Symptoms
Although the different forms of eczema in babies (such as toxic and allergic contact dermatitis, atopic eczema or seborrhoeic eczema) are based on different causes and mechanisms of disease development, they all ultimately result in a typical eczema reaction based on a disruption of the skin’s barrier function. This eczema reaction manifests itself in a blurred redness of the skin with swelling and blistering. These blisters are filled with liquid and can be very itchy.
Scratching or spontaneous bursting of the blisters causes the affected skin areas to become weepy. In most cases, the eczema heals with the formation of crusts or scales. Typical locations of eczema in babies are the hairy head, the face, especially cheeks and around the mouth (lat.
: perioral), as well as the feet, hands and bottom. However, these forms of eczema can also become chronic.This means that eczema, for example, due to persistent irritation by the trigger, does not heal but becomes chronic (long-lasting). Again, redness, swelling and blistering are the result.
In addition, nodules can form. Finally, the skin thickens, dries out and becomes scaly, which is called lichenification and is typical of chronic eczema. The main symptom of eczema in babies is usually severe itching, more rarely forms of eczema are found which do not itch.
The massive itching can lead to constant scratching of the affected skin area, which can cause small wounds to form. Problems arise when bacteria or viruses penetrate the scratched skin areas. Colonization of the wounded skin areas with bacteria or viruses is called superinfection or secondary infection and considerably impairs the healing process of eczema in babies.
and atopic dermatitis General information on this topic can be found here: Eczema in the faceA predisposed site of eczema in the baby is the neck. As with the face, redness and even nodular or blister-like skin changes occur. In most cases, these spots in the entire neck area show neurodermatitis as the cause.
The first visible skin changes usually occur in the area of the face or head, and can spread to the trunk via the neck. However, the neck is rarely affected as a manifestation site in babies. The skin appears rather dry and lackluster when involved, due to an underfunction of sebaceous and sweat glands.
It is advisable to control the baby’s tendency to manipulate and to reduce its strength by wearing gloves in order to avoid subsequent infectious skin diseases. The scalp as a milieu rich in sebaceous glands and sweat glands is a part of the baby’s body where eczema can often be observed. A characteristic phenomenon here is seborrhoeic eczema, which presents itself by means of yellowish-greasy scales on reddened scalp.
The boundaries of the redness are sharply defined. The occurrence is more frequent in infancy. Several reasons for eczema are possible.
It has not yet been clearly established whether it is due to increased sebum production, infection of the hair follicles or hormonal factors. It should also be noted that atopic eczema (neurodermatitis) can be the reason for the onset of seborrheic eczema in about one third of cases. It is noticeable that there is usually no itching.
As a rule, the healing process adjusts itself and is completed within a few weeks to months. A lot of fresh air and oil baths can help to alleviate the itching. In severe forms, glucocorticoid therapy (usually cortisone) and antimycotic therapy (therapy against fungal infections) can also be used.
Fungal infections can occur as a secondary disease due to reduced immune function in the eczema area and delay healing. Redness in the area of the cheeks can occur as a result of a baby’s teeth. Teething occurs at the age of 6 months and can last until the complete set of teeth is formed at the age of three years.
If there is redness in the cheek area, care should be taken to ensure that it is only a consequence of teething. Here, redness must be distinguished from eczema formation. Eczema in the cheek area usually has other causes.
In this case, the atopic eczema of an infant should be considered, which can occur at this age without great risks. Characteristic here is a frequently observed itching. An atopic eczema is summarized under the term neurodermatitis.
However, only a few people who had a pronounced eczema in infancy later bear the consequences of the symptoms. This means that for the majority of them, there is a lack or absence of symptoms in adulthood. It should be noted that cheeks are a predisposed site for early childhood neurodermatitis.
Teeth refers to the breakthrough of the teeth in the jawbone through the gums. In some babies, this causes pronounced negative stress, as the mechanical pressure or tension of the gums can often be accompanied by pain. It can be observed that reddening of the skin can occur at the point where a tooth breaks through.
This is often seen in the area of the cheeks. Irritations up to slight inflammations can be seen at the same place on the gums. The reddening of the skin, exclusively as a result of teething, is rather not to be considered as eczema.
