Atopic eczema – Flexural eczema

Atopic eczema in babies usually appears within their first year of life, but most children grow out of it as they get older. Sometimes – though far from always – eczema is paired with asthma and allergies.

What is atopic eczema and what does it look like?

Atopic dermatitis, or atopic eczema, is the most common form of eczema. A breakout is a sign of hypersensitivity and the term atopic means there is an ingrained tendency to get eczema, sometimes in combination with asthma and allergies. But other external factors also play a role. For example, heat, sweat, swimming and dry air can produce eczema or worsen an existing case. As a result, it is often difficult to pinpoint a specific reason behind eczema in babies and children.

A breakout generally starts out as redness, which is easier to see on light skin, as well as itchiness. The itching evolves into little bumps and blisters, which will form small scabs when they break. The skin often feels tough and a bit leathery, and may develop cracks that sting. Eczema breakouts often occur around the elbows and at the creases of the knees and feet, and this is called flexural eczema. However, infants tend to have breakouts on their faces, on the arms/legs, or spread across the back and chest. Most cases of atopic eczema improve mostly – or completely – in summer.

Atopic eczema is a clinical diagnosis that is easy to get from a doctor. Rarely does the diagnosis involve an in-depth exam with samples; rather, a doctor looks at the outbreak and weighs in factors such as genetics and how early the rash first appeared.

How is atopic eczema in babies treated?

Flexural eczema breakouts are treated with a moisturising cream several times per day, sometimes in combination with a cortisone-containing cream or salve. But before using cortisone cream, it is important to talk to your paediatrician for expert advice on babies’ sensitive skin and what your child needs in particular.

Once the rash is gone, usually you will just need to keep the skin moisturised with a rich cream applied both morning and night. The rash could return quickly if you forget to moisturise. Because babies have much thinner skin than adults, it’s a good idea to apply cream recommended specifically for sensitive baby skin.

You can also prevent skin irritation by:

• Not bathing the baby too often, and using perfume-free baby oil in the water when you do.
• Not applying soap and water directly to the rash.
• Using fragrance-free laundry detergent and avoiding all fabric softeners.
• Dressing your child in airy clothing.
• Try long-sleeve (but airy) pyjamas at night, to keep your child from scratching the rash, which will tear up the skin and make the itching worse.
• Keep baby’s nails short, for the same reason as above.

Atopic eczema in babies and children is sometimes aggravated by sensitivity to certain foods, such as eggs, milk, or citrus fruits. If you suspect a certain food is making the eczema worse, then talk to your paediatrician. Our article on skin has more information about babies’ skin and how best to care for it.

Please note that all information above is based on Swedish recommendations.