Eczema (atopic dermatitis) is an inflammatory skin condition characterised by dry, itchy, red patches of skin. It is the most common chronic skin condition in children and is on the rise in India, particularly in urban areas. While it cannot always be cured, it can be very well-managed with the right approach.
What Eczema Looks Like
In babies under 6 months: red, weeping, crusting patches primarily on the face, scalp, and outer arms and legs. In older babies and toddlers: dry, scaly, intensely itchy patches in skin folds — the inside of the elbows, behind the knees, wrists, and ankles. The itch-scratch cycle — scratching damages skin, damaged skin itches more — makes eczema self-perpetuating without treatment.
Common Triggers in India
Heat and sweat — extremely common in India's climate. Sweating irritates eczema significantly. Synthetic fabrics and rough textiles. Certain soaps, detergents, and bath products — even marketed baby products often contain fragrance and preservatives that trigger eczema. Dust and pollen — particularly relevant in Indian cities. Food allergens — in some but not all children with eczema. Dry air in air-conditioned rooms.
Treatment: The Two-Step Approach
Step 1: Moisturise aggressively. Emollient (moisturiser) therapy is the cornerstone of eczema management. Apply a fragrance-free, thick emollient (not a lotion — creams and ointments are more effective) immediately after bathing while skin is still damp, and 2 to 3 times daily. Products containing ceramides help restore the skin barrier. Vaseline (petroleum jelly) is an effective, inexpensive option.
Step 2: Treat flares with prescribed medication. Mild topical steroids (hydrocortisone 1%) are safe for babies when used as directed by a paediatrician on affected areas. They are not to be used on the face without specific guidance. Steroid phobia is common in India and leads to undertreated eczema that causes significant suffering. A short course of topical steroid on a flare is far safer than prolonged uncontrolled eczema.
Bathing for Eczema Babies
Short, lukewarm baths (5 to 10 minutes, 28 to 30 degrees). Use a soap-free, fragrance-free wash. Pat dry gently — never rub. Apply emollient within 3 minutes of drying. In Indian summers, twice-daily brief rinse baths followed by immediate moisturiser application helps enormously.