A dry, red, itchy rash on a baby's cheeks, forehead or scalp is often eczema (atopic dermatitis), one of the most common skin conditions in infants. Children of any age, including babies, can see a dermatologist for eczema. It's worth booking a visit if the rash isn't improving with gentle skin care, is disrupting sleep or feeding, or you simply aren't sure what it is. Signs of infection, such as oozing, yellow crusts or a fever, need prompt medical care.
Here is how to recognize baby eczema, tell it apart from common look-alikes, care for it at home, and know when it's time for a dermatologist.
Where eczema often appears in babies
According to the American Academy of Dermatology (AAD), eczema in babies and young children often starts on the cheeks, forehead and scalp. Flare-ups can later appear on the trunk, arms and legs. Once a baby starts crawling, the elbows and knees are common spots, since they get rubbed and scratched.
Typical signs include:
- Dry, rough or scaly patches
- Redness on lighter skin. On brown and Black skin, patches may look dark brown, purple or gray, and small rough bumps are common.
- Itch, which in young babies often shows up as rubbing their face against bedding, fussiness or poor sleep rather than obvious scratching
- Patches that weep clear fluid and crust over during a flare
Eczema often begins in the first year of life. For many children it becomes milder as they grow, though it can come and go along the way.
Look-alikes: cradle cap, drool rash and diaper rash
Several common baby rashes are easy to mix up with eczema.
- Cradle cap is a form of seborrheic dermatitis. It causes greasy, yellowish or white scales on the scalp that can build into a crusty layer, and it can also appear in skin folds and on the eyebrows. It usually isn't very itchy, and it often clears up on its own in weeks to months.
- Drool rash shows up around the mouth, chin and neck, where saliva sits on the skin, and it's common during teething. Saliva can also trigger eczema on the face. The AAD suggests a thin layer of plain petroleum jelly around the mouth before feedings and naps to help protect the skin.
- Diaper rash sits in the diaper area. It's usually caused by moisture and by contact with urine and stool, and sometimes by yeast. Babies with eczema can get diaper rash too, so a diaper-area rash that doesn't clear with frequent changes and a barrier cream should be checked.
Baby acne and heat rash can also look similar at a glance. Some babies have more than one of these at the same time, which is a good reason to have a confusing rash examined.
Gentle care at home: bathing, moisturizing and soft fabrics
The AAD recommends a few simple habits for babies with eczema:
- Keep baths short and lukewarm. Five to 10 minutes is enough. Use a mild, fragrance-free cleanser only where it's needed, and don't scrub.
- Moisturize right after the bath. Gently pat the skin dry and apply a fragrance-free cream or ointment. Thick creams and ointments usually work better than lotions or oils. Moisturize at least twice a day, or more often if the skin feels dry.
- If a medicated cream has been prescribed, apply it first and the moisturizer second, following your dermatologist's directions.
- Watch for triggers. Common ones include saliva, sweat, overheating, fragranced products, scented wipes or baby powder, and some laundry detergents and fabric softeners.
- Choose soft, breathable clothing such as cotton, and keep wool and scratchy fabrics away from the skin.
- Keep nails short to limit damage from scratching and rubbing.
Check with your baby's doctor before using any medicated cream, including over-the-counter hydrocortisone, because babies' skin is more sensitive to these medicines. And don't remove foods from your baby's diet to treat eczema without talking to your pediatrician first.
Signs of infection that need prompt care
Babies with eczema get skin infections more easily, because scratched or cracked skin lets germs in. Contact your pediatrician or a dermatologist promptly if you notice:
- Yellow, golden or honey-colored crusts
- Pus-filled bumps, blisters or sores
- Oozing that is increasing, or redness, warmth or swelling that is spreading
- A fever, or your baby seems unusually sleepy, fussy or unwell
- Clusters of small blisters or open sores that appear suddenly, especially with a fever
That last sign can point to eczema herpeticum, an infection caused by the cold sore virus in skin with eczema. The AAD advises getting medical care right away for it. For a baby younger than 3 months, a temperature of 100.4°F (38°C) or higher is a reason to call your pediatrician right away, even if there are no other signs of illness. If your baby is hard to wake, is having trouble breathing or seems very ill, call 911 or go to the nearest emergency room.
Bay Ridge treats eczema in infants through seniors: how to book
Bay Ridge Dermatology sees patients of all ages, pediatric through geriatric, and treats eczema in babies, children, teens and adults as part of our medical dermatology care. The practice also treats skin infections.
At a visit, the clinician will examine your baby's skin and ask about feeding, sleep, bath products and any family history of eczema, allergies or asthma. Together, you'll build a skin care routine that fits your home. If medicine is needed, it will be chosen with a baby's sensitive skin in mind. Many babies do well with a steady routine, though flares can still happen, and individual results vary.
To book:
- Book online at any time, or call (347) 497-4984.
- Check whether your insurance plan requires a referral from your pediatrician.
- Bring the products you use on your baby's skin, or photos of their labels, plus photos of the rash on a bad day.
- See our new patient page for forms and what to bring.
When to see a dermatologist rather than wait it out
Mild eczema sometimes settles with gentle care. Book a visit if:
- The rash isn't improving with consistent gentle care and moisturizing
- Itch or discomfort is interrupting your baby's sleep or feeding
- The rash is spreading or covers large areas of skin
- You aren't sure whether it's eczema, cradle cap or something else
- The rash keeps coming back
- A cream you were given isn't helping
Many families start with their pediatrician, who may treat mild eczema or suggest a dermatologist. You don't need to wait until eczema is severe to ask for help.
If your baby's skin is bothering them, or you'd just like a clear plan, we're happy to help. You can book online or call (347) 497-4984.
This article is general information, not medical advice. For advice about your own skin, see a dermatologist.