How to Prevent and Treat Eczema Flares

The best way to treat eczema is to prevent flares from happening in the first place.

Find and Avoid Your Baby’s Eczema Triggers

In order to prevent your baby’s eczema from flaring up, it’s important to identify their triggers. This means keeping an eye on when their eczema seems to get worse, and noting the activities or substances your baby came into contact with beforehand to try to eliminate them.

Here are some come places and triggers that might cause your baby’s eczema to flare up.

The Bathroom

Soaps are one of the most common eczema triggers. Hand soap, shampoo, bubble bath and body wash — even the ”all-natural” ingredients in these soaps (fruit extracts) — can irritate skin.

Household products may also contain isothiazolinone, an antibacterial, or cocamidopropyl betaine, used to thicken shampoos and lotions, which can both irritate the skin.

Doctors recommend:

Avoiding bubble bath and body wash, especially those with sodium lauryl sulfate
Sticking to a simple soap like Dove
Using fragrance-free products
Avoiding bath oils and additives, which are very drying
Avoiding chemical/soap-based baby wipes, if possible

Use fragrance-free soaps.

The Laundry

Clothes are worn all-day long, and can be a major source of skin irritation. Eczema triggers in clothing can come from laundry detergent, fabric softener, or dryer sheets and the fragrances in all of them.

Certain fabrics such as wool and polyester, and dyes found in leather, can also irritate the skin.

Doctors recommend:

Washing clothes in a soap like Charlie’s Soap and avoiding fabric softener or dryer sheets
Dressing your baby in lightweight cotton, including socks
Putting your baby to sleep in cotton sheets
Washing clothes regularly to remove oils, dirt, etc.

The Air

We think of air mostly as something we breathe, but the air carries pollen and molds onto every surface in our house, including carpets, sofas, and bed sheets.

Pollen in the air can trigger eczema or make it worse. So can dust mites, pet dander from cats and dogs, mold, and dandruff.

Doctors recommend:

Having an allergist test your baby for allergies to environmental pollens, etc.
Using air filtration systems in your house
Cleaning regularly to remove excess dust mites
Washing sheets and pillow cases regularly to remove pollens

Meals

If you are breastfeeding, an elimination diet can tell you within a few days if food allergies are the cause. Milk is the biggest culprit, but any food can cause a reaction. If your baby is eating solid foods, consider testing for possible food allergies.

Weather Extremes

Babies with eczema become itchy, or experience a “prickly heat” sensation when they sweat or get too hot. While parents always want to make sure their baby is warm enough, a baby that is in too many layers will sweat. During the drier months of the year, your baby’s skin may also get dry more easily.

Doctors Recommend:

Daily use of moisturizers that protect and heal the skin barrier
Only dressing your baby in one more layer than yourself
Removing your baby’s hats and gloves when indoors

Here's our list of the best emollient creams for baby eczema.

How to Treat Baby Eczema Flares When They Happen

Part of the chronic nature of eczema is that flares will still happen occasionally despite your best efforts. The goals of any eczema treatment are to:

Stop the itching by removing triggers or removing the histamine
Prevent infection of the skin
Heal skin irritated by scratching

Stop the itching

To stop the itching, you have to remove the histamine in the skin and ideally stop the body from producing more.

Topical steroids like hydrocortisone cream can be spread thinly over the affected area — a fingertip of cream is enough for an area double the size of your hand. The strength varies from over-the-counter creams with 0.1% or 1mg hydrocortisone in each gram of cream, to prescription-strength creams with 2.5% or 25mg hydrocortisone in each gram of cream.

Always ask a doctor before using hydrocortisone creams on babies to treat their eczema, and generally avoid areas around the eyes, around the bottom or genitals, or on broken or infected skin.

Don’t use hydrocortisone cream on the same spot for longer than a week. Long-term use of topical steroids has been associated with thinning of the skin, so it should only be used until the flare is under control, and only at the lowest strength needed.

For babies and children whose eczema cannot be controlled with topical steroids, a group of medications called immune modulators such as Protopic Elidel may be needed. Other newer medications include phosphodiesterase 4 ( PDE-4) inhibitors, such as Crisaborole, which can be used on children as young as 2 years.

Lastly, many allergists may recommend the use of daily antihistamines in children, not babies. Antihistamines basically help to alleviate the itching sensation. They do not stop the triggers, but they do stop the scratching. There is no significant long-term effect of daily antihistamine usage. Commonly-used antihistamines for eczema include hydroxyzine, cetirizine, and Benadryl (diphenhydramine).

Prevent Infection of the Skin

In persistent eczema where your baby is scratching their skin, doctors are often concerned that the normal bacteria that live on the skin will get into the cuts and cause an infection. Infections are dangerous and can prolong the itching-scratching cycle.

Apple cider vinegar baths are often recommended as a way to stop a staph aureus (staph a) infection. Studies have shown that babies with eczema who develop a staph a infection are much more likely to develop food allergies.

To safely give your baby a vinegar bath:

Put 2 cups apple cider vinegar into a full bath tub, or 1/10 of a cup for every gallon of water.
Never apply vinegar directly to your child’s eczema.
Soak for 15 minutes.
Pat your baby’s skin dry, apply any medications, and then moisturize the skin

Heal the Skin, Trap in Moisture

The best way to heal the skin is to "soak and seal."

Soaking the skin can be done in a warm bath or shower that lasts at least 10-15 minutes:

Wash the skin with a gentle soap like Dove without excessive scrubbing
Then dry the skin by gently patting it rather than rubbing
Finally, “seal” the skin with a moisturizer that is applied within three minutes of the bath. Ointments and creams are recommended instead of lotion for babies with very dry skin due to eczema

The most popular sealers are:

100% pure petroleum jelly
Vanicream Moisturizing Skin Cream
Cetaphil® Eczema Soothing Moisturizer
CeraVe Moisturizing Cream

Wet wrap therapy is a more intense way to soak and seal the skin. Wet wraps are done after bathing, applying any medication, and moisturizing. The affected area is wrapped in a slightly damp strip of clean cotton or gauze. Then, a dry layer is put over the damp layer to keep the dressing in place.

Wet wraps are left on overnight. If the eczema is on the feet and/or hands, medical gloves or food-grade plastic wrap can be used as the dry layer.

Will my baby’s eczema go away?

If you can stop flares from happening, then your child will look and feel no different than a child without eczema. It is possible to keep flares from happening such that your baby is essentially eczema-free. However, the underlying disease will always be there.

There is currently no way to cure eczema, though about half of infants with atopic dermatitis will eventually outgrow it.