October is Eczema Awareness Month, and Ready, Set Food! is here to help with tips for baby eczema care. What is the skin barrier, and how does it connect to the flares that eczema babies experience? How can you help protect your baby’s skin barrier when they have eczema? Today, we’ll go over the answers in this parent’s guide.
What is the skin barrier?
The skin barrier is the protective layer on the outside of the skin. It is also called the stratum corneum. Under normal circumstances, it works like a brick wall that helps keep bacteria, irritants, and allergens from entering the skin.
This barrier is made up of skin cells that function like bricks. In between these skin cells, there are lipids, or fats, that function like mortar. The lipid area contains fats called ceramides, as well as fatty acids and cholesterol.
The skin barrier of babies without eczema vs. babies with eczema
A baby without eczema has an intact skin barrier, which functions like a strong brick wall that isn’t missing any bricks or mortar. When it’s fully functioning, the skin barrier’s cells hold natural moisturizers, and the ceramides in the lipid area help lock moisture in the skin.
But in babies with eczema (atopic dermatitis), the skin barrier is compromised, so it is not as strong. It’s almost like a brick wall with the mortar missing, or with big cracks in several of the bricks.
This means it’s much easier for bacteria, irritants, and allergens to pass through the skin barrier. These invaders can cause inflammation beneath the skin– called a flare-up – after they enter the skin of a baby with eczema. The inflammation makes the skin itchy.
The compromised skin barrier also lets moisture escape quickly, drying out the skin.
To sum things up, eczema babies have a weaker skin barrier. Eczema makes a baby’s skin dry, rough, and itchy. And whenever certain irritants enter the skin through the weak skin barrier, a baby’s eczema will flare up (get worse).
This image illustrates the difference between a typical skin barrier (left) and the skin barrier of a person with eczema (right):
Why is the skin barrier compromised in eczema babies?
We don’t know what causes a baby to develop eczema. But we do know that it involves the immune system. (Some theories suggest that a malfunction in the immune system causes skin barrier breakdown, and leads to eczema.)
We also know that there are a few different ways that an eczema baby’s skin barrier can be compromised.
Some people with eczema don't produce enough ceramides. Since they don’t have as many ceramides in their skin barrier, it's harder for their skin to lock in moisture.
And many people with eczema – up to half – don’t make filaggrin properly. Filaggrin is a protein needed for the skin cells to function properly. Without enough filaggrin, the skin cells can’t hold moisture as well as they’re supposed to, and they may shrink. This can create gaps, or holes, in the skin barrier.
Baby eczema triggers and the skin barrier
Eczema babies’ skin flares up whenever certain irritants, or “triggers,” pass through the skin barrier. But the exact “triggers” that cause a flare-up vary from baby to baby.
Here are some of the common “triggers” that can make babies’ eczema worse:
- Dry skin
- Dry air
- Dyes (often in soaps, shampoos, and laundry detergents)
- Fragrances (often in soaps, shampoos, lotions, and laundry detergents)
- Fabrics (such as nylon, wool, and polyester)
- Skin infections
- Food allergens, especially if your child already has an allergy to a food
- Environmental allergens, especially if your child already has an allergy
Figuring out your baby’s eczema “triggers,” and keeping them from coming in contact with baby’s skin, is key to minimizing flare-ups.
How to strengthen an eczema baby’s skin barrier?
Bathing baby daily, and applying moisturizer to baby’s skin regularly, are key to building up baby’s skin barrier and guarding against eczema flare-ups. This routine is known as the “soak and seal” method.
Moisture escapes through baby’s skin barrier more easily because of their eczema, but the daily bath helps replenish that moisture.
For baby’s bath, use warm (not hot) water, and unscented body wash and shampoo that are free from dyes. That way, you won’t activate “triggers” that could make baby’s skin flare.
Then, have baby soak for 10-15 minutes, or the length of time your baby’s dermatologist recommends. Once the bath is finished, gently pat baby dry, so some of the moisture from the bath stays on baby’s skin.
After the bath, it’s time to moisturize quickly – within 3 minutes or less.
Applying moisturizer all over baby’s skin, within 3 minutes after the bath, helps seal the moisture from the bath into baby’s skin. It helps strengthen the skin barrier as well.
It’s also important to spritz baby with water frequently throughout the day – at least twice a day – and then apply moisturizer within 3 minutes after every spritz.
If you wait too long to moisturize, the moisture from the bath or the spritz will escape through baby’s compromised skin barrier.
Choosing a moisturizer with ceramides is ideal, because ceramides are the fats that form part of the skin barrier. Using a moisturizer with ceramides helps make up for the weaknesses in baby’s skin barrier, and helps create a new, temporary barrier.
Another great moisturizer choice is coconut oil, as it’s both a natural moisturizer and inflammation reducer. The fatty acids it contains are similar to the fatty acids in the skin barrier – they help baby’s skin hold in moisture.
Moisturize all the areas of baby’s body, especially the areas where baby’s eczema is flaring up the worst. And whenever baby’s skin looks itchy or feels dry, it’s time to spritz and moisturize. You might choose to keep the spritz bottle and moisturizer in baby’s room, or their diaper changing area, as a cue to moisturize frequently.
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