Eczema

Eczema is a dry, skin condition that causes the skin to become red (inflamed) and itchy. On darker skin, eczema may not look red - it may look darker or lighter, and feel rough.

It is a long lasting (chronic) condition but many children will improve as they get older. There is no cure - it can usually be managed but does take daily care. 

What causes eczema? 

Our skin is meant to work as a barrier, but in children with eczema their skin barrier does not work properly. Their outside layer has micro-cracks that can let moisture out and triggers such as dust and dirt in.  This causes inflammation - the red angry areas or dark, rough areas you see on their skin.

You can't catch eczema and you cannot pass it on to someone else. People with eczema often have other allergic/atopic conditions, including asthma, hayfever and food allergy, but stopping foods is not recommended for the treatment of eczema.

It's important to note that breastfeeding is still supported, and māmā can continue with a normal diet. There is good information on infant feeding to prevent the development of allergies on the Nip Allergies in the Bub website.

You can usually control your child's eczema by:

1. Avoiding triggers

Some common triggers are:

• Heat
• Soaps and bubble baths
• Scratchy fabrics (it is often helpful to use cotton against the skin)
• Fragrances and chemicals (it is often helpful to use sensitive products) 

2. Bathing

• Bathe once a day for 10-15 minutes using plain water, or a soap free body wash (you can also use your moisturiser as soap), and pat the skin dry.
• Bleach baths (see below) may also help improve eczema control by reducing the bacteria on the skin.

3. Moisturising

• Apply moisturiser as often as needed to keep the skin moist.
• If a moisturiser comes in a tub, scoop out the cream with a clean spoon, not your fingers.
• Most babies and children will need to use 500g of moisturiser a fortnight.

4. Steroids

• Use steroids on the skin as prescribed (topical steroids) when your child's skin has active eczema.
• Apply a shiny layer of steroids early into the flare and daily until it is normal. This should take less than 14 days.
• There are different strengths of steroids and types, your doctor or nurse will prescribe the appropriate one for your child’s face and body.
• Go back to your GP or nurse for regular reviews and if you need steroid cream for longer than 2 weeks in a row. 
  

Giving your baby antiseptic baths

Giving your baby an antiseptic bath twice a week can help improve eczema, decrease bacteria, and prevent skin infections. The best antiseptic to use is bleach. However, you need to dilute the bleach with water first. Bleaches come in different strengths and how much water you use depends on the strength of the bleach you are using.

Bleach is sold at the supermarket and will be in the cleaning aisle. You need bleach that has no added detergent or fragrance. 

Always store the bleach where your baby or young children can’t reach it.

How to give your baby an antiseptic bath

You should only give your baby an antiseptic bath when they have ‘active eczema’. This is when their skin is infected or very itchy, dry, and red.  

Antiseptic baths are perfectly safe when prepared and carried out the correct way. To do this: 

• fill your bath or tub with enough warm water - please read our Bathing page for how to do this safely.
• add bleach and mix well, following these ratios:
  
  • for bleach that is 4.2% strength add 1 ml for every litre of water
  • for bleach that is 3.1% strength add 1.3 ml for every litre of water
  • for bleach that is 2.1% strength add 2 ml for every litre of water
• soak in the bath for between 10 - 15 minutes, always keeping one hand on your baby
• wash with non-soap cream
• rinse off with tap water
• pat skin dry with a towel (remember not to share towels)
• apply a steroid cream and/or moisturizer straight afterwards. 

Taking care of you

It can be stressful when your little one has eczema, and hard to see them uncomfortable and itchy. It can be helpful to reach out to whānau or friends if you're feeling overwhelmed or need support. 

You can try:

• talking to whānau, friends or someone who may have a similar experience with their own child
• calling PlunketLine.

Your doctor or nurse can help you to create a skin care plan to help control your child's eczema. An eczema action plan can be useful.

You should visit them as soon as possible if your child's eczema doesn't improve after treatment or becomes infected. If you’re not sure what to do, or you’re worried about your child’s eczema, call PlunketLine.