What is eczema?

Q&A with Dr. Gayin Lee, Dermatologist

Baby eczema - most commonly known as atopic dermatitis - is one of the most common skin conditions we see in infants in our practice. I feel deep empathy for my young patients, but also for their parents.

Smiling person wearing a white coat and necklace.

What is eczema?

  1. Q: What exactly is eczema (including atopic dermatitis)? How common is it in babies?

    A: Eczema, also called atopic dermatitis, is a common chronic skin condition causing dry, itchy, red, and inflamed skin. It mostly affects infants and children—up to 1 in 4 children may develop eczema at some point (American Academy of Pediatrics). Baby eczema results from a disrupted skin barrier, leading to moisture loss and irritation.


  2. Q: Where does baby eczema usually start? Can it appear only on the face?

    A: In babies, eczema often first appears as a dry, red rash on the cheeks and around the mouth, worsened by drooling. As kids grow, eczema can develop on the arms, legs, and other scratch-prone areas. Teenagers typically experience eczema inside the elbows, knees, hands, feet, and around the eyes.


  3. Q: What is the difference between eczema and contact dermatitis?

    A: Contact dermatitis is a type of eczema caused by direct skin contact with irritants or allergens such as metals, fragrances, or preservatives. It leads to rashes, itchiness, and sometimes blisters. In babies, contact dermatitis often occurs on the face during messy meals—using barrier creams can help protect the skin from food irritation.


  4. Q: Can baby eczema spread to others?

    A:     Eczema is not contagious. It may appear in several family members due to shared genetics and environment, but it cannot be passed from person to person.

  5. Q: Can baby eczema get infected? What should I watch for?

    A:     Babies with eczema have a more sensitive and weakened skin barrier, which makes them more prone to infections.. The most common infection is caused by Staphylococcus aureus bacteria. Signs include:


    - Honey-colored crusts on the skin

    - Raw, weepy, or oozing skin

    - Fever or lethargy

    If you notice any of these, contact your doctor promptly. Also, try to avoid close contact with anyone who has an active herpes virus outbreak (such as cold sores), as babies with eczema are more vulnerable to this type of infection.

What causes eczema?

  1. Q: What causes baby eczema and what are common triggers?

    A: Baby eczema results from a combination of genetic factors (like mutations affecting skin moisture retention) and environmental triggers. Common triggers include:


    - Pet dander

    - Dust mites

    - Dry or hot weather

    - Irritating skincare products

    - Smoke exposure

  2. Q: Can baby eczema be caused by breast milk, formula, or foods?

    A: Regarding diet, foods, breast milk, and formula do not cause eczema. Food allergies that worsen eczema are rare. Avoiding foods without medical advice can increase allergy risk and cause nutritional gaps. Always consult your pediatrician or allergist before making dietary changes.


  3. Q: is there a cure for baby eczema?

    A: Currently, there is no definitive cure for eczema, but many children outgrow it. Eczema can cause discomfort and sleep issues, but with proper care and treatment, symptoms can be managed effectively to keep your baby comfortable.

What products should I use for my child's eczema?

  1. Q: How can I soothe or clear baby eczema?

    A: When we treat eczema, we focus on:


    - Preventing & reducing dryness

    - Treating rash

    - Reducing inflammation & itch

    - Minimizing exposure to triggers


  2. Q: What are the best products for babies with eczema - such as creams, ointments, oils and lotions?

    A: Choose fragrance-free, hypoallergenic, and deeply nourishing creams or ointments. We highly recommend products containing petrolatum, known for locking in moisture without irritation. Avoid lotions with alcohol or harsh additives, as they can worsen eczema. Consistency is key—find a product your baby tolerates to maintain a daily skincare routine.


  3. Q: Should you bathe a baby with eczema every day?

    A: During flare-ups, bathe your baby daily or every other day using:


    ✔ Lukewarm water (5–10 minutes max)

    ✔ Gentle, fragrance-free, hypoallergenic cleansers

    ✔ Avoid harsh soaps and bubble baths

    ✔ After bathing, leave the skin slightly damp and immediately apply a rich moisturizer or ointment to lock in hydration.


  4. Q: How can I relieve my baby’s eczema itch?

    A: Reducing skin inflammation is the best way to ease itching. Consistent moisturizing helps prevent dryness-induced itch. Sedating oral antihistamines may help improve sleep for eczema patients, indirectly easing the itch-scratch cycle, but usually do not reduce eczema-related itch directly. Diluted bleach baths can reduce inflammation and itchiness—though we recommend consulting your doctor for safe instructions.


  5. Q: What about steroids or other prescription eczema treatments?

    A: The most common prescription treatments are topical corticosteroids. Other options include tacrolimus ointment, pimecrolimus cream, and newer FDA-approved options like ruxolitinib cream (for ages 12+). Always follow your doctor’s instructions closely to balance treatment benefits and minimize side effects. Untreated eczema risks skin damage, infection, and prolonged discomfort.

    For severe and treatment-resistant cases of atopic dermatitis, systemic medications may be necessary. Your doctor might discuss this option when/if needed

How can I prevent and manage my child's eczema?

  1. Q: How do I prevent eczema flare-ups and avoid triggers?

    A: Preventing eczema flare-ups involves identifying and minimizing triggers, including:


    ✘ Excessive bathing without moisturizing

    ✘ Dry, low-humidity environments

    ✘ Sweat, friction and overheating

    ✘ Irritating products: wool, harsh soaps, bubble baths, nickel, certain detergents

    ✘ Common allergens in skincare, such as cetyl alcohol, fragrance, phenoxyethanol, essential oils, botanical extracts, and cocamidopropyl betaine


    If you suspect food allergy triggers, consult an allergist before making any dietary changes.


  2. Q: What routines can help my baby's eczema?

    A: Practical daily care tips include:


    ✔ Avoid common triggers in skincare, laundry detergents, and clothing:


    ✘ Skincare: fragrance, cetyl alcohol, phenoxyethanol, essential oils, botanical extracts, cocamidopropyl betaine, harsh soaps, bubble baths

    ✘ Laundry detergent: Fragrance and methylisothiazolinone

    ✘ Clothing: Wool, synthetic fabrics and nickel (sometimes in zippers, buttons)

    ✔ Bathe with gentle cleansers in lukewarm water, limiting bath time to 5–10 minutes

    ✔ Consider bleach baths for itch relief - contact doctor for safe instructions

    ✔ Follow prescription instructions carefully; allow prescription creams and ointments to absorb fully before layering other products


    ✔ Reduce home irritants: run bleach cycles in washing machines/dishwashers, use air purifiers, double wash baby clothes to remove detergent residue, and use humidifiers in dry conditions

    ✔ Store skincare products in the fridge for added cooling and anti-inflammatory effects