Adults also have eczema, but it usually appears in the first six months to five years of a child’s life. In fact, as many as 10% of all infants have some form of eczema. There are a few different types of this condition that your infant, toddler, or child can develop, but the most common one is called atopic dermatitis (AD).
Eczema, including atopic dermatitis, may look and act very differently as your child gets older. It’s important to understand which type of eczema they may have and also their symptoms and triggers, so that you can better treat and manage it as they grow and change. The only way to be sure what your child has, is to make an appointment with your doctor.
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How did my child develop eczema?
The exact cause of eczema is unknown. Researchers do know that children who develop eczema, including AD, do so because of a combination of genes and environmental triggers. When something outside the body “switches on” the immune system, skin cells don’t behave as they should causing flare ups.
We also know that children who come from families with a history of atopic dermatitis, asthma, or hay fever (known as the atopic triad) are more likely to develop AD.
What’s the difference between eczema and AD?
Atopic dermatitis is one of the most common types of eczema. Both AD and other forms of eczema are conditions that infants, toddlers and older children can develop. Symptoms include skin redness and itch. Atopic dermatitis is considered a chronic condition and may last into the child’s teenage years and beyond.
What does AD look like?
Unlike other kinds of eczema your child might develop, AD does not usually go away in a few days or weeks. It might get better (or worse) at times, but it usually keeps coming back. AD is also very itchy, and your child’s skin can become damaged from repeated scratching or rubbing.
Where AD usually appears and what it looks like:
Infants and toddlers: Atopic dermatitis usually starts on the face, or on the elbows and knees — places that are easy to scratch and rub as they are crawling. It may spread to other areas of the body, but not usually in the diaper area, where moisture protects the skin. The skin can appear as red, dry and scaly, and scratch marks are often present. If the skin becomes infected, it may form a yellow crust, or very small “pus bumps.” Your child’s skin may also become more thick, from too much scratching and rubbing. It’s important to understand that the appearance AD may be very different from one child to another, so it’s helpful to look at where the the irritated skin appears on the body.
Learn more about the eczema symptoms you should look for in infants and toddlers.
Older children: AD usually appears in the folds of the elbows and/or knees. Sometimes it’s only on your child’s hands — at least 70% of people with AD have had “hand eczema” at some time in their life. Rashes or redness behind your child’s ears, on their feet, or scalp, may also be a sign of AD. These could be symptoms of another condition, like seborrheic dermatitis, so it’s important to make an appointment with your doctor to be sure. As with babies, it’s helpful to look at where the irritated skin appears on your child.
Are there things that can make my child’s eczema worse?
The key to helping your child stay healthy while living with eczema is to keep the symptoms under control. That’s why it’s good to know about the everyday “triggers” in your child’s surroundings that might make their eczema flare up, or get worse. Knowing what to look for and which triggers your child seems to have, can help you keep their AD under control.
Some of the most common eczema triggers, and how to control them, include:
When your child’s skin gets too dry, it can easily become brittle, scaly, rough or tight, which can lead to an eczema flare up.
How to control dry skin: Keep your child’s skin moisturized — especially after bathing, and during the cold, dry, winter months when the indoor heating is on. Dress your child in soft, breathable clothing and avoid itchy fabrics like wool that can irritate their skin.
There are everyday products and even natural substances that can cause your child’s skin to burn and itch, or become dry and red. These could be products that you use on your body or in your home — hand and dish soap, laundry detergent, shampoo, bubble bath and body wash, or surface cleaners and disinfectants. Even some natural liquids, like the juice from fresh fruit, vegetables, or meats can irritate your child’s skin when they touch them.
How to control irritants: Watch carefully to see how these everyday products do or don’t make your child’s eczema flare up and remove the ones that seem to be a problem.
Children experience emotional stress, too. This can take the form of frustration, anger, or fear. Even just knowing they have eczema can be stressful for your child and make their skin flare up.
How to control stress: What seems to make your child feel frustrated, angry, or afraid? Make a list of these things and then think about some new, mindful ways to help your child cope with them. Making eczema treatment a part of your family’s daily routine can also help. Your doctor or a mental health professional may be helpful in setting up this routine and in teaching your child how to cope with stress.
Heat and sweating
Most children with eczema will become itchy, or experience a “prickly heat” sensation when they sweat, or get too hot. This can happen when your child exercises, wears too many clothes to bed, or when they quickly move from one temperature to another (cold to hot).
How to control heat and sweating: Avoid letting your child become overly active when they’re having a flare up. Make sure not to overheat your child’s bedroom or other rooms in your house where they spend a lot of time. Wearing soft, breathable clothing (in layers) is best. If your child does become overheated, a cool shower or bath can provide relief. Just be sure to moisturize your child’s skin within three minutes after you’ve gently patted him or her dry with a towel.
Your child’s eczema can become infected with bacteria or viruses that live in the environment.
Staph is one of the most common types, especially on your child’s arms and legs. The molluscum virus, herpes virus (fever blisters and cold sores), and fungus (ringworm or athlete’s foot) are other common contributors to infection. It’s important to know the symptoms of these different infections and what causes them, so that your child’s eczema does not get worse.
How to control infection: Learn to recognize signs of an infection and treat them early. If your child’s eczema “weeps,” has small “pus bumps” (especially ones with a white center), or if the lesions on their skin are crusted or look differently than before, your child may have one of these common infections. The only way to be sure your child has an infection is to make an appointment with your doctor. If your child does have an infection, it can be effectively treated with medication.
There are common materials in the environment that can cause your child to have an allergic reaction and trigger a flare up. Some of the most common are seasonal pollen, dust mites and pet dander from cats and dogs.
How to control allergens: Keep pets off beds, rugs and furniture. Dust mites collect in bedroom carpets and bedding, so it’s a good idea to use pillow and mattresses covers, remove carpets in your child’s bedroom and wash their pajamas often, using hot water.
If your doctor thinks a different kind of allergen is causing your child’s eczema to flare up (like a skin care product), they may do something called a patch test — where the allergens or substances that might be causing problems are applied to the skin in light scratches, or under a patch.