A Complete Guide To Bathing Babies With Eczema

by Tara Saltzburg

Learning that your beautiful baby has irritating, itchy eczema might set off some serious mommy fears, especially since it’s often noticed in the first few months of bringing your little one home. The redness, combined her obvious signs of discomfort (itching, crying, sleeplessness) will likely leave you frantically searching for methods to alleviate the symptoms as soon as possible.

But fear not - many of your fellow mama warriors have been there! In fact, eczema is fairly common in infants and affects up to 1 in 5 children. You may be relieved to learn that bath time can provide effective, immediate relief of symptoms in the sanctuary of your own home by adding moisture to baby’s skin and ridding it of bacteria. But there are a few things to keep in mind when bathing babies with eczema. Here we dive into some considerations and best practices to keep her delicate skin hydrated and the flare-ups at bay.

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      What does eczema in babies look like? 

      First, is it eczema? The general symptoms of infant eczema include itch, redness and rash, skin that’s very dry and/or scaly or open, crusted or “weepy” sores. Yup, it’s not fun and your new baby will scratch the itchy areas which can lead to infection, sleep disturbances and generalized anxiety for you. Factors that can cause eczema flares include wind, low humidity, cold temperatures, harsh soaps, and frequent bathing without properly moisturizing. In order to determine if your little one is suffering from eczema, it’s important to note that it does often manifest itself differently between infants and older babies. 

      According to the National Eczema Association, when eczema appears in the first 6 months, it’s usually on the face, cheeks, chin, forehead and scalp. It can also spread to other areas of the body, but it usually doesn’t appear in the diaper area where moisture protects the skin. The skin at this stage also tends to look more red and “weepy.” 

       

      At the 6-12 month stage, eczema often appears on baby’s elbows and knees - places that are easy to scratch or rub as they’re learning to crawl. If the eczema rash becomes infected, it may form a yellow crust, or very small, “pus bumps” on the skin.

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      How can bathing babies with eczema help?

      When your little one’s skin is dry, it’s not because it doesn’t contain enough oil, which is a common misconception. Dryness occurs because the skin isn’t doing a very good job of retaining its own moisture. A daily baby eczema bath treatment can actually help to lock in moisture, but it must be done correctly. We’ll delve deeper into that shortly.

      Things To Consider At Bath Time

      When bathing babies with eczema, there are some things to keep in mind to ensure you’re not making the condition worse and you’re helping to retain the skin's moisture. We'll dive into each one below.

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      Water Temperature 

      While adult skin is less impacted by heat, a new baby’s skin has not yet developed fully, and bathing infants with eczema too frequently in hot baths can lead to dry, itchy skin and eczema flare ups. In order to prevent a flare up, (which is your baby’s immune system naturally responding with an over-reaction to allergens due to eczema), it’s important to take note of the water temperature. As a general rule of thumb, bath water should not be warmer than average body temperature. Soaking in a tub of lukewarm (not hot) water can help skin better absorb moisture and prevent further irritation to sensitive eczema-prone skin. Ideally, keep the water around 98.6 degrees, which is the optimal temperature for bathing infants and young children with eczema (If you battle dry skin, you may want to remember that!). You can set aside guessing the temperature by simply buying a baby bath thermometer. You can find them on Amazon.com for less than $15: B&H Baby Thermometer.

      Length of Bath

      Although professionals may disagree about the frequency of baths (more on that in a sec) for little eczema sufferers, it’s widely advised to keep baths relatively short in order to prevent eczema flare ups. When bathing babies with eczema, you should limit bath time to 5-15 minutes, but that’s no reason to rush her out. If your little one is really enjoying her bath, let her stay in and reduce the temperature by a couple of degrees. Remember, the optimal bath temperature for bathing infants with eczema is 98.6 degrees. This cooler temp allows the skin to absorb moisture better than warmer water and we want to lock in all the moisture we can!

