Eczema – Top 10 Questions Mom Asks


ID-100281316Is there something wrong with my baby’s skin? Many parents with eczema babies ask themselves this when the red, itchy rash first affect their newborn. Eczema, also known as atopic dermatitis, is an itchy inflammatory skin condition. It is fairly common with increasing prevalence in developed countries, affecting up to 20% of children. It is common for eczema to appear in the first year of birth and apart from the appearance of a rash and itch, lesions, pigmented skin or thickened skin, blister and pus may also appear. Most parents find themselves lost when the diagnosis is first made, particularly with the constant itch and discomfort that is affecting their infant. Here are top 10 questions parents ask that covers the basics and myths of eczema.

1. Why did my baby get eczema?

2-month-eczemaThere are many factors causing eczema, with the key ones being:

  1. Defective skin barrier – the inability of the skin barrier to retain moisture and reduced protection against irritants and allergens is associated with genetics. Babies with parents or siblings with eczema or other allergic conditions are at higher chance of eczema.
  2. Environment – interaction of the skin with the environment triggers eczema flare-ups. These can range from substances our skin come into contact with, to allergens we inhale (pollen and house dust mite) to allergens we eat.
  3. Intrinsic – For a smaller proportion of children, no known allergen is identified but instead they may get eczema when feeling hot or stressed.

Not all causes of eczema are identified, for instance, in more recent years, the role of skin microbes gains recognition as it is discovered that eczema skin has different flora compared to normal skin.

2. Can my Baby’s Eczema be cured?

Eczema is classified as a chronic condition that has no cure. However, many children ‘outgrow’ their eczema as their eczema goes into remission. Eczema can also be controlled, allowing eczema children to have a normal quality of life. The less severe the eczema, the fewer allergies, the higher chance of outgrowing the eczema.

3. Why is my baby’s face full of oozing blisters?

For an infant, the cheek is one of the common areas of body for eczema rash. Other parts of body include the scalp, torso and at joints. The cheek is one of the common areas possibly due to contact with milk and saliva, and oozing blister/pus is a sign of infection that can be due to constant rubbing of cheeks. Most parents are distressed that their infants rub their cheeks so much!

4. Is my baby dirty? Should I shower my baby more?

Some parents think that eczema is due to lack of hygiene or skin that is not showered properly. However, this is not so and moreover, prolonged shower in hot water can dry the baby’s skin and worsen the eczema. Baby wipes should also not be used for baby’s face as most of them contain ingredients that can trigger rash for a baby with eczema/sensitive skin.

5. My baby’s skin seems OK, do I need to moisturize?

Yes. As explained above, part of the problem with eczema skin is its defective barrier. Even when there is no visible eczema rash, it is important to moisturize so that the skin barrier is strengthened as moisturizer aims to absorb moisture, retain them and form a protective layer over the skin. Moisturizing has been shown with good results to reduce the medication needed (both in potency and frequency of use).

6. How can I stop the ITCH?

The constant itch and the lack of sleep (from the itch) can really wear both parents and children down. This may not be just for a few days; for many families with eczema babies, they have never had a good night’s sleep for years. Antihistamines can be prescribed for better sleep at night, but more importantly, having the eczema under control stops the itch.

7. Can I use the steroid cream prescribed?

This is to be used with caution because there are side effects to both topical and oral corticosteroids. The risk is over-using – where a cream may be used for too long, too often or of too high a potency. More often than not, the risk comes with visiting different doctors (for instance, seeing a general practitioner then seeing different specialists) and using the creams that all these doctors prescribe together or one doctor not knowing that a child has already been prescribed and using a certain cream for so long.

8. Is my older child spreading the eczema to the newborn?

No, eczema is not contagious. The likelihood of a younger sibling having eczema when his/her older sibling has it is high as genetics is involved in eczema.

9. What is triggering the eczema flare-up?

The good news to this question is that there are common triggers for different age groups and in different countries. For instance, for older children, house dust mite is usually the trigger. Countries with seasons seem to have higher pollen allergy. Countries that has fish as part of diet record lower fish allergy. Allergy testing can be performed for children as young as six months old.

10. The internet says this, why doesn’t my doctor say so?

In this age where everyone googles their medical condition, many parents find themselves confused – they may read something on the internet, ask their doctor and their doctor may wave them off. This can be due to many reasons, for instance, blatantly incorrect information, lack of time on doctor’s part or doctor’s apprehension to comment as studies are not conclusive. For parents researching information online, it is best to go to trusted websites.

Screen Shot 2014-08-21 at 9.56.48 AMThis article is contributed by Mei, also known as MarcieMom of Mei has co-authored the book Living with Eczema: Mom Asks, Doc Answers with her child’s doctor Professor Hugo van Bever. The book is available for sale at Amazon here.

Photo: Baby Under Blanket by patrisyu

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