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What helps eczema?
Q: My 7-month-old son has eczema. What can I apply on his skin that will not irritate it?
A: Jessica, thank you for your question about your baby’s eczema. Eczema is a fairly common skin condition in infants.

Eczema, also known as “atopic dermatitis,” is a red, dry, scaly, and itchy rash that is common in infants on the face, elbows, and knees. Eczema is often considered an allergy or sensitivity of the skin. It is more common in children when the parents have eczema, allergies, or asthma, since they tend to be hereditary.

Your baby’s skin is likely to be sensitive to many things—over time you’ll observe what tends to make his eczema worse and what makes it better. Think in particular about everything that comes in contact with your baby’s skin, and try to minimize his exposure to chemicals, perfumes, and other things that can be irritating. Some general guidelines are:

  • Dress your baby in cotton clothes—avoid wool and other rough fabrics, which can be irritating.

  • Wash the baby’s clothes, cot sheets, towels, and bib (and even your own clothes and linen)—anything that touches your baby’s skin—in mild laundry detergent that doesn’t contain perfume. Consider running the laundry through an additional plain water rinse cycle to remove the soap residue.

  • Don’t give your baby a full bath every day since the soap and water can be irritating for his eczema. You might want to clean his face, hands, and bottom well every day, but do a full bath only 1-3 times a week. Use a mild soap (like Neutrogena or Dove) that doesn’t have perfume or antiperspirant in it. Some babies are so sensitive to soap that you may need to use a soap-free cleanser instead, such as Cetaphil lotion. Consider adding baby oil to the bath water. And pat your baby dry gently—don’t rub—to minimize skin irritation.

  • Use a moisturizer on your baby’s skin to prevent dryness and itchiness, especially during the winter when the air is dry. Be sure to use a lotion that is free of perfume. Apply the moisturizer to his skin after the bath when his skin is still damp to help keep in the moisture.

  • Try different nappys to see whether they make a difference with his eczema. Some parents find that cloth nappys are best, and others find that a certain brand of disposable nappy is best. Many parents find that the chemicals in nappy wipes can also irritate their baby’s skin. Use nappy wipes that don’t have perfume. Try a hypoallergenic brand or rinse a regular tub of nappy wipes under running water and squeeze out the water and chemicals so you’re simply left with damp cloths to use. Use the nappy wipes only when your baby has a bowel movement, not just a wet nappy.
Some children develop eczema as an allergy to milk or a specific food. Try to see whether you notice a connection between his eczema and what he eats or drinks.

Work with your pediatrician to find out how best to minimize your son’s eczema. Sometimes, an antihistamine medication can help to reduce your baby’s itching, especially at night. Sometimes, steroid creams are helpful in controlling the eczema. Be sure to contact your pediatrician if your baby’s eczema patches show signs of infection—intense redness, swelling, warmth, and crustiness or pus. Ask your pediatrician if a referral to a dermatologist (skin specialist) might be helpful.

About half of infants with eczema seem to outgrow it by 2-3 years of age. In others, it can recur off and on. In all, the more you can do to try to prevent the skin rashes and itching, the better.
Karen Sokal-Gutierrez M.D., M.P.H. Pediatrician