Teething produces more saliva, which in babies is not exclusively swallowed but also escapes to the outside.Saliva already contains enzymes that initiate digestion and serve to break down food components. With large amounts of saliva and certain retention times on the skin, irritations may occur here, which can lead to slight eczematous changes due to contact. Teething can even lead to an increase in body temperature, which should be normalized within 24 hours.
In the case of more serious defects of the oral mucosa, massive eczema formation in the cheek area, as well as further increased body temperature (>24h), it is to be refrained from a consequence of the tooth. In this case, a pediatrician should further limit the symptoms and, if necessary, initiate the indicated treatment. In most cases, eczema in babies occurs on the extensor sides of the arm, such as the elbow.
The arm can be seen as a further spreading area as a result of atopic eczema (neurodermatitis). Forerunners are eczema in the area of the head and face. Here the child often suffers from pronounced itching.
Attempts to alleviate the symptoms can be made by strictly observing the child and avoiding certain foods or textiles that may trigger the eczema. If severe symptoms persist, medical advice should be sought. Since eczema is predominantly an immune response, excessive immune responses on the skin can be treated locally.
In most cases, however, a self-healing process can be expected within a few weeks or months. With increasing age, there is usually a marked improvement, so that up to 70% of young patients in puberty are symptom-free or free of symptoms. A reddening of the abdomen can occur in the context of atopic eczema.
However, it is more likely to be a contact allergy that occurs in about 30% of cases. Triggering factors are skin-irritating clothing, cool and dry climate, as well as metal alloys on clothing, for example in the form of a button. Furthermore, lipid metabolism disorders can also cause skin changes.
If causative irritating substances on the skin are avoided, there is usually an improvement. Overall, the degree of severity of a skin change in the context of a contact allergy is rather mild. In the case of an acute worsening, contact allergy can be dispensed with.
This could be a secondary bacterial and/or viral disease, which can occur as a complication. Therefore, pediatrician advice should be sought. Due to the constant contact with incontinence pads/diapers and textiles, contact eczema often develops on the bottom or buttocks of the child, which can be described as diaper dermatitis.
Dermatitis is an eczematous inflammatory reaction of the middle layer of skin. It results from the softening of the skin by urine and stool. In addition, the skin is confronted with the decomposition of urine with the formation of ammonia, in which an unusually high pH value additionally stresses the skin.
This can lead to the activation of enzymes that dissolve the uppermost layer of the skin. In the genital area, seborrhoeic eczema usually occurs. It is therefore conceivable that localized proximity may cause an existing eczematous phenomenon in the area of the vagina and penis, as well as in the anal fold, skin irritations in the area of the buttocks.
This can be remedied by regular skin cleansing and skin care in the skin-ph-neutral area, as well as by preventing stagnant moisture by regularly airing out the affected skin areas. This allows the skin barrier formed by the epidermis to regenerate itself again. Eczema with itching occurs relatively frequently in infancy, mostly in the context of neurodermatitis.
The itching aggravates the actual eczematous change by additional injury to the organ. This is followed by a delayed healing process and a primarily resulting worsened skin condition. This means that a pronounced inflammatory reaction is provoked or further developed.
The psychological component of the child and the parents suffering with their baby must be taken into account. The unbearable physical symptoms have a lasting effect on the daily routine and the day-night rhythm, so that an unbalanced mood can follow on both sides. Thus, in case of persistent itching and irreducible complaints by means of nursing measures, a medicinal therapy is usually indicated.
A relaxed psyche and lack of manipulation of the child accelerate the improvement of the symptoms. By refraining from treatment, psychological suffering and the resulting bacterial and mycotic infectious diseases can be provoked.In the absence of itching in the baby, it is usually the form of seborrheic eczema. It occurs mainly in areas with many glands, such as the T-zone on the face, scalp, neck and throat.
Since itching is a complicating factor, a milder course of the eczema can be observed in some cases. As a rule, seborrhoeic eczema usually heals itself in infancy and only requires supportive therapy. Examples of this would be exposure to the open air, careful adherence to hygienic measures to prevent further complications, and skin care with gentle skin care products. Topically (locally), the use of glucocorticoids may be considered under certain circumstances in complicated and protracted cases.
