Baby eczema can feel overwhelming and stressful for parents. It’s a common challenge in early parenthood that can easily catch parents off guard.

Eczema often shows up in the first year of life¹, however mild baby eczema is usually manageable with the right care. Understanding what it looks like and spotting potential triggers can be great first steps in caring for your little one’s skin.

In this article, we’ll explore what eczema is, common causes, how eczema in a baby typically appears, and some simple ways to help manage the symptoms. We’ll also discuss the connection between eczema and other allergies. Let’s take a closer look.

What is eczema in babies?

Eczema in babies is a chronic inflammatory skin condition that often begins before 12 months of age.² It typically appears as dry or red patches on the cheeks, legs or arms¹, and can range from being mild to severe. In Australia, eczema affects around 30 per cent of children.²

When a baby has eczema, their skin barrier doesn’t retain moisture effectively, making it more prone to dryness and irritation. This also makes the skin more sensitive to allergens and irritants, which may cause flare-ups.³

What causes eczema in babies?

The exact cause of eczema isn’t known.¹ However, babies with a family history of eczema and allergies such as asthma may be more likely to develop it.⁴ Environmental factors can also play a role, such as changes in weather and allergens from dust and pollen.

Every baby is different, and baby eczema causes can vary from child to child. In some cases, eczema can also be an early sign of a bigger picture when it comes to allergies, something known as the atopic march.⁵ 

The atopic march and what it means for your baby

Adapted from Czarnowicki T et al., 2017.⁶

Eczema in babies isn’t always just a short-term skin concern. For some children, it may be the first step in what’s known as the Atopic March.⁵ This refers to a pattern where allergic conditions can develop over time, often starting with eczema in infancy and progressing to food allergies, hay fever or even asthma.^7,8

When your baby’s skin barrier is weakened, it can let allergens and irritants in more easily, potentially increasing the risk of developing other allergies.⁵ The good news? Gently caring for eczema early, by protecting the skin barrier and managing flare-ups, may help lower the risk of becoming sensitive to allergens and support your little one’s overall skin health.^3,9

Not every baby with eczema will go on to develop other allergies, however being aware of the Atopic March can help you feel more prepared to have confident, informed conversations with your healthcare provider.

What does eczema look like in babies?

Eczema can look different from baby to baby. However, some typical signs of eczema in babies include red or pink patches that feel dry, flaky or bumpy to touch.³ You’ll often notice these patches on the cheeks, forehead, arms and legs. However, you may also find an eczema rash on baby’s scalp, around the hairline, in the creases of the elbows and armpits, or behind the knees.³

Scratching can lead to a more noticeable eczema rash, and your baby may show signs of restlessness, discomfort and even interrupted sleep.

Baby acne vs eczema vs heat rash

Eczema, baby heat rash and baby acne can all look similar, which is why many parents find themselves wondering: is it baby acne or eczema? While these skin conditions can be confusing at first, there are a few key differences to help tell them apart:

• Baby acne: Usually appears as red or white bumps on the cheeks and forehead. It tends to show up within the first month after birth and generally clears up on its own.¹⁰
• Eczema: Appears as dry, itchy patches of skin. It normally affects the face, scalp, arms and legs.¹⁰
• Heat rash: Shows up as red, raised bumps, often on the upper body, when your baby gets too warm. It usually comes on quickly and disappears once your baby cools down.¹⁰

Some symptoms can overlap, so it's always best to speak with a healthcare professional for an accurate diagnosis.

Early signs of eczema in babies

Eczema in babies doesn’t always start with a full flare-up. Sometimes, the early signs are subtle and easy to mistake for dry skin. You might notice small rough patches, mild redness or areas where your baby’s skin seems unusually dry. Other common early signs of eczema in babies are unsettled behaviour or scratching at a certain spot, even before a visible rash appears⁷.

Noticing these signs early can help you seek support. Early care can make a difference in managing symptoms and keeping your baby’s skin as comfortable as possible.

How to manage eczema in babies

While there’s no cure for eczema, a consistent and gentle skincare routine can make a big difference in managing symptoms. The main goal is to help support the skin’s barrier function and reduce irritation. One of the best ways to do this is with regular moisturising with a lotion that doesn’t irritate the skin.² You may have to experiment to find the best one for your baby.

It can also be helpful to avoid common irritants like harsh soaps, fragranced products, or exposure to heat, which can aggravate sensitive skin.¹

In addition to looking after the skin from the outside, improving the health of the babies’ gut can help to alleviate eczema symptoms and lower the risk of developing further allergies. Talk to your healthcare professional about different options such as prebiotics and probiotics, for the dietary management of eczema.

