an ointment called an ‘emollient’. An emollient is a cream or lotion which helps to keep the skin soft and smooth. Avoid highly scented soaps and shampoos that contain chemicals which may trigger a flare up of eczema.
• Trim your baby’s nails so that they are short and unable to scratch his/her eczema. Try putting soft cotton mittens or socks over her hands - if possible - to prevent him/her from scratching.
• Change your baby’s bedding for cotton sheets and dress him/her in loose, cotton clothing.
• Switch to non-fragrant products such as washing powder, soap and shampoos. Change to a biological brand of washing powder and avoid fabric softeners.
• If your baby also experiences sickness and diarrhoea then look at changing his/her diet. Eliminate certain foods such as cow’s milk, eggs and soya foods as these can trigger an eczema outbreak but check with your health visitor or GP first.
• Avoid any rapid changes in temperature. If your baby becomes too hot then this will worsen his/her eczema.
• If your baby has a flare up then apply a cold compress (damp cloth) to the itchy area several times a day. Then apply a moisturiser.

If your baby’s eczema doesn’t improve or worsens then contact your GP. He/she may require a prescription medicine such as a steroid cream or antibiotics.

Many cases of baby eczema disappear over time.

Complications of eczema

The main risk is that of infection. Eczema causes the skin to crack and bleed which opens it up to a bacterial infection. This risk also increases if your baby scratches his/her eczema. A bacterial infection can develop into something more serious so if your baby has an infection, see your GP.