The Wall Street Journal
By DANA WECHSLER LINDEN
Nov. 3, 2014 11:19 a.m. ET
Are You Bathing Your Baby Too Much?
Improper Care of Infant’s Skin May Increase Risk for Eczema
New thinking on the cause of eczema is prompting some scientists to investigate whether how parents care for their infants’ skin has contributed to the disease’s growth.
How often a baby gets a bath, what is in the baby wash and shampoo and whether the skin is properly moisturized after bathing are things that could help bring on eczema, recent studies suggest. Researchers say many babies may be getting too many baths, and two to three a week is enough. Eczema causes patches of dry, itchy, inflamed skin that usually starts in early childhood.
Scientists increasingly believe that environmental factors, such as bathing, pollutants and indoor heating, can disrupt the skin’s ability to keep moisture in and allergens and microbes out. A weakened skin barrier—the outermost layer—allows outside irritants to penetrate the skin and spark an immune-system response. Other research has found that genetic variations in some eczema patients also can compromise the skin barrier.
Eczema was long believed to begin as an allergic reaction, perhaps to something a child ate or encountered, that then led to skin inflammation. But experts say decades of viewing allergies as the primary culprit behind eczema yielded few preventive strategies.
“The more we understand about the causes of eczema, the more it seems how we take care of the skin of babies may be relevant,” says Eric Simpson, associate professor of dermatology at Oregon Health & Science University in Portland. “Are the things we’re doing that we think are good for our babies causing eczema?” he says.
Eczema, formally known as atopic dermatitis, usually appears on the face and scalp of babies and in the crooks of elbows and backs of knees in older children. Prescription ointments can reduce the itching and redness but there isn’t a cure.
The condition usually develops before the age of 18 months, when a baby’s skin is still developing. It can come and go for months or years and often disappears by adolescence. Occasionally it persists into adulthood. The American Academy of Dermatology estimates 10% to 20% of children get eczema, up from just 3% in 1960. It isn’t clear if the rate is still rising.
SKIN PROTECTION
Recent research suggests proper care of infants’ skin may help reduce the risk for eczema. Here are some tips:
- For the first year, give baths no more than two or three times a week to avoid drying out the baby’s skin.
- Apply moisturizer liberally immediately after the bath. Putting it on when the skin is still moist will seal in the water.
- Use mild, non-soap cleansers designed for a baby’s skin.
- Fragrance-free is best. Even herbal ingredients can be irritating to the skin.
- Thicker or oily moisturizing products are better at keeping the skin moist.
- Consider products with the National Eczema Association’s seal of acceptance. These don’t contain ingredients that are known irritants to sensitive skin.
In a recent study, Dr. Simpson and a team of investigators from the U.K. looked at whether protecting the skin barrier of infants with a moisturizer could help prevent eczema. They divided 124 newborns at high risk for eczema because of family history into two groups. Parents of the first group were instructed to apply a fragrance-free moisturizer all over their babies’ body once a day. In the other group, parents were asked not to use moisturizer. When the babies were 6 months old, the incidence of eczema in the moisturized group was about half that of the controls, or 22% versus 43%.
The study is published in the current issue of the Journal of Allergy and Clinical Immunology. Another small study in the same issue, by a group of Japanese researchers, also found a greatly reduced rate of eczema among babies whose parents applied daily moisturizer. That study involved 119 babies.
“There hasn’t been much ever before that’s been shown to alter the chances of a child to develop eczema,” says Seth Orlow, chairman of the Ronald O. Perelman Department of Dermatology at NYU Langone Medical Center in New York. “This suggests we can do something low-tech and change whether a child gets this disease. Wow, that’s pretty exciting if so,” says Dr. Orlow, who wasn’t involved in the research on eczema and moisturizers.