The most common form of eczema across all ages is atopic dermatitis. This type of eczema mostly affects people who tend to have asthma, hay fever, or food allergies. In addition, many experts believe there is a genetic predisposition to developing it.
In infants and toddlers, eczema most often involves the:
Face, especially the cheeks, but also the chin and forehead Chest Back of the scalp, where it is sometimes mistaken for cradle cap
If eczema progresses, it can appear on other areas of the face and body. The elbows, knees, stomach, and feet are other areas often affected in older babies.
This distribution reflects where the child is able to scratch and which parts of the skin are prone to drying out, and therefore usually spares the diaper area.
Eczema in babies typically begins between 1 month and 6 months of age. Mild cases may last just a few months; others can be longer-lasting.
Treating Eczema in Babies
For babies, medications are not often needed. Instead, application of a fragrance-free cream or ointment several times per day, and immediately after every bath, is often enough to control eczema.
If emollients aren’t doing the trick, your healthcare provider may suggest over-the-counter hydrocortisone creams or, in severe cases, prescription medications. Only very mild steroids are used in babies because of the risk of side effects.
Crisaborole is a non-steroid cream that can be prescribed for FDA-approved indication of mild-to-severe atopic dermatitis in infants as young as 3 months; insurance may not cover this medication.
Other things you can do to help control your baby’s eczema include:
Avoid rough, scratchy fabrics: Keep everything that comes in contact with your baby’s skin as soft as possible to prevent irritation. This includes their clothing, as well as your own. For example, don’t allow your baby to rest their head on the shoulder of your nubby sweater; drape a baby blanket over your shoulder first. Don’t use soap: Even soaps and washes marketed for babies can be too irritating. Instead, wash your baby in plain water. If you must, a fragrance-free, lipid-free cleanser can be used. Use gentle, fragrance-free laundry detergents: You may consider using the same detergent you use on your baby’s laundry for yours as well. Put mittens on little hands to prevent scratching: Even small hands can do big damage to delicate skin. Mittens are a perfect way to keep infants and babies from scratching. (Putting socks over their hands can work in a pinch. )
If you can’t get your baby’s eczema under control with home treatment, let your child’s pediatrician know.
Eczema in Children (Age 2 Years to Puberty)
Eczema is a very common childhood skin problem. It can start when a child is an infant or sometime thereafter, typically before age 5.
As kids age, they won’t break out as much on the cheeks and outsides of the limbs. Rather, eczema in children tends to develop:
In the creases of the elbowsOn the wrists or handsBehind the kneesBehind the earsAround the eyes and mouth
During this time, it most commonly affects the skin inside the elbows and behind the knees. These areas are known as flexural areas.
It can also begin to affect areas of the body that begin to come in contact with more surfaces as children become more mobile, such as the lower legs and feet.
Many children outgrow eczema by the time they are 5 years old. In other cases, though, it’s longer-lasting.
Treating Eczema in Children
As your child ages, keeping the skin well-moisturized and avoiding irritants is still an important step in managing eczema. Apply creams or ointments several times per day (in the morning, after returning home from school, and before bed is a good routine). Again, always moisturize immediately after bathing or showering.
Treatment options for children include:
Topical steroids (both over-the-counter and prescription) Topical calcineurin inhibitors, such as Elidel and Protopic Dupixent (dupilumab), a monoclonal antibody against interleukin-4 receptor alpha given by subcutaneous injection in children with refractory moderate-to-severe atopic dermatitis who are at least 6 years of age Antihistamines are sometimes used for their sedating properties if itch is impairing sleep Antibiotics in cases of infection
Other tips for controlling childhood eczema include:
Keep baths and showers fairly short: Some kids love to spend time in a bath, but soaking for too long can strip the skin of moisture. Also, don’t add bubble bath products, as they can be irritating. Colloidal oatmeal baths are OK and can help relieve itching. Keep your child’s nails trimmed short: Scratching makes eczema flares worse and causes damage to the skin. Watch for signs of infection: While it can happen to anyone with eczema, children are especially prone to developing infections. If you see notice increased redness, swelling, draining of fluid, or warmth coming from the rash, or if your child complains of increased pain, call a healthcare provider .
Eczema in Teens and Adults
While most people outgrow atopic dermatitis by the time they are teenagers, it can persist into adulthood. For others, childhood eczema that had cleared up years prior may reemerge.
Eczema can also develop for the very first time in adulthood; this is called adult-onset eczema. Some of the prime years for developing adult-onset eczema include middle age and older. Skin naturally becomes drier as people get older, leaving it more vulnerable.
In teens and adults, eczema classically involves:
Creases of the elbowsBehind the kneesHandsScalpAround the eyes or on the eyelidsNipples
Eczema most often affects areas exposed to allergens or irritants, as well as flexural areas that are easily scratched. Adults may find their skin becomes thickened and leathery-looking in areas affected by the rash.
Treating Eczema in Teens and Adults
As with young children, keeping the skin well moisturized is key to controlling eczema in teens and adults. Apply emollients often throughout the day. Ointments are very effective at sealing in moisture, but because they’re heavier and leave your skin a bit greasy, you may want to save the application of these for nighttime.
Treatments for teens and adults with eczema include many of the same options used for children, namely topical corticosteroids, topical calcineurin inhibitors, and dupilumab. Antihistamines are sometimes used for their sedating properties if itch is impairing sleep, but they are not generally helpful in controlling the itch that comes with eczema.
Remember, too, that good personal care is important to allowing eczema to heal and preventing flareups. For instance, make sure your shower or bath water isn’t too hot. Very hot water can strip the skin of its natural oils. Aim for lukewarm water temperatures for your shower.
And don’t overlook things that may be contributing to skin irritation like perfumes and body sprays, makeup, laundry detergent, or fabric softeners.
A Word From Verywell
The location of eczema follows a fairly predictable location pattern depending on one’s age. But whether someone is 1 or 91, keeping skin moisturized and away from possible skin irritants are essential to easing symptoms. If you can’t get your or your child’s eczema under control on your own, call your healthcare provider. Although eczema can’t be cured, it can be effectively managed with the right treatments.
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