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      Frequency of Bathing 

      Should babies with eczema bathe daily? Water is an effective way to put moisture back into the skin and many experts believe that bathing your baby at least once a day with a fragrance free or mild cleanser (not soap - more on that in a sec) will increase hydration in the skin by keeping the skin barrier healthy and flexible so that it can better lock in moisture. It should be noted that if you’re not moisturizing baby’s skin immediately after every bath, you’re likely making things worse. According to The National Eczema Association, moisturizer should be liberally applied within three minutes of bath time. Failure to apply moisturizer within the first few minutes can cause the skin to lose its moisture content and become more dry and irritated. The NEA refers to this method of moisturizing as the “soak and seal” and we’ll discuss it in more detail shortly.

       

       

       

       

       

      When dealing with baby eczema, how often to bathe a bit divisive. There are some medical professionals that are apt to suggest ‘infrequent’ bathing (less than once a day) in order to prevent further irritation in eczema-prone skin, but it’s well documented that more frequent bathing can actually lock in moisture when done correctly. In our experience, daily bathing followed by a “soak and seal” has been very effective in locking in hydration. 

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      Water Hardness

      According to Sarah Hackley, a writer at dermatitis.net, several studies have associated hard water with an increased risk of eczema in children and infants. A 2017 study from the UK found that hard water damages the skin barrier by increasing its surface pH, and in turn, increasing its susceptibility to irritation. Dr. Simon Danby from the University of Sheffield’s Department of Infection, Immunity and Cardiovascular Disease and lead author of the study also notes that “patients with eczema are much more sensitive to the effects of hard water than people with healthy skin. This increase in sensitivity is associated with a genetic predisposition to a skin barrier defect brought about by mutations in the gene encoding filaggrin. Filaggrin is a structural protein important for the formation of our skin’s barrier to the outside environment.”

      I have to say there is something to this. I noticed the hardness of our water when I was testing our fish tank - thanks, Seraphina and Nelson (RIP)!

      My test strips showed our water at 180 ppm - pretty much as hard as it can get. We made the choice to install a water softener and although it was pricey (around $900), I have to say I’ve noticed a significant difference in the health of my own hair and skin as well as my son’s.

      Bath Time Best Practices for Infant Eczema Relief

      Avoid Bubbles

      bathing-babies-with-eczema-bubble-bathKnow what can irritate baby’s eczema-prone skin? Bubbles! Although bubbles are fun and relaxing, a bubble bath for babies with eczema is not ideal. Most bubble baths use chemicals, like sodium lauryl sulfate, to create the bubbles. Unfortunately, those chemicals can severely irritate a baby’s delicate skin. If you do use a bubble bath, use caution and always check the ingredients. Trukid’s Eczema Care Bubble Pods are packed with colloidal oatmeal and allantoin, both of which work wonders on dry skin and eczema flares. However, when examining the ingredients, you’ll notice it contains sodium lauryl sulfate, a known irritant. Although there are some “eczema-safe” bubble baths out there, we usually recommend just staying away from them when bathing babies with eczema; they can cause unnecessary irritation.

      Use Cleanser, NOT Baby Soap for Eczema

      When bathing babies with eczema, it’s important to avoid drying soaps or harsh detergents. Baby soap for eczema will likely cause more irritation on the skin. While the skin’s normal pH level is 4 to 5, the average pH level (acidity or alkaline) of soap is 9 to 10. Soap increases the skin’s pH to an undesirable level and can severely worsen eczema symptoms. Just like bubbles, soaps usually contain sodium lauryl sulfate to create it’s foaming action, and unfortunately, that can wreak havoc on dry skin. It’s best to avoid soap, even specially-formulated baby soap for eczema.

      Instead, opt for a cleanser when bathing a baby with eczema. I personally had great success with Exederm’s Cleansing Bath and think it’s the best baby wash for eczema, but again, that’s because that’s what worked. Don’t get frustrated if you find that you have to try more than one. Remember, dealing with eczema is more of an art than a science - there will usually be some trial and error. There are tons of other options, including some by trusted skincare lines like Aveeno and CeraVe.  Check out all of the cleansers that have been approved by the NEA.

