Eczema Creams, Emollients and Moisturisers
Choosing a cream for baby eczema is really about personal preference. If there is no sensitivity to a chosen cream then regular application is more important than what you apply.
In many ways it is easier to outline what shouldn’t be in creams than what should; added ingredients are likely to cause reactions. Perfumes and colours are completely unnecessary and should always be avoided. Preservatives although needed in some creams like those containing water should be kept to a minimum. Additives like parabens and surfactants (detergents) are common causes of skin irritation and should be avoided.
It’s also worth mentioning Aqueous cream this was designed as an emollient cleanser and should NOT be left on the skin. It can irritate the skin of children with Eczema and make it much worse. One study of children attending one dermatology clinic showed irritant reactions to aqueous cream in over 50% of children (Cork et al 2003). The same study showed reactions to 17% of other commonly prescribed emollients.
Eczema creams themselves can be either mineral oil based products or natural plant based oils and butters.
Petroleum jelly and other pure mineral based emollients are unlikely to cause a reaction even in the most sensitive of people but these creams are frequently full of preservatives and additives, they also do little to actually nourish and moisturise the skin. Creams derived from plant oils or butters still have the benefits of the living plants in them and when well-chosen can have many advantages over mineral based emollients.
Moisturising is so very important that it’s great to make it an enjoyable part of you and your baby's routine. It can be a lovely time to make eye contact, smile, kiss and bond with tiny babies. Try to make it a special time for you both. Older toddlers will love the attention too even if they are a little harder to keep still!
It really is much easier to feel that you’re caring for and pampering your little one than medicating them.
Tips on Applying Creams
- Creams should be applied at least twice daily. Even when the skin looks fine, preventing flare ups is much easier than settling them back down.
- Cream should not be rubbed into the skin as this can cause redness/itching. Instead gently smooth them on in the direction the hair grows.
- Apply extra at any sign of redness or itching and after very soon after a bath as this helps to seal in the moisture from the water.
- Keep a cream with you were ever you go so you always have some to put on at the first sign irritation.
- Special care should be taken to protect freshly healed skin, these areas will be especially vulnerable to new break outs for several weeks.
In wet eczema skin is so inflamed and sore it is weeping fluid or blood. When the skin is like this it requires different management to the dry or itchy stage and it can easily become infected. If your itchy baby develops wet eczema stop moisturising and consult your doctor quickly for appropriate treatments.
Distilled witch hazel is a traditional external treatment for wet eczema. It’s said that dabbing a cotton wool ball soaked in witch hazel can help to dry out wet eczema, help with the itching and has antibiotic properties. There are no conclusive studies to back this up but distilled witch hazel is a relatively safe product widely available so it could be worth a try on a small area. Once the weeping is controlled then it’s back to emolliating.
Eczema on Babies Faces
Baby’s faces, cheeks and chin are very vulnerable to eczema breakouts. There are several reasons for this. Faces are often damp with drool meaning they are in wet contact with any irritants in clothing or toys. Messy eating means food gets onto baby’s sensitive skin. Infants also instinctively chew hands and toys bringing bacteria to the skin.
Add to this a tendency to flush easily when warm, teething which can increase the blood supply to the cheeks and make their dribble more acidic and the fact the face is always exposed to the elements and you’ll soon understand why they’re lovely faces need lots of special attention!
It’s worth keeping a pot of cream near the highchair, pop a layer on as a barrier before meals. When the meal is over clean the face thoroughly and apply more cream, covering checks, chin, hands and wrists before you get them down.
We were never far from a pot of cream, I’d pop some on at any signs of redness several times a day to help keep eczema at bay.
Further Note on Safety of Creams
Additives and preservatives in creams are definitely something to watch out for. What we apply to the skin is also absorbed into the body, especially so in babies. This is because baby skin is thinner and more porous than adult skin. A large skin surface area compared with body weight also means additives in creams applied all over their body can potentially reach high concentrations in the blood (read study).
The safety of some preservatives are still under question. The Health & Consumer Protection directorate-general concluded “The SCCP is of the opinion that, based on the available data, the safety assessment of Propyl and Butyl Paraben cannot be finalised yet” (read study).
These same chemicals have also been found in the breast tumours of women so I personally err on the side of caution.
Other very common preservatives like Phenoxyethanol can cause contact irritation. The American FDA states “Phenoxyethanol is a preservative that is primarily used in cosmetics and medications. It also can depress the central nervous system and may cause vomiting and diarrhoea”.
There are more links to additives in creams on the news and links page.
Any cream or emollient can cause skin problems in people sensitive to one or another of the ingredients, so remember with any product it’s always important to patch test a small area first, preferably on healthy skin. When trying a cream look for redness or the child itching the area. Some creams can also sting on application which a child or baby would object too. If you are not sure about a product trust your instincts and find an alternative.