I learned more than I wanted to know about eczema, or atopic dermatitis, after the birth of my son. According to MayoClinic.com, eczema is a chronic, or long-lasting condition, in which the skin becomes itchy and inflamed. Asthma or hay fever are also common with eczema.
I knew my son's skin was different from the time he was only 3 weeks old.
I used the same baby wash that I had used for my daughter. It was a lightly scented, more natural brand infant body wash & shampoo. I liked it so much, I started using it myself in the shower! However, when my son was just 3 weeks old, I noticed that his cheeks became very red. I dismissed it, chalking it up to that flushed cheek look that babies get at times.
A few days later, I noticed that he had started to develop small raised bumps on his cheeks. In retrospect, he also suffered severe cradle cap around this time, which I now believe was definitely linked. I didn't put anything on his rashy cheeks. I just continued to wash him with the baby wash. I soon became alarmed when his cheeks developed small, brown, almost flaky or crusty type patches! Then it looked like one of his cheeks was oozing a very scant amount of clear fluid. I was horrified and called the pediatrician's office, in tears, to have the doctor have a look.
I got a same day appointment with the nurse practitioner. After examination, she wasn't very sure what the cause was and so called in an older male doctor. They determined it was a type of dermatitis and prescribed an antibiotic cream--with a $50 copay. The N.P. instructed me to call the next day with an update. By the next afternoon, I hadn't noticed any real change and called to update the N.P. She told me to discontinue use of the cream and to avoid using any soap, with the exception of his diaper area. She suggested using something like Aquaphor skin ointment, which is similar to petroleum jelly and can be bought at any drug store, on his cheeks.
After several weeks his skin gradually improved. Yet it seemed he would go through cycles and have milder flare-ups. I also noticed he started to have itchy rash-like areas in the folds of both arms and to both knees. The nurse in me began to suspect eczema. I started to do research and became convinced that it was indeed the cause. At his next routine doctor's appointment, at around 4 months, I mentioned this this doctor, who had always been very friendly and helpful. He disregarded my concerns with the words "Babies this young don't get eczema." I challenged him but he continued to maintain that it was a fluke-type thing and not eczema.
I just knew it was eczema though. He gave me some samples of Eucerin cream to try. Since it was unscented I thought I would use it to see what happened. Within a day or two his skin had a horrible flare-up of itchy rash to his face and arms. I was so upset with the doctor for not listening to me, and upset with myself for listening to him. At this time I decided to take matters into my own hands.
I did as much reading on the causes of eczema flare-ups and treatments as I could. I had noticed that when he would lay his head on our clothing, his cheeks would be red for awhile. I had always washed his clothing separately in a mild baby detergent. I begin washing our entire household's clothing and the baby's in a perfume and dye-free detergent. That helped tremendously! He was no longer in contact with irritants from our clothing and bedding. I also used huge burping pads or small blankets to shield him when others held him.
I found that Cetaphil bar soap and lotion were so awesome for his skin. I only used the soap on a washcloth to clean his scalp and diaper area. I figured out that using the lotion and sealing it in with a generic brand similar to Aquaphor ointment, several times daily, his skin was no longer feeling like sandpaper in flare up areas and was softer. Being African-American, I noted that when a rashy area healed, the skin pigment would be much lighter to the area. Soon he had patches of white to his face, arms, and legs. Since his skin tone was pretty light anyway, it wasn't very noticeable in general.
My husband and I had found, by process of elimination, what was an irritant to him. We washed all his brand-new clothes with the perfume and dye-free detergent before he wore them. When he started solids, I introduced them one-by-one with days in-between new foods and I avoided blends like strawberry-banana, so that I knew offending foods. It seemed that citrus was a problem. I also noticed that if I drank too many juices or drinks with red coloring or citrus, and breastfed him, he would develop a rash. I also learned to be diligent with cutting his nails to prevent scarring from scratching and an increased risk of infection.
By the time my son was 8 months old, we had become used to him awakening during the night several times. He would feed, but many times, I saw that he would scratch at his face, trunk, arms, or legs. We finally broke down and used a 0.5% hydro cortisone 0ver-the-counter cream after talking our local pharmacist--I was very nervous to use any steroidal-type creams on an infant, but I knew my baby needed some relief. Yet his sleep, and ours, was still being disturbed by the frequent bouts of itching. It was at this time that I decided it was necessary to see a pediatric dermatologist. I found one I felt I would be comfortable with and made an appointment.
The pediatric dermatologist was the answer to our prayers! The minute she walked into the room, as I held my son on my lap, she said to him in a sweet voice "You just had a bad flare-up didn't you buddy?" Finally, a doctor who knew exactly what the problem was and gave an official diagnosis: Atopic dermatitis -- eczema. She was patient and answered all of our questions. She was quite reassuring, and would start him on the lowest dose of prescription ointments possible and evaluate his response and their effectiveness. She also mentioned the link between eczema and asthma and discussed what to look out for. My son had not shown any difficulty breathing before, but I did know that asthma was very prominent on my mother's side of the family. She also assured us that the areas of skin that had lost some pigment would return to their natural color with 6-12 months.
We filled his prescriptions and followed her instructions on using the medicated ointments. We noticed results within a day. He was sleeping better and itching less. Also the stubborn raised, rough areas were smoothing out. She had encouraged us to continue using the Cetaphil lotion and soap since it worked and for the first time, I felt we had got a handle on my baby's eczema.
Today my son is a healthy 15-month old. He still had occasional flare-up, mostly to the areas around his armpits and elbow/knee folds, however, his flare-ups are generally mild in comparison to what we started with. The medicated ointments are used right away to treat those areas and he's back to new within a day or so. He no longer has any discolored skin pigmentation and he does not get any new areas because his flare ups are less severe and resolve quickly with medication. He is able to tolerate citrus in small amounts, but I'm very careful with what I give him.
We've come a long way in our journey with eczema, but so has my son. He's sleeping through the night and doing generally well. There were so many times we felt helpless and frustrated throughout this process, but we persisted because it was difficulty seeing our son in so much discomfort. We changed his pediatrician a while ago. He still follows up with his dermatologist every few months or so, just so she can monitor him. She told us there's a good chance he might just outgrow the eczema. Let's hope she's right!
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Disclaimer: This article is for informational purposes only. It is not intended to provide medical advice. Always consult your personal doctor.