Managing eczema in babies: five things to know

Eczema—atopic dermatitis—is common in babies and can be stressful for parents to manage. An article in CMAJ (Canadian Medical Association Journal) outlines practical tips to manage this condition.

"Atopic dermatitis affects 10%–20% of Canadian infants. Recognizing atopic dermatitis, getting it into remission, then keeping control can be challenging for both clinicians and caregivers," says Dr. Derek Chu, assistant professor at the Division of Allergy and Immunology at McMaster University and co-chair of upcoming American Academy of Allergy, Asthma & Immunology and American College of Allergy, Asthma & Immunology atopic dermatitis guidelines. "We hope these five key messages for general and specialist care providers, as well as caregivers, promote best practices for managing atopic dermatitis in infants. Atopic dermatitis affects more than just the skin and it impacts on the whole family, so optimally managing atopic dermatitis at this critical stage in an infant's development is important."

• Atopic dermatitis on cheeks, outer limbs and trunk are common in infants, and classic eczema affecting behind the knees and in the elbow creases may not develop until later in childhood.
• The best moisturizer is one that caregivers and patients will use.
  
  • New evidence shows that any type of moisturizer—lotion, cream, gel or ointment—used at least twice daily helps with managing atopic dermatitis.
• Atopic dermatitis is an inflammatory condition that requires anti-inflammatory treatment.
  
  • The lowest dose of topical steroids should be used to gain control of flares.
  • Applying once a day is as effective as twice per day.
  • If flares frequently recur, using topical medications intermittently (two consecutive days, e.g., on weekends) can prevent subsequent flares.
• Evidence does not support using antibiotics routinely to treat local secondary bacterial infection.
• Food avoidance may not improve eczema and may increase risk of food allergy.