Pediatrics: Lillian Beard, M.D.

My 3-month-old has a reddish, scaly rash over her eyelids, cheeks and forehead that comes and goes. Are these symptoms of eczema?

By Lillian Beard, M.D.

The pattern you describe may be eczema, a term used to refer to a variety of skin conditions which have reddened, sometimes raised, scaly, usually itchy, thickened areas. The class that we see most commonly in infants is known as atopic dermatitis. With many of these rashes occurring during early infancy, there is frequently a family history of some form of allergy. However, this does not have to be a signal that your baby is allergic. She may be exhibiting some transient sensitivity to any number of factors.

Try to keep a diary for 2 weeks, recording when the rashes appear and all that you can recall surrounding your notice of the rash. For example, critical points to consider include what products you use for baby's bathing and skin care and laundering her clothing and bedding, as well as creams and lotions applied to her face and body and your chest (where her body has contact with your skin). If you're breastfeeding, note if the rash occurred within 12 hours of your eating certain foods on more than two occasions. And remember, babies quickly become overheated. Keep the room temperature to a comfortable 68 to 70 degrees, and layer her clothing so you can easily remove it as needed. Share your concerns and findings with your baby's doctor who will evaluate and observe her over time and determine if the diagnosis is eczema.

Although there is no cure for eczema, measures can be taken to make your baby more comfortable. Avoid frequent baths; they actually dry the skin. However, oatmeal in bath water is non-irritating and soothes itchy skin. Moisture trapping ointments and moisturizing lotions decrease dryness and promote healing of inflamed scratched areas.

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