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      Use The Right Moisturizer

      Moisturizing baby’s skin immediately after bath time is very important, but using the right type of moisturizer is equally as important. With all of the ointments, creams and lotions that are specially formulated for baby eczema, it can be confusing to know what will be effective. Moisturizers are considered to be either an ointment, a cream or a lotion, and they are classified based on the amount of oil and water they contain. The more oil in a moisturizer, the better it usually is at treating eczema. The best moisturizers to use for baby eczema relief are the ones that feel “greasy” - they contain more oil and are effective at keeping moisture in and irritants out.

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      Ointments: The first choice for eczema relief is always an ointment because ointments have the highest oil content of the moisturizers (followed by creams and then lotions).  Ointments are usually more soothing for eczema sufferers - they don’t burn when they’re applied to sensitive skin, which is definitely a concern with creams or lotions. Products high in oil content, such as petroleum jelly and mineral oil, are particularly good for treating eczema. Baby Pibu has a great hydrating ointment. Good ol’ fashioned Vaseline tends to work well to combat dry skin, too. But if your little one doesn’t like the feel of an ointment (or you don’t want ointment getting all over her clothes), your best alternative is a cream.

      Creams: Creams are second to ointments in the amount of oil they contain, and they do a good job of sealing in moisture. Because they contain less oil, they are not as greasy to the touch. The best natural eczema cream for babies that I've found is Mustela’s Stelatopia Emollient Cream is a great option. For something a little less expensive, you can try CeraVe’s Baby Moisturizing Cream.

      Lotions: Lotions contain the least amount of oil and because they are primarily made of water, they evaporate quickly. They also often contain preservatives that burn when applied to skin that’s scratched or broken. It’s best to just stick with an ointment or cream since lotions don’t do much for eczema sufferers.

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      Consider Bath Oil 

      When bathing babies with eczema, adding a bit of oil directly into the bath water can also help to retain some much-needed moisture. One of the best bath products for baby eczema is Mustela’s Stelatopia Bath Oil, a plant-based solution specially formulated for an infant’s delicate, eczema-prone skin. It’s enriched with Sunflower Oil Distillate to soothe, Avocado Oil to strengthen and protect the skin barrier, and Chamomile Extract to leave skin feeling extra soft. It’s fragrance-free and completely safe to use daily or during eczema flare-ups. Just throw a capful or two directly into the bath water - there’s no need to even rinse it off after. I also love Exederm products and their Soothing Baby Oil is another great choice.

        Opt for Ultra-Soft, Cool Clothing

        Keep baby's skin cool by dressing her in lightweight sleepwear, preferably without tags or seams that can cause itchiness and make the condition worse. Our long sleeve pajama set and short sleeve pajama sets are a perfect option to keep baby’s skin cool and calm. You may also want to consider a garment with mittens if eczema is affecting your little one's face. If your little one is in the 0-6M range, our baby sleeper gown is a great option.

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        Always “Soak and Seal”

        The “soak and seal” method is recommended by The National Eczema Association and many healthcare providers because it effectively locks in skin’s moisture when done properly. Most importantly, always remember that it’s imperative to liberally moisturize baby’s skin within 3 minutes of bathing, otherwise you may be making the condition worse. To get the full therapeutic benefit for baby, be sure to “soak and seal” often and follow these steps in order:

        • Take a bath using lukewarm (not hot) water for five to 10 minutes. Use a gentle cleanser (no soap) and avoid scrubbing the affected skin.
        • After bathing, pat the skin lightly with a towel leaving it slightly damp (do not rub as this can cause irritation!).
        • Apply prescription topical medication to the affected areas of skin as directed (if applicable).
        • Within three minutes, liberally apply a moisturizer all over the body. It’s important to apply the moisturizer within three minutes or the skin may become even drier.
        • Wait a few minutes to let the moisturizer absorb into the skin before dressing or applying wet wraps (more on that below).

