Atopic Skin in Babies and Children: Causes, Symptoms and Tips

Published: 27 August, 2024 | 7'

Do you notice that your baby's skin is very sensitive or reactive with the frequent appearance of eczema? The skin of young children requires special attention during this initial stage of their lives, as there are many factors that can affect its structure and functionality, and moreover, it is more delicate than adult skin.

Among the many ailments that can affect the skin of both young children and adults, the most common is dermatitis or atopic skin. Continue reading to discover its symptoms and how to care for it.

What is atopic dermatitis and why does it affect babies?

The state of our skin varies throughout our lives, as there are many factors that can affect the condition of our dermis. Especially during childhood, as during the first years of life it has very specific characteristics, being more sensitive.

Atopic dermatitis (AD) is an inflammatory skin disease and is the most common type of eczema. In AD, the function of the skin barrier is affected, causing it to be drier and more irritable than usual. It presents with visible lesions that can appear anywhere on the body, commonly referred to as eczema flare-ups that cause intense itching.

Differences between adult skin and baby skin

Our skin serves a protective function throughout life; however, during the early stages of life, skincare is key to preserving it. The skin during childhood has a special structure, as it is thinner than when we reach adulthood and, therefore, is more sensitive and delicate. It has a more alkaline pH, produces less melanin and sebum, making it more susceptible to the action of sunlight.

Moreover, as it is not fully developed, it loses a greater amount of water and also lacks a significant amount of beneficial microorganisms (skin microbiota), which coexist on the skin and play a role in maintaining its integrity.

Understanding atopic skin in early childhood

Although there are various causes that can trigger the development of atopic skin, such as environmental or hereditary factors, this condition is becoming increasingly common in babies and children, and in many cases extends into adulthood.

It is estimated that between 15% and 25% of children experience atopic skin in early childhood.

In those cases, approximately 45% of all cases of atopic dermatitis begin in the first six months of life; 60% during the first year, and between 80-90% before the fifth year of life.

During the last few decades, the incidence of this condition has multiplied in industrialised countries such as the United States, Europe, and Japan, with some populations showing a peak prevalence of nearly 30%.

Why does atopic dermatitis occur in babies?

As mentioned, the skin of babies or children has specific characteristics different from that of adults: their skin barrier is thinner, and they have less sebum and sweat. Therefore, they are particularly sensitive to any skin afflictions.

Hereditary factors: family history of atopic skin

Additionally, the main risk factor for developing atopic dermatitis is family history. If either parent has this condition, the risk of a baby developing it increases by 1.5 times, while the risk multiplies by 3 or 5 if both parents have it.

Immune system

Another risk factor that can trigger atopy is a deficient functioning of the immune system (especially of immunoglobulins E and G), imbalances in intestinal bacterial microflora, or diets high in sugars and polyunsaturated fatty acids.

Environmental factors

Environmental factors can also influence the appearance of atopic skin, such as living in industrialised urban environments, regions with low exposure to ultraviolet light, or dry climatic conditions, which also affect the incidence of atopic skin. For example, low temperatures and humidity increase the likelihood of more irritation, while heat is also poorly tolerated due to increased sweating and changes in pH.

How to detect atopic dermatitis in babies and children?

No specific diagnostic tests exist for atopic dermatitis, so its diagnosis is established through a physical examination of the lesions present on the skin, which exhibit characteristic clinical traits and the personal and/or family history of atopy.

The most typical clinical trait is the elevation of total or allergen-specific IgE levels in the blood; however, this is not present in all individuals with atopic skin.

Symptoms of atopic skin in babies and children

In general, atopic skin presents with intense itching and irritation, along with eczematous lesions that can appear anywhere on the body.

In cases of atopic dermatitis in breastfeeding babies, more acute skin lesions may appear, such as severe erythema, oedema, excoriations, serous exudate or crusting, which are distributed across different parts of the body, especially on the face, cheeks, and trunk, without affecting the nappy area.

During childhood, atopy becomes more localised and chronic, with paler erythema, xerosis, and thickened, dry skin from repetitive scratching, and typically affects flexural surfaces, such as the knees and elbows.

This symptomatology is defined according to the Hanifin and Rajka criteria, used by medical societies and groups such as the American Academy of Dermatology. Medically, the SCORAD scale (Scoring index of Atopic Dermatitis) is the most commonly used to assess the severity of atopic dermatitis.

