These are the top 5 skin conditions that are commonly mistaken for eczema (even by doctors!)
Published On: Sep 2, 2022
Last Updated On: Sep 9, 2022
For new parents, life changes forever when you bring a baby into the world. Some parents have more to deal with than others. Within weeks, some newborns develop rashy, scaly skin so itchy they scratch themselves to the point of bleeding. And it’s not always clear how to help them stop. Parents of babies with eczema carry a heavy load, and it can be overwhelming.
We spoke with Samantha Casselman, pediatric nurse practitioner and owner of Happy Skin Pediatric Dermatology in Phoenix, Arizona, to find out what steps parents can take when navigating life with eczema for the first time.
After receiving an eczema diagnosis, Casselman advises parents to “choose sensitive skin products with hypoallergenic ingredients.”
Babies with eczema have ultra-sensitive skin that loses moisture easily. Using gentle products that help the skin retain moisture is key to managing this condition. Look for skincare products, shampoos and cleansers marked “hypoallergenic” or “for sensitive skin.” You can also try NEA’s Eczema Product Directory for ideas.
Ointments (such as petroleum jelly) are usually recommended for eczema-prone skin. Your doctor may prescribe a medicated ointment for your baby, suggest a non-medicated product, or both. Ointments have a higher fat (lipid) content and contain fewer irritating ingredients. However, many people find them to be greasy. Moisturizing creams can be a good alternative; be sure to read labels carefully and check with your care provider before trying them.
Casselman also recommends using moisturizers with ceramides, a type of fatty acid found in skin cells, to help the skin’s natural protective barrier. People with eczema have fewer ceramides in their skin;1 research has found that applying ceramide-rich emollients can improve eczema symptoms.2
Once you have the right products, the next step is to use them. “Moisturize as often as possible,” said Casselman.
Life with a new baby is beyond busy, and it can be tough to find the time. Casselman recommends keeping products “in the bath area to apply after a bath, and at the diaper changing area to apply a moisturizer as often as possible.”
Bath time is important for all babies, but it can provide extra benefits for little ones with eczema. Applying a cream or ointment after a bath (within three minutes) is an especially effective way to hydrate skin and lock in moisture. Adding a small amount of bleach to the bath water can help reduce inflammation and bacteria. Be sure to check with your health care provider, and read these instructions carefully before trying it. And if your little one has a hard time falling asleep, bathing and moisturizing before bed may help to soothe itchy skin and encourage sleep.
Eczema is a complicated condition and every family experiences it differently.
Babies are more prone to eczema because of their immature skin barriers, which presents extra challenges for parents. “There’s a lot to consider when taking care of a newborn with eczema,” Casselman said. “So it’s important to stay patient with yourself and your family. Eczema flares very easily in newborns and can make you feel like you’re in a losing battle.”
Working with an expert healthcare provider can be a game changer. Casselman advised, “Early partnership with a trustworthy healthcare team will pay off in the long run by reducing stress and anxiety.”
Most families initially receive an eczema diagnosis from their pediatrician or family doctor. While these professionals can provide new parents with critical advice for their babies, they may not always have much experience with pediatric dermatology.
Many families work with a pediatric dermatologist. In some states, nurse practitioners like Casselman can also provide care for newborns with eczema. You may also consider adding an allergist to your care team, since nearly the majority of newborns with eczema will also go on to develop allergies and asthma, a sequence known as the Atopic March. Asking other parents of children with eczema for referrals can be a great place to start your search for the right healthcare team. The NEA Provider Finder is also an excellent resource for identifying the eczema experts in your area.
Once you have an expert in your corner, Casselman recommends “using treatments as directed and under medical guidance.”
Many parents expect eczema therapies to work right away, but each baby is unique, and managing your baby’s eczema may involve some trial and error. Be prepared to check in with your health care provider frequently in the beginning to review progress, and adapt the treatment plan if necessary.
“In a perfect world, check-ins every two to four weeks will improve satisfaction, clinical outcomes and confidence,” said Casselman. Families dealing with moderate to severe eczema may need to use multiple medications and meet with care providers more often, while families handling milder cases may not need as many appointments or medications before symptoms are under control.
As a new parent dealing with eczema, building community online can help you through the toughest days. But medical information shared in social media groups may not always be accurate. Casselman warned, “Use social media cautiously for advice.”
A 2020 study on the quality of videos about atopic dermatitis on YouTube found that only 32% of them could be classified as useful.3 The rest were found to be misleading or potentially harmful. While there isn’t research on the quality of information on social media, it’s best to approach medical advice carefully on these platforms. If you hear about a new or alternative treatment on social media, talk to your eczema expert before trying it.
If your little one attends daycare, you will need to work closely with staff there to create a supportive environment and routine away from home.
Casselman recommends explaining your infant’s condition as follows: “Eczema is not contagious. Their skin is sensitive to the point of excessive dryness which triggers inflammation and itching. Because their skin can flare so easily, it is important to use hypoallergenic, fragrance-free skin care products.”
Since most facilities won’t have the products you need on hand, create an eczema care kit. Casselman recommends including a cleanser for hand washing, petroleum jelly, water-based wipes and 40% zinc oxide cream. Be sure to provide 100% cotton bedding from home for nap time. Next, write down your infant’s skin care routine. Make a list of the products to use, and note when they should be applied. Remember to include instructions for flaring skin, and ask about your daycare’s procedures for handling prescription medications, if necessary.
Parenting a baby with eczema is not easy. Be kind to yourself, and measure progress through your actions, instead of looking for fast results. Casselman said, “If you are using sensitive skin care items, controlling inflammation and itching, and staying in contact with your provider to triage your concerns, then you are doing great!” Got any other tips that worked for your newborn with eczema? Let us know at Editor@NationalEczema.org.