It is important to note that some foods may also trigger eczema and cause flare-ups, or there may be an underlying food allergy. Speak to your healthcare professional to understand more about food allergens.

It's important to note that every baby’s skin is different. What works for one may not suit another. It’s always best to talk to your healthcare professional for more information of managing eczema in your little ones.

Should you bathe a baby with eczema every day?

This is a common question for parents, and the answer is: it depends. Daily bathing can be helpful for some babies with eczema, but it needs to be done gently.

Use lukewarm water and limit bath time to about five to ten minutes. After the bath, pat dry their skin, avoiding rubbing. Then apply moisturiser straight away to help seal in moisture while the skin is still damp.¹¹

What not to do when a baby has eczema?

Sometimes, even the most well‑meaning habits can make eczema symptoms worse. From bath time routines to skincare choices, a few common mistakes may irritate your baby’s skin or trigger flare-ups.

Here are a few things to avoid.¹²

• Harsh soaps or bubble baths: These can strip the skin of natural oils, worsening dryness and irritation.
• Overdressing: Babies who get too warm may sweat, which can lead to itching and flare-ups.
• Using heavily fragranced skin products: Fragrances are a common trigger for sensitive skin.
• Scratching: While it’s difficult to prevent, scratching can break the skin and increase the risk of infection.
• Trying multiple new products at once: Introducing too many products can make it difficult to identify what's working and what may be irritating the skin.

Does baby eczema go away?

The good news is that baby eczema does typically go away later in childhood. However, some cases may still persist into later years.⁸ Sensitivities can continue, particularly during illness, teething or exposure to environmental triggers like dry weather.⁸

There’s no set timeline for when eczema will resolve. Some children outgrow it quickly, while others may have flare-ups for years. Creating a skincare routine that's tailored to their skin needs and working with a healthcare professional can be a great way to minimise discomfort over time.

Looking for more information on baby allergens and guides? Head over to the Biostime Parent Lounge for more articles and useful tips.

References

1. Pregnancy, Birth and Baby. Eczema – babies and children. Available from: https://www.pregnancybirthbaby.org.au/eczema-babies-and-children
2. Royal Children’s Hospital Melbourne. Eczema management – Clinical Practice Guidelines. Available from: https://www.rch.org.au/rchcpg/hospital_clinical_guideline_index/eczema_management/
3. Healthdirect Australia. Eczema. Available from: https://www.healthdirect.gov.au/eczema
4. Cleveland Clinic. Baby eczema: Symptoms, causes and treatments. Available from: https://my.clevelandclinic.org/health/diseases/23408-baby-eczema
5. Allergy Choices. How Early Eczema Treatment May Help Slow the Atopic March. Available from: https://www.allergychoices.com/blog/how-early-eczema-treatment-may-help-slow-the-allergic-march/
6. Czarnowicki T, Krueger JG, Guttman-Yassky E. Novel concepts of prevention and treatment of atopic dermatitis through barrier and immune manipulations with implications for the atopic march. J Allergy Clin Immunol. 2017;139(6):1723–1734. doi:10.1016/j.jaci.2017.04.004.
7. Kelleher MM, Dunn-Galvin A, Gray C, Murray D, Kiely M, Kenny LC, et al. Skin barrier impairment at birth predicts food allergy at 2 years of age. J Allergy Clin Immunol Pract. 2021;9(5):2063–70. Available from: https://www.jaci-inpractice.org/article/S2213-2198(21)00515-8/fulltext
8. National Eczema Association. Atopic dermatitis persistence over time. Available from: https://nationaleczema.org/blog/atopic-dermatitis-persistence/
9. Dhar S, Banerjee R. Atopic dermatitis in infants and children in India. Indian J Dermatol. 2010;55(2):109–12. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC4789144/
10. Mayo Clinic. Baby rashes: What to know. Available from: https://www.mayoclinic.org/healthy-lifestyle/infant-and-toddler-health/in-depth/baby-rashes/art-20546833
11. Children’s Health Queensland. Queensland Paediatric Clinical Guidelines: Eczema. Available from: https://www.childrens.health.qld.gov.au/for-health-professionals/queensland-paediatric-emergency-care-qpec/queensland-paediatric-clinical-guidelines/eczema
12. American Academy of Dermatology. How to treat eczema in babies and children. Available from: https://www.aad.org/public/diseases/eczema/childhood/treating/treat-babies