Toddler eczema: Signs, development, triggers, and more - Medical News Today

Toddlers with eczema develop patches of itchy, inflamed skin that can also be cracked, blistered, and scaly. The itching associated with eczema can be very irritating and can disrupt sleep. Eczema can occur due to a combination of genetic and environmental causes and triggers. There are many medical and home therapies that can reduce itching and dry skin in toddlers, including wet wraps and diluted bleach baths.

Atopic dermatitis is the most common type of eczema. It affects more than 9.6 million children and about 16.5 million adults in the United States.

Atopic dermatitis usually begins in the first 6 months of a person's life. Children who have asthma or hay fever may be more likely to develop eczema.

Other types of eczema include:

This article will explain the symptoms and locations of eczema rashes. It also will go into detail about how to treat eczema in toddlers.

The appearance of eczema varies depending on the type a toddler has. The skin can also change over time if eczema persists. Signs of eczema in toddlers include:

• dry, itchy skin
• flushed skin that is made worse by scratching
• small blisters
• weeping or oozing patches of skin, caused by rubbing or scratching
• discolored skin
• rough and scaly skin

Because eczema can be intensely itchy and sore, toddlers might be more irritable than usual. Eczema may also disturb sleep, which can affect how toddlers feel and behave throughout the day.

Eczema may appear differently depending on a child's skin tone.

See what eczema may look like on black skin here.

Infants younger than the age of 1 may be more likely to develop an eczema rash on their:

• cheeks
• forehead
• scalp

It may then spread to their:

• knees
• elbows
• trunk

It is rare for eczema to affect a child's diaper area.

The location and appearance of eczema change as children grow and may vary from child to child. However, the National Eczema Association lists the following signs that may be more likely at certain ages:

Infants (up to 6 months)

• Eczema is most common on the face, cheeks, scalp, and forehead. It may later affect the elbows and knees.
• Eczema on the scalp is common in infants and is known as cradle cap.
• Skin can look flushed and weepy.

Babies (6–12 months)

• Eczema may appear on the elbows and knees.
• Babies may rub or swat at itchy patches of skin, causing more irritation.
• Infected eczema may form a yellow crust or "pus bumps."
• Food that stays on the face during this period of messy eating may cause more irritation.

Toddlers (2–5 years)

• Eczema is most common in the elbow and knee creases, wrists, ankles and hands, and around the mouth and eyelids.
• Toddlers may deliberately scratch or rub itchy skin, causing redness and weeping.
• Skin that has been affected for a while may appear rough and scaly.

Children (5 years and above)

• Eczema remains common in the elbow and knee creases.
• Flare-ups can occur anywhere on the skin.
• Triggers may become easier to spot.

Many children who have eczema as babies or toddlers show signs of improvement by the age of 5 or 6. It can go away entirely on its own.

However, some children may notice their eczema returns as they enter puberty. It can also persist into adulthood.

Eczema is not contagious, so one person cannot spread it to another. Experts believe eczema happens because of a combination of inherited genes and triggers in the environment.

Eczema may run in families.

Some people with eczema have a mutation of the gene that creates the protein filaggrin. If a person does not have enough filaggrin, their skin can become dry and more prone to infection.

Children born to parents with a history of allergic conditions such as eczema, asthma, and hay fever are more likely to develop the same conditions. Children with eczema in infancy and toddlerhood are more likely to go on to develop asthma and hay fever, according to one 2017 study.

In these conditions, an allergen or irritant from inside or outside the body can trigger the immune system to produce inflammation. That causes eczema flare-ups, which are recurrent areas of inflammation on skin that is prone to eczema.

As toddlers explore their environment, they meet a wider variety of potential allergens and irritants. It is very difficult to identify substances that trigger flare-ups. It may be a series of biochemical processes that lead to toddler eczema, rather than simply cause and effect.

Toddler eczema is common and often comes and goes on its own. Seek the advice of a doctor if any of these signs of infection occur:

• fever
• pus-filled bumps on affected areas of skin
• increased redness and heat around eczema patches
• yellow crust on the eczema

If a toddler's eczema is not responding well to a particular treatment, contact a doctor. They may alter the child's prescription or recommend a different treatment.

A doctor will usually be able to diagnose toddler eczema by looking at the skin and asking questions such as:

• What are the toddler's symptoms?
• When did the symptoms begin?
• Where do the rashes appear?
• Does anyone in the family have eczema, asthma, or hay fever?

