Atopic dermatitis in infants – Early signs, causes, and management

Atopic dermatitis or eczema is a chronic skin condition characterized by skin inflammation and irritation. Itchiness is a prominent and distressing symptom of the condition. The itch can be intense and lead to scratching, which can irritate the skin and cause it to thicken and develop small bumps. The condition can affect children and adults of all ages with flare-ups that may get out of control without prior warning. Here is a comprehensive overview of the condition. Early signs of atopic dermatitis in infants Itchy skin One of the most evident signs of atopic dermatitis is intense itching on the surface of the skin, which can be particularly distressing for infants who cannot express their discomfort verbally. Keep an eye out for the redness and inflammation that develops with this itching, causing small bumps to pop out as well. The skin in eczema-prone areas also becomes dry, thickened, and scaly, developing a rough texture with disease progression. There is no telling how bad the skin problems can get, as it all depends on the periods of worsening (flare-ups) affecting infants with varying intensity levels. Common sites In infants, atopic dermatitis typically starts on the face, especially on the cheeks and chin. Visible redness and swelling here indicate early inflammation that should not be ignored at this stage as it may also quickly spread to affect the scalp, forehead, and other parts of the body. Causes and potential triggers The precise cause of atopic dermatitis is not fully understood, but triggers and irritants often arise from a combination of genetic, immune system, and environmental factors. Potential external triggers for flare-ups also include allergens like pollen, dust mites, and pet dander found in the environment, skin irritants like harsh soaps and detergents, even weather changes and increased cortisol levels due to stress are potential triggers that one must pay attention to if early eczema among infants is suspected. Diagnosis and treatment Diagnosis is usually based on a physical examination by a healthcare provider. In some cases, allergy tests may be recommended to identify specific triggers. The first-line treatments for atopic dermatitis in infants primarily focus on hydrating and soothing the skin to relieve itching and inflammation. These treatments are typically tried before considering more aggressive interventions. Here are some dermatologists recommended options for managing the flare-ups. Emollients (Moisturizers) Moisturizing is the first line of defense, preventing the skin from worsening with eczema progression. Emollients actively help maintain and restore the skin's natural barrier function. For infants, dermatologists recommend using fragrance-free and hypoallergenic emollient creams or ointments. It is better to avoid scented or heavily perfumed products that may irritate sensitive skin. Apply emollients generously and frequently, especially after bathing, to lock in moisture. Bathing habits Simple changes in bathing habits will also provide much comfort to infants battling eczema. Dermatologists suggest using only lukewarm water for a short duration of five to ten minutes. For lather, consider an organic cleanser that is not too harsh on the skin. One must avoid direct contact with hot water as it can exacerbate dryness and itching. Also, gently pat the skin dry with a soft towel, as rubbing vigorously only irritates the skin's surface. Finally, apply a generous layer of moisturizer immediately after patting dry to leave the skin hydrated and supple. Clothing and fabric Infants don't need too many layers. It is always a good idea to dress the baby in soft, breathable fabrics like cotton. Avoid wool and synthetic materials that irritate the skin and cause eczema to flare up. Also, wash any new clothes before use to remove potential irritants or allergens from the fabric. Redness and surface irritation are indicators of fabric allergy that the infant might develop with the slightest contact. So, keep checking for these signs vigilantly. Avoid harsh laundry soap Use fragrance-free and hypoallergenic laundry detergents for washing. Also, baby clothes don't necessarily require a fabric softener, so skip this step but ensure the fabric is disinfected in the wash itself. For the skin and hair, choose mild, fragrance-free soaps and shampoos. Also, use baby wipes with caution, as some may contain ingredients that can worsen irritation if infants develop an allergic reaction. Temperature control The surrounding environment is also a potential trigger, with something as simple as climate control being a factor to consider. Keep the baby's room at a comfortable, stable temperature to prevent overheating. Dress infants in layers as required to regulate body temperature and avoid excessive sweating. Look for these signs if the baby starts to fidget or make a fuss and adjust accordingly. Trim nails and use scratch mittens Nails grow out quickly and can pry against the baby's soft skin. This will be extremely painful around the eczema-affected areas. So always keep the baby's nails short and smooth to minimize skin damage from scratching. Alternatively, use soft scratch mittens to prevent accidental scratching during sleep. Changes in nutrition Consult a doctor before making any changes in nutrition. In some cases, certain foods may trigger or worsen atopic dermatitis symptoms. Exclusively breastfed infants may benefit from adjustments in the mother's daily nutrition if breastfeeding is continued. But it's okay to implement these adjustments only when a certified nutritionist has assessed these changes. Allergen control Limiting exposure is also a proactive way of controlling atopic dermatitis flare-ups. Pollen, dust mites, and pet dander can exacerbate atopic dermatitis symptoms. Implement measures to reduce exposure to these allergens in the home environment. Outlook and emotional impact Atopic dermatitis often improves as children grow older. Many infants who have it outgrow the condition or have milder symptoms as they age. Also, managing a baby's eczema can be emotionally challenging for parents, as it can disrupt sleep and cause distress. It is necessary to seek support from healthcare providers, support groups, or therapists. It's also important to regularly consult a pediatrician or dermatologist for proper diagnosis and a personalized treatment plan for infants with atopic dermatitis. Early intervention and consistent management can help minimize symptoms and improve the baby's quality of life.