What to do when eczema flares up

By Dr. Eddie Valenzuela

Eczema is a skin condition that creates an itchy, dry, and often scaly rash on the skin. Common in adults and children alike, eczema is most known for symptoms, including:

• Severe itching
• Raw and sensitive skin
• Dry, scaly patches of rash
• Cracked or thick patches of skin
• Raised small bumps that leak fluid and scab when scratched

Eczema is also known for having periods of reduced symptoms as well as periods of intense symptoms, called flare-ups. These flare-ups can be very uncomfortable and even painful, leading to severe itching, loss of sleep, and even scarring if not controlled.

What to Do When Baby Eczema Flares Up

Though baby eczema isn’t particularly dangerous, flare-ups can be painful for both babies and parents alike, leading to tears, fussing, and sleepless nights.

Baby eczema can flare up for a variety of reasons, including stress and changes in temperature. What can you do when your little one has a flare-up?

1. Apply a Steroid Cream – Severe flare-ups can be treated with corticosteroid creams, when prescribed by a doctor. Your pediatrician will work with you to decide what steroid strength is best, depending on the location of the eczema rash and how severe the symptoms are. Apply the steroid cream and then wrap a wet bandage around it to help the cream sink in and keep the area moist.
2. Apply a “topical calcineurin inhibitor” or topical crisaborole – depending on the age of the patient, and severity and location of the eczema one of these steroid sparing agents may be prescribed by your doctor.
3. Biologic Agent or Phototherapy– With so many advances in the past several years in science there is now injectable immunotherapy (dupilumab) for severe refractory cases of eczema. Doctors might also prescribe phototherapy for severe flare-ups that are resistant to other treatments. Phototherapy uses different light wavelengths to soothe the inflammation and itching associated with eczema rashes.
4. Use a Gentle Cleanser – It’s important to keep eczema-prone skin clean to prevent infection, especially during a flare-up. Give your baby a warm – not hot – bath for 5 to 10 minutes and cleanse his skin and hair with a gentle baby eczema shampoo and body wash that’s free of dyes, fragrances, and alcohol. Pat them dry with a soft towel, taking care not to rub his skin.
5. Moisturize – Eczema is worsened when the skin is dry, so it’s imperative to moisturize your baby’s skin during a flare-up. Look for a moisturizing cream for eczema that can help restore the skin’s natural barrier to protect it against irritants and keep it hydrated all day long. Apply the cream immediately after bath time as well as at least one other time throughout the day.
6. Use a Humidifier – Dry air leads to dry skin. Help calm a baby eczema flare-up by using a humidifier to add moisture back into the air. You can set up a portable humidifier in your baby’s room at night and move it to the playroom during the day. Just be sure to change the water and clean it regularly to avoid a buildup of bacteria.

Help Prevent Baby Eczema Flare-Ups

The best way to treat a baby eczema flare-up is to prevent it in the first place.

Triggers are the environmental factors that irritate the skin and induce flare-ups, so avoiding triggers is key for preventing flare-ups. While triggers may vary from person to person and baby to baby, the most common triggers are:

• Materials and Fabrics – Many common fabrics like wool, polyester, and other scratchy materials can irritate the skin. Avoid these fabrics and instead, look for soft fabrics like cotton for towels, clothing, and bedding.
• Extreme Temperature – Extreme temperature, either heat or cold, can trigger a flare-up. Keep baths warm, use a humidifier to moisten the air, and limit exposure.
• Tight Clothing – Restrictive clothing, like too-tight pants or shirts, can build up friction against the skin and cause irritation. Dress your baby in loose, soft clothing.
• Harsh Products – Common household products are often made with skin-irritating chemicals, fragrances, and dyes. The wrong soaps, laundry detergents, lotions, shampoos, and body washes can all cause flare-ups. Instead, choose gentle products, like a fragrance-free, non-soap shampoo for baby eczema.

Baby eczema flare-ups can be scary for parents and uncomfortable for babies. Use these tips for what to do when baby eczema flares up to help soothe your little one’s skin.

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Dr. Eddie Valenzuela

Dr. Eddie Valenzuela is an award winning pediatrician and the founder and CEO of Pediatric Solutions, LLC.

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