Q: “I am a first-time expectant mother. My family has a history of atopic dermatitis. Is it possible to prevent eczema symptoms with my newborn?”
David Stukus, MD: Eczema is a common condition in infants that is caused by an altered skin barrier, leading to excessive loss of moisture from the skin. It often runs in families and has a very strong genetic component. Infants may start to show dry, itchy skin and formation of red, irritated patches around 3-6 months of age.
Eczema often takes a waxing and waning course and it can be worsened by many different factors including fragranced soaps, detergents, and lotions, serious illness, severe weather, or exposure to allergens.
Most infants with eczema improve with age but it can be very severe for some children. In addition to intense itching, their skin can become very dry and irritated, and may even bleed from scratching, which can lead to infection.
Eczema can be effectively managed with a daily skin care routine that includes avoidance of known triggers, generous use of unscented moisturizers, lotions, ointments or creams, and use of topical anti-inflammatory medications as needed.
Parents frequently ask if they can prevent eczema from happening in the first place. As it is generally an inherited condition, it is often already “programmed” into the baby’s DNA prior to birth.
Multiple studies have investigated preventions such as vitamin D supplements, probiotics and elimination diets in both the mother and baby. Unfortunately they have not shown the ability to prevent the development of eczema.
Some new research has emerged suggesting the daily application of an unscented moisturizer to the baby’s skin shortly after birth may delay or possibly prevent the onset of eczema. This makes sense as it prevents moisture loss and damage to the skin, as well as serves as a protective barrier from allergens and irritants. It also doesn’t involve any type of medication and allows for important bonding time for parents and their baby.
David Stukus, MD, FACAAI, is an Associate Professor of Pediatrics in the Division of Allergy and Immunology at Nationwide Children’s Hospital in Columbus, Ohio. He is a Fellow of the American College of Allergy, Asthma and Immunology (ACAAI) and serves on the ACAAI Public Relations Committee.
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