By: Sarah Stein, MD, FAAD, FAAP
At least one in 10 children have
eczema (also called
atopic dermatitis), an ongoing skin problem that causes dry, red, itchy skin. Children with eczema have more sensitive skin than other people. Here's what parents need to know about the condition.
What causes eczema?
Eczema is caused by problems with the skin barrier. Many children with eczema do not have enough of a special protein called “filaggrin" in the outer layer of skin. Filaggrin helps skin form a strong barrier between the body and the environment. Skin with too little of this protein has a harder time holding in water and keeping out bacteria and environmental irritants.
Both a person's genes and their environment play a role in eczema. It often runs in families and tends to occur with other
allergic conditions such as asthma and allergic rhinitis (hay fever and seasonal allergies). Many children with eczema also have
food allergies, but foods themselves do not cause eczema.
What does eczema look like?
Eczema rashes can be different for each child. They can be all over the body or in just a few spots. The eczema rash often worsens at times (called “exacerbations" or “flares") and then gets better (called “remissions"). Where the rashes develop may change over time:
In babies, eczema usually starts on the scalp and face. Red, dry rashes may show up on the cheeks, forehead, and around the mouth. Eczema usually does not develop in the diaper area.
In young school-aged children, the eczema rash is often in the elbow creases, on the backs of the knees, on the neck, and around the eyes.
Is eczema contagious?
No. Children with eczema are more prone to skin infections, but
eczema is NOT contagious. The infections that children with eczema tend to get are often from germs that usually live harmlessly on everyone's skin. These germs cause more problems for children with eczema because their skin doesn't always have a strong barrier to keep them out.
How do I know if my child's skin is infected?
Occasionally bacterial or viral infections develop on top of eczema rashes.
Talk to your doctor if you see yellow or honey-colored crusting and scabbing, weepy or oozy skin, blisters or pus bumps, or rash that is not getting better even with the usual treatments.
Do children outgrow eczema?
For some children, eczema starts to go away by age 4. However, some children may continue to have dry, sensitive skin as they grow up. It is hard to predict which children will outgrow the condition and which ones will have eczema as adults.
Eczema can be frustrating for children and their parents, especially when the itching makes it difficult to sleep. Your pediatrician and pediatric dermatologist can help you manage your child's eczema symptoms with a good treatment plan and a healthy skin maintenance routine.
About Dr. Stein:
Sarah Stein, MD, FAAD, FAAP, a member of the American Academy of Pediatrics Section on Dermatology, is Associate Professor and Director of Pediatric Dermatology for UChicago Medicine.