The doctor will rule out other skin conditions that could be causing the inflammation. They might recommend that the toddler sees a dermatologist or an allergist.

A doctor might prescribe a corticosteroid to treat a toddler's eczema. These are sometimes called steroid creams or cortisone. Apply a small amount to affected areas of skin once or twice per day. These creams and ointments vary in strength and can thin the skin over time. Use them sparingly.

Non-steroid eczema medicines may also help. These include tacrolimus ointment, pimecrolimus cream, and crisaborole ointment.

Some toddlers might benefit from oral medicines, including:

• antihistamines to reduce itchiness
• antibiotics if the eczema gets infected
• corticosteroid pills that suppress the immune system

Biologics

Biologic therapies, or biologics, are a type of medicine that helps treat the part of the immune system that is causing eczema.

Dupilumab is an FDA-approved biologic therapy that children can use from age 6 and up. It may be particularly useful for moderate to severe eczema where topical medicines and gentle skincare have not worked.

Caregivers should not use any medication unless a doctor has prescribed it or advised it for their child. Caregivers must ensure they keep medications out of reach of children.

Here are some tips to help manage dry skin in toddlers with eczema:

• Bathe in warm (not hot) water for up to 10 minutes. Avoid perfumed, foaming or colored cleansers. Gently pat the skin dry and apply any medication. Then, apply a moisturizer. Allow the moisturizer to soak in for at least 15 minutes. Apply moisturizer twice a day or as needed, even when a rash is not present.
• Dress toddlers in natural fibers, such as 100% cotton. Soft fabrics will be less irritating to itchy skin.
• Ensure the toddler is drinking enough water and staying hydrated.

Learn more about natural remedies for eczema here.

The following tips can help prevent itchiness in a toddler with eczema:

Stop the toddler from scratching

Scratching can lead to infection and make the skin feel even itchier. Keeping a toddler's nails cut short, giving them cotton gloves to wear at night, and generally discouraging them from scratching can help them feel better.

Try wet wrap treatments

Wet wraps can increase moisture intake. A caregiver can take the following steps to apply a wet wrap to the toddler after bathing them and before putting them to bed:

1. Apply any medicine a doctor has prescribed to any rashes and apply some moisturizer to the rest of the skin.
2. Soak some close-fitting items of clothing in warm water.
3. Wring out the clothes until they are damp but no longer dripping.
4. Dress the child in the damp clothes, then put dry comfortable clothes on top.
5. Ensure the child's bedroom is warm or give the child a blanket if they feel cold.
6. Keep the wet wraps on for at least 30 minutes, or leave them on overnight.
7. Remove the wet wraps.
8. Reapply moisturizer.

Toddlers with eczema may be more prone to infections that require treatment with antibiotics. However, a caregiver can help prevent infections by giving a toddler diluted bleach baths 2–3 times a week.

The American Academy of Pediatrics gives the following instructions for a diluted bleach bath:

1. Add half a cup of unscented plain household bleach or one-third of a cup of unscented concentrated household bleach to a full adult tub of lukewarm bathwater. Stir the water well to dilute the bleach and spread it out in the water. For a smaller, infant tub, only use 2 tablespoons of bleach for a full tub of water.
2. Allow the child to sit in the water and make sure the water is applied to their arms, face, and scalp if these parts are affected by eczema. Supervise the child at all times during bathing, and keep bleach out of reach of the child.
3. Rinse the bath water off the toddler thoroughly.
4. Dry the skin by patting it gently with a towel.
5. Apply eczema medicine to any rashes.
6. Apply a moisturizer all over the toddler's skin.

See what infected eczema may look like here.

Sometimes, cutting out certain food groups from a toddler's diet can help. However, a person should seek the advice of a doctor before doing so.

According to a 2019 study, many caregivers of toddlers with atopic dermatitis cut out certain foods from their toddlers' diets in the belief that they trigger flare-ups. Common foods to eliminate include nuts, milk products, and eggs.

This study found that toddlers who had up to three foods eliminated from their diets lacked certain nutrients such as protein, fat, calcium, and iron. The researchers suggested that restricting foods negatively impacts growth in toddlers with atopic dermatitis, but more research is needed to back up this claim.

Eczema in toddlers is common and can come and go on its own. Triggers vary and can be difficult to identify, but can include certain foods, pollens, or lotions.

Caregivers can manage toddler eczema by taking steps to avoid flare-ups, keeping skin moisturized, and preventing damage from scratching.

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