Tips for caring for atopic skin in babies and children

Care for atopic skin in babies and children should be individualised, and it is recommended that a specialist evaluates each case. It is important that the family receives sufficient information to alleviate the symptoms of atopy and improve quality of life.

The atopic dermatitis currently lacks an effective treatment, although it can spontaneously remit and is treatable. The treatment focuses on improving the skin barrier by maintaining its hydration, relieving itching, reducing inflammation, and balancing the skin microbiota, in order to decrease outbreaks and the risk of infections.

Some tips for babies and children with atopic skin for daily care are:

Fragrance-free emollients and moisturisers, once or twice a day: these are essential as part of the prevention and daily treatment of atopic dermatitis. They help to reduce transepidermal water loss and replenish the moisture of the skin, decreasing the severity of lesions and outbreaks. The use of structural lipid preparations such as ceramides, urea, lactic acid, alpha hydroxy acids, and omega-6 fatty acids (found in ingredients like sea buckthorn and shea butter) is recommended. It is advisable to apply them after bathing once or twice a day.

Short baths with lukewarm water: short baths, lasting no more than 10 minutes and with lukewarm water, are recommended. These baths provide hydration and clean the skin of crusts, scales, irritants, bacteria, etc. Furthermore, it is preferable to use body cleansers (preferably soap-free) that do not contain colourants or perfumes and are hypoallergenic. After the bath, the skin should be dried with a hypoallergenic towel using patting motions (without rubbing or scrubbing), immediately applying an emollient afterwards.

Cotton or linen clothing: synthetic materials should be avoided, opting for lightweight cotton or linen garments. It is important to remove labels from clothing that may scratch the skin. Additionally, it is advisable to wash clothes with mild detergents specifically designed for babies or children with atopic skin.

Clean environments: it is important to maintain home hygiene, especially ensuring it is free from dust or pet hair. It is also beneficial to keep the environment at moderate temperatures and with humidity at 50%.

Natural ingredients: regarding topical treatments with corticosteroids, the most commonly used should be prescribed by a doctor as they require monitoring and follow-up. Natural ingredients are increasingly gaining ground, and evidence suggests some of them show good results, particularly in repairing the skin barrier and relieving symptoms; these include sea buckthorn, calendula, black cumin, Boswellia, shea butter, neem oil, among others.

Other measures such as restricting certain foods in the diet are a controversial topic and should only be implemented when in vitro tests detect an intolerance, and even then it should be tested whether it truly influences the course of the disease.

Soothing and moisturising products for babies and children with atopic skin

The main symptoms of atopic skin are irritation and itching, which is why it is especially important to seek products for their care, particularly those that soothe the skin on a daily basis. Natural ingredients are valid options for use on atopic skin.

Repairs the skin barrier and soothes irritated skin with BioAtopic Repair oil, specially designed for the atopic skin of children and adults, suitable from 3 months onward.

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For especially dry and rough areas, Shea Butter with Sea Buckthorn and Organic Calendula helps to deeply hydrate and regenerate the skin. It can be used on children from 3 years old.

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For very exposed areas like the lips and nose during times when they become excessively dry, the BioAtopic Nose and Lips Balm deeply hydrates and protects these areas from external aggressions to help regenerate and soothe the skin. Suitable from 3 years of age.

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Frequently Asked Questions about atopic skin in babies

Should you have any doubts regarding any variations or afflictions in the skin, it is most advisable to see a specialist who can examine the symptoms and determine the correct origin and treatment.

Can atopic dermatitis be cured?

Throughout our lives, the skin undergoes various changes that can affect its condition and lead to the development of certain conditions. Atopic skin or dermatitis is a chronic condition, although the presence of eczema outbreaks or other symptoms can worsen depending on certain external or internal factors, or can be alleviated through proper care and continuous hydration.

Is atopic skin contagious?

No, the origin of atopic skin is due to intrinsic factors which directly depend on individual characteristics such as genetics, environmental factors, or certain conditions like a weakened immune system.

What can I do to prevent outbreaks?

A proper daily hygiene and moisturisation routine for the skin, following the advice described above, is the way to help reduce the appearance of eczema outbreaks, as well as alleviate and restore the skin when one occurs.

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References

Content reviewed by specialists from the Scientific Information area of MARNYS. This article is informational and does not replace a consultation with a specialist.