The baby's skin flakes and turns red: could it be atopic dermatitis?

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My five month old baby has reddish patches on his face and scales on his forehead. Could it be atopic dermatitis? (Mum Chiara)

The answer to this mom's question is yes: it could be atopic dermatitis or eczema, one chronic inflammatory skin disease quite frequent, which mainly affects children. Dermatitis generally appears in the first two years of life, starting from 5/6 months of age, and is typical of the first 6/7 years. It is not contagious and in many cases it disappears with puberty or adulthood (although the skin often tends to remain dry and sensitive).

How it looks and what it depends on

It generally occurs with the appearance of reddish patches on the skin of certain areas of the body such as the face (except the area around the mouth), the hands, the hollow of the knee and arm, the root of the foot or the nape of the neck. In addition, there may be areas of peeling, especially on the forehead and scalp.

Contrary to what was once hypothesized, the disorder is almost never linked to the type of milk the baby takes or to the introduction of other foods such as eggs. Today, however, it is believed that there is one at the basis of this condition constitutional predisposition (genetic), combined with environmental triggers. Among these, for example:

  • exposure to irritants (such as synthetic clothing or wool) or environmental pollutants
  • cold and dry climate
  • stress
  • emotional disturbances
Read also: Allergies to egg proteins: what it is and how to behave

What to do

First of all, eczema must be brought to the attention of the pediatrician from its first appearance because it is necessary that the diagnosis of atopic dermatitis be sure. The problem is tackled with a so-called "step" therapy because the modalities change according to the phases of the condition, which alternates moments of remission and reappearance. 

In the phases of remission, the use of emollient and moisturizing creams after the bath, while in the so-called flares (acute phases) the use of cortisone cream. In the event that not even cortisone proves to be sufficient to control eczema, the pediatrician can prescribe a drug antihistamine by mouth. Sometimes bacteria can proliferate on the damaged skin: in this case an antibiotic may also be necessary.

Bathing in children with atopic dermatitis

proper hygiene it is essential for children with atopic dermatitis: on the one hand, in fact, washing helps to remove scabs, any irritants and microbes. On the other hand, however, we must be careful don't be too aggressive, so as not to damage the skin. Here are the recommendations of an official document published in 2022 by the experts of the Del Paesena Society of pediatric allergology and immunology and of the Del Paesena Society of pediatric dermatology:

  1. Don't stay too much in contact with water: washes should be daily but of short duration, about five minutes;
  2. To wash, lukewarm water and mild detergents, as poor as possible or free of preservatives and / or fragrances. If there is one bacterial superinfection bathrooms with diluted sodium hypochlorite;
  3. To dry no rubbing: yes to one instead gentle dabbing with soft towels, not rough.
  4. After washing, remember to spread a thin layer of emollient product.

  • child's agenda
  • newborn 4-8 months
  • skin
  • dermatitis
  • if the baby has dermatitis
  • eczema atopico
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