Baby eczema (atopic dermatitis): triggers and care

Eczema affects around 1 in 5 children in the UK and is the most common chronic skin condition in infancy.¹ The good news: it is manageable, most children improve significantly by school age, and there is a clear set of steps that reduce flares substantially.

What atopic dermatitis is

Atopic dermatitis (the medical name for eczema) is a chronic inflammatory skin condition characterised by a defective skin barrier. In babies with eczema, the skin is less effective at retaining moisture and keeping out irritants — so it dries out easily, becomes inflamed, and cycles through periods of flare and remission.¹

The "atopic" in the name signals a common connection: eczema, asthma, and hay fever frequently cluster in the same children and families. Having one significantly increases the likelihood of the others. There is a strong genetic component — if one parent has atopic conditions, the child's risk is around 25–30%; if both parents are affected, the risk rises to 50–75%.²

Where it appears, by age

The location of eczema changes as babies develop:

• Under 6 months: Typically on the cheeks, forehead, and scalp — parts of the face that rub against fabric. It may also appear on the outer surfaces of the arms and legs.
• 6–12 months: Spreads to include the trunk, and often the wrists and ankles where clothing rubs.
• Over 12 months: Increasingly flexural — appearing in the elbow creases, behind the knees, and around the wrists and ankles. This is the classic adult pattern and becomes more pronounced into toddlerhood.

Common triggers

Eczema is a chronic condition that flares in response to triggers, which vary between babies. Identifying your baby's personal triggers is one of the most useful things you can do.

Environmental:

• Heat and sweating
• Cold, dry air
• Synthetic fabrics, rough textures (wool)
• Cigarette smoke exposure
• Dust mites (more relevant in older children)

Product-related:

• Soap, bubble bath, and any product with fragrance or preservatives
• Biological laundry detergents
• Some baby wipes

Possible food triggers: Food allergy (particularly cow's milk, egg, and peanut) can drive or worsen eczema in some infants, but this applies to a minority and should only be explored with GP guidance — elimination diets in infants carry nutritional risks and need professional oversight.³

The moisturising routine

Liberal, regular moisturising is the cornerstone of eczema management. Emollients (medical moisturisers) work by replacing the lipids missing from eczema-prone skin and reducing water loss through the surface.¹

How much: Use a thick, unperfumed emollient cream or ointment generously — 250g per week for a baby is not unusual during a flare. The NHS prescribes emollients for babies with eczema; ask your GP.

How often: Apply at least twice daily as a baseline, and ideally after every bath and any time the skin looks dry. During flares, increase the frequency — applying up to 5–6 times a day is reasonable.

How to apply: Smooth in the direction of hair growth (not rubbing up against it, which can block follicles). Apply within 3 minutes of getting out of the bath while the skin is still slightly damp to lock in moisture.

What to use: Look for unfragranced creams or ointments designed for eczema-prone skin. Lighter lotions evaporate faster and are less effective for eczema. Your GP can prescribe effective options.

Bathing

A short daily bath can help eczema-prone skin by removing surface allergens and moisturising — if done correctly:

• Temperature: Lukewarm, not hot. Hot water strips the skin's natural oils and triggers itching.
• Duration: 5–10 minutes maximum. Longer soaking after the initial hydration benefit starts to dry skin out.
• Wash products: Use a soap-free, fragrance-free baby wash or prescribed emollient wash. No bubble bath, no standard soap.
• Drying: Pat (don't rub) gently with a soft towel, leaving the skin slightly damp, then apply emollient immediately.

When your GP needs to be involved

Steroid creams (topical corticosteroids) are the standard treatment for eczema flares and are safe when used correctly under medical guidance. They are not a permanent treatment and should not be applied without GP advice — but fear of topical steroids leads many parents to undertreat flares, which prolongs suffering unnecessarily.³

See your GP if:

• Eczema is affecting your baby's sleep or causing obvious distress
• The skin is broken, weeping, or crusting — this can indicate secondary bacterial infection (often with Staphylococcus aureus), which requires antibiotic treatment¹
• Over-the-counter emollients are not controlling the condition
• You want guidance on whether food allergy testing is appropriate

Red flags — seek same-day or emergency care:

• Eczema skin that develops multiple painful fluid-filled blisters, especially alongside fever — this may be eczema herpeticum (a serious herpes simplex infection of eczema skin), which is a medical emergency¹
• Rapidly spreading, hot, swollen infected skin

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Also in this cluster: Diaper rash · Common newborn rashes

Sources

1. NHS. "Atopic Eczema." NHS, 2023. https://www.nhs.uk/conditions/atopic-eczema/
2. NICE. "Eczema in Under 12s: Diagnosis and Management." NICE Guideline NG190, 2023. https://www.nice.org.uk/guidance/ng190
3. American Academy of Pediatrics (AAP) / HealthyChildren.org. "Eczema (Atopic Dermatitis)." HealthyChildren.org, 2023. https://www.healthychildren.org/English/health-issues/conditions/skin/Pages/Eczema.aspx