Does your child have skin patches that are dry and itchy? Are these patches red and swollen? Do they sometimes bleed? It could be a condition called eczema.
Eczema, or atopic dermatitis, is a skin disorder characterized by dry, scaly, inflamed, and itchy skin. It’s the most common skin condition of early childhood. It affects up to 20% of kids, usually by their fifth birthday.
Eczema isn’t contagious or typically serious, but it can be irritating to children and concerning for their parents. This article will discuss the causes, symptoms, and treatment for toddler eczema.
What Is Eczema?
Eczema is referred to as “the itch that rashes” because it’s the scratching that leads to the rash (not vice versa). The itch can be severe and interfere with your toddler’s sleeping, eating, and playing. Plus, the scratching can cause skin infections.
Eczema is part of what doctors call the “atopic march.” This a theory used to describe the progression of “atopic,” or allergic, conditions.
Many children with eczema, for example, will also develop a food allergy, allergic rhinitis (hay fever), and asthma, usually in that sequence. Although it’s a chronic condition, eczema can come and go. The location of the rash may also wander over time.
Babies, for example, tend to experience eczema on their cheeks, chin, and scalp. In toddlers, it’s often seen on the face, hands, and in the creases of the elbows and knees. About two-thirds of kids will outgrow their eczema.
Causes of Eczema
Experts aren’t exactly sure what causes eczema, but they think it may be due to a combination of factors.
Eczema seems to run in families. Research indicates that a child is two to three times more likely to develop eczema if their mother or father has a history of it.
One of the genetic factors that may predispose a child to eczema is an inherited problem with the gene filaggrin, which plays an important role in making the cells that build the skin’s outer “barrier” layer.
This layer helps prevent allergens and irritants from penetrating the skin while keeping moisture in. When that layer doesn’t perform properly, the risk of eczema increases.
Up to 30% of people with a filaggrin gene mutation have eczema, as opposed to 8%–10% of those who don’t have the skin condition.
People with eczema tend to have overactive immune systems. Exposure to a seemingly benign substance—a cosmetic, soap, or pet dander, for example—can cause their immune system to launch an inflammatory response, leading to itchy, red skin.
Environmental factors don’t directly cause eczema—in children or adults—but they can trigger the condition in someone with a genetic predisposition. Some things that can bring on a bout of eczema include:
- Certain soaps, cleaners, and laundry detergents
- Rough fabrics, such as wool
- Dry, cold air
- Allergens, such as pollen, dust, or pet dander
- Long baths with hot water
- Cigarette smoke
- Eggs, milk, wheat, soy, and other foods that many young kids are allergic to
Signs and Symptoms of Toddler Eczema
Dermatologists have a saying: “If it’s not itchy, it’s not eczema.” These are some of the other hallmarks of eczema in toddlers:
- Dry, scaly, rough patches of skin that may appear red and inflamed
- Rash, which may have small, raised bumps that bleed or ooze when scratched
- Skin that becomes thick, dark, and leathery when excessively scratched
Eczema can occur on any part of the body, but in toddlers, it’s most likely to appear:
- In the creases of the knees and elbows
- On the wrists, hands, and ankles
- Around the mouth and eyelids
Diagnosis of Eczema
Eczema is generally diagnosed based on an examination of the skin and an evaluation of your child’s medical history. Your child’s doctor may ask if your child or anyone in your family has eczema, allergies, asthma, or food sensitivities.
Children with a family history of one of these “atopic” conditions are more prone to developing others. For instance, 30% of babies with severe eczema also have a food allergy, often to cow’s milk.
If a definitive diagnosis can’t be made, your child’s doctor may order a blood test to look for certain antibodies the body’s immune system produces in response to allergies. In children with eczema, these antibodies tend to be elevated.
Treatment of Eczema
There is no cure for eczema. Treatment generally involves calming the itch and keeping the skin moisturized, both of which can improve the rash and reduce the risk of skin infections.
Many mild cases of eczema can be brought under control with simple at-home measures, including:
- Wash your child with a mild, fragrance-free cleanser and lukewarm water. Don’t assume that something labeled “organic” or “all-natural” is your best choice. These products may contain skin-irritating botanical ingredients.