          Using Bath Time To Manage Baby Eczema Flare Ups

          Try A Soothing Bath

          breast-milk-bath-for-baby-eczemaIf your little one is suffering from a flare up, a soothing baby eczema bath treatment is a great way to combat painful, itchy symptoms. Although there are no scientific studies that prove it, there is quite a bit of anecdotal evidence showing that a breastmik bath is effective in reducing the symptoms of skin conditions like eczema, psoriasis, and cradle cap. Breastmilk is comprised of tons of vitamins, nutrients, water, and fat. One of the key components is Lauric Acid, a fatty acid that softens skin and has antimicrobial properties, making a milk bath for baby eczema an excellent natural treatment. (Photo: MissKyreeLoves)

          Another common bath for infant eczema relief is an oatmeal bath. Yup, it sounds delish, but what we’re talking about here is “Colloidal oatmeal, which refers to oats that have been finely milled and then suspended in liquid or gel. This type of oat has been used for centuries to ease irritated skin. Colloidal oatmeal binds to skin and forms a protective barrier while locking in moisture and restoring essential minerals while easing inflammation. In fact, an oatmeal bath can be beneficial for any type of baby rash, not just eczema!

          Other baths that may ease discomfort and provide infant eczema relief include sea salt baths, chamomile baths, coconut oil baths, and more. For a deeper dive into all the soothing bath options for your little one, check out 8 Soothing Baths For Baby Eczema Relief. There are a variety of effective bath options, making them an invaluable baby eczema home remedy.

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          Consider Wet Wrap Therapy

          If your little one is having a particularly nasty flare up with severe itchiness or pain, wet wrap therapy may be able to help by rehydrating skin and allowing topical medications to work better. When applying an ointment or medication just before your little one goes to bed, it may rub off on the bed sheets or clothing, allowing moisture to escape. So what is wet wrap therapy for eczema? It’s basically what it sounds like. It involves covering the moisturized skin in wet gauze or wraps to ensure ointments and medication won’t rub off throughout the night.wet-wrap-therapy

          To perform wet wrap therapy, moisten clothing or gauze in warm water until they’re slightly damp. Next, wrap the moist dressing around the affected area. Lastly, being careful not to disturb the wraps, put on cool, lightweight pajamas over top. Leave wet wraps on for several hours or overnight.

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          Summary

          Hopefully I’ve convinced you that bath time can actually be very beneficial for your little one and do wonders for her dry skin. Although all baby skin is delicate, eczema-prone skin requires a little extra TLC. When bathing babies with eczema, remember these tips:

          • Keep bath lukewarm, not hot. The ideal temperature for the bath is around 98 degrees.
          • Bathe baby once a day, but be sure to lock in moisture every time.
          • Limit bath time to 10-15 minutes.
          • Check your water hardness and consider a water softener.
          • Avoid bubble baths which usually contain irritating chemicals.
          • Use a mild cleanser, not soap.
          • Use ointments to moisturize after bath time. If your little one doesn’t like the feel, use an eczema-friendly cream. It’s best to stay clear of lotions, which have the least amount of oil.
          • Always “Soak and Seal” and liberally apply moisturizer within 3 minutes of bath time.
          • Dress baby in cool, lightweight sleepwear without irritating tags and seams that can cause itchiness and make the condition worse.
          • To manage a flare up, consider a soothing  bath or wet wrap therapy.

          XO, Tara

          Sources:

          https://www.aaaai.org/conditions-and-treatments/library/allergy-library/skin-care-tips-atopic-dermatits

          https://www.mustelausa.com/baby-eczema-bathing-guide

          https://nationaleczema.org/eczema/children/atopic-dermatitis/

          https://nationaleczema.org/eczema/treatment/bathing/

          https://nationaleczema.org/eczema/treatment/wet-wrap-therapy/

          https://atopicdermatitis.net/clinical/hard-water-eczema-symptoms/

          https://www.adrescuewear.com/blog/nighttime-wet-wrap-therapy-routine-for-eczema-children/

          https://www.kidspot.com.au/parenting/real-life/in-the-news/mum-claims-she-cured-her-babies-eczema-by-bathing-them-in-her-breast-milk/news-story/5cff4095aa6de140c5f72017a8456fb0

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