Eczema usually shows up when a baby is between 3 and 6 months old, and 85% of eczema will begin during the first year of life. Many children with eczema outgrow it, with chances increasing 5, 10, and 20 years from onset.
While about 1 in 8, or 13% of babies develop eczema, we still aren’t exactly sure what causes it.
One thought is that eczema starts from the inside.
An allergy to food, pollen, or even genetics causes a baby’s immune system to flare up, creating skin inflammation, which damages the skin.
Another thought is that chemicals, soaps, or infections damage the skin first, which then causes an immune system inflammation response.
In either case, we know that skin damage, inflammation (redness), and itching are all involved.
Allergies and Eczema in Infants
Eczema is usually the first sign of a malfunction in the immune system. Instead of ignoring harmless substances like pollen, food, and dust, the immune system releases histamines that cause itchiness when a baby comes into contact with them. This is an allergic reaction.
That is why antihistamine medications like Zyrtec can control eczema for some people.
Most often things like pet dander, pollens, or mold cause this histamine response in babies.
Food allergies can also cause eczema.
Dr. Peter Lio, Assistant Professor of Dermatology and Pediatrics at Northwestern University and Founding Director of Chicago Integrative Eczema Center, spoke to the National Eczema Foundation and said that “there is a group of people who have food reactions that look like an eczema flare-up rather than specific hives, and can take days to manifest.”
The only way to determine if a food allergy is the cause of eczema is to remove the food and see if the symptoms persist. It can take two weeks to see a change. In babies, cow’s milk is the biggest culprit. In older children, it can be soy or wheat.
If you believe a food allergy may be the cause of your baby’s eczema, discuss with your pediatrician how to safely alter their diet.
Skin Barrier Dysfunction and Eczema in Infants
The other possible cause of eczema is a defective skin barrier. Some people have a genetic mutation where their body doesn’t produce a key protein called filaggrin. This protein is what makes the skin soft and springy. Filaggrin also helps prevent excessive water loss through the skin.
This leads to dry, cracked, itchy skin that we know as eczema.
Other people may have a less healthy skin microbiome. Having the right microbes on your skin can help create and enhance its strength. The outermost skin wall is made of dead cells (brick) and ceramides (mortar). Humans don’t make their own ceramides, the bacteria do. With the wrong bacteria, you can lose the mortar, causing cracks in the skin, which allows bad bacteria like staph A to infect the skin and cause irritation.
What To Do?
Unfortunately, there’s no perfect way to get rid of eczema once a baby has it. If you notice dry, itchy skin on your baby, try an elimination diet and remove as many triggers as possible. Emollients, or thick lotions that contain ceramides, can replace what a baby is missing, allowing the skin to heal. A no sugar, diverse diet, along with apple cider vinegar baths can restore the skin balance to stop eczema.