- Baths should be limited to 10 minutes or under. Some doctors recommend “bleach baths,” or bleach diluted in bath water, to help treat eczema. If you decide to try this, follow your doctor’s instructions exactly. Bleach can be toxic.
- Apply an over-the-counter (OTC) corticosteroid cream to the affected skin. (Your doctor can advise you on which one and how to use it.) These creams help soothe irritated skin.
- Moisturize your toddler’s skin twice a day with a thick moisturizer that’s free of fragrance, such as petroleum jelly. Moisturizer is most effective when it’s applied to slightly damp skin, so use it after a bath.
Medications and Treatments
In moderate-to-severe cases, your child’s healthcare provider may prescribe certain medications or therapies that help reduce skin swelling, alleviate the itch, and keep skin moisturized. Some of the more common medications and treatments include:
- Steroid creams: These reduce skin inflammation.
- Antibiotics: These are used to treat skin infections.
- Antihistamines: These are used to control itch. An added benefit of these drugs is that they may help a child who is up at night scratching to fall asleep.
- Topical calcineurin inhibitor creams: Elidel (pimecrolimus) and Protopic (tacrolimus) are two of these medications. Applied directly to the skin, these creams help suppress some of the overactivity of the immune system.
- Phosphodiesterase (PDE4) inhibitors: Eucrisa (crisaborole) is a nonsteroidal cream for eczema that is approved for infants and children as young as 3 months old.
- Light therapy (phototherapy): This treatment uses ultraviolet wavelengths that are thought to help reduce skin inflammation.
Prevention of Toddler Eczema
If your child is genetically predisposed to eczema, there’s not a lot you can do to prevent it from occurring. But you can try to minimize flare-ups when you can with these actions:
- Get to know your child’s triggers—whether it’s cigarette smoke or scented detergent—and avoid them when possible.
- Moisturize your child’s skin regularly. One study conducted on babies found that those who were moisturized daily were less likely to develop eczema than those whose skin was not moisturized.
- Keep your child’s fingernails short to reduce injury if they scratch their skin.
- Dress your child in soft, nonirritating clothing.
- Keep your child cool—heat and sweat can cause eczema to flare.
- Get a dog. Research shows that children who have a dog in their household before they turn 1 have a lower risk of developing eczema by age 4 than those living in households without a dog.
Eczema is common in toddlers. The skin disorder produces itchy, dry, scaly, and inflamed skin. It is a chronic condition and is not contagious. Treatment aims to calm the itch and keep the skin moisturized.
A Word From Verywell
Eczema is a common skin condition in babies, toddlers, and young kids. While you can’t cure eczema, you can control it. Your child’s pediatrician can recommend over-the-counter treatments and prescribe medications if necessary.
Eczema may be concerning to parents and annoying to kids, but most children see an improvement in their eczema as they grow older, and many will completely outgrow the condition by the time they’re 10 years old.
Frequently Asked Questions
How can you help a toddler with their eczema?
Helping your toddler deal with the itch can go a long way in helping them manage their eczema. When you notice your toddler scratching, distract them with another activity, particularly one that keeps their hands busy, like coloring.
You can also try “wet wrapping” the affected skin to help alleviate the itch and keep little hands from getting at the rash.
Wet wrapping involves wrapping the skin with a cloth or bandage dressing that’s first moistened with warm water. When the wrap is in place, apply a dry cloth or dressing over the wet one.
Clothing can act as another barrier between your child and their eczema. If your child has eczema around their elbows, dress them in long sleeves when possible. If it’s on their legs, try long pants.
What does eczema look like in a toddler?
Eczema can look different in all children. It can even look different in your own child over time.
But for the most part, eczema in toddlers is characterized by dry, scaly patches of skin with pink or red raised bumps. Sometimes blisters can form. When they pop and ooze, they may leave a crust on the skin.
When should I take my child to the doctor for their eczema?
If you think your child might have eczema, make an appointment with your pediatrician. A trained eye can tell the difference between eczema and other skin conditions.
Speak to your child’s doctor right away if skin appears infected (it’s hot, red, or oozing pus and occurs with a fever), if the eczema seems painful and blistered, or if it’s preventing your child from sleeping or is just generally making them miserable.