How Age Affects Eczema

Eczema on face of newborn
Radist / Getty Images

The location of atopic eczema rashes is different, depending on the age of the person. Eczema develops in predictable locations for babies, toddlers, children, and adults. The areas of skin that break out in eczema rash changes as a person ages.

In all ages, areas affected by eczema are typically very itchy, dry, crusty, scaly, and/or thickened. In addition, these areas may cause skin discoloration, causing the skin to become lighter or darker, depending on your pigmentation.

The most common form of eczema is atopic dermatitis, which usually has a red, itchy rash. This type of eczema mostly affects people who tend to have asthma, hay fever, or food allergies. In addition, many experts believe there is a genetic predisposition to developing it.

With other kinds of rashes, the rash comes first, then it feels itchy. Instead, atopic dermatitis is an itch that, when scratched, erupts into the identifiable eczema rash. Therefore, for a person who has atopic dermatitis, scratching any area of the skin long enough will result in eczema.

Eczema in Babies (Age 0 to 2 Years)

In infants, eczema typically begins on the cheeks as a rough, red, scaly rash. Because eczema is itchy, your baby may rub their faces against you, their crib, or anything else available.

In infants and toddlers, eczema most often involves the:

  • Face, especially the cheeks, but also the chin and forehead
  • Chest
  • Back of the scalp, where it is sometimes mistaken for cradle cap

If eczema progresses, it can appear on other areas of the face and body. The elbows, knees, stomach, and feet are other areas that are often affected in older babies.

This distribution reflects where the child is able to scratch, and therefore usually spares the diaper area.

Although eczema is one of the most common babyhood skin problem, you should always contact the pediatrician if your child, especially a very young infant, develops a rash.

Eczema in babies typically begins between 1 month and 6 months of age. Mild cases may last just a few months; others, though, can be longer-lasting.

Treating Eczema in Babies

For babies, often medications are not needed. Instead, application of a fragrance-free cream or ointment several times per day, and immediately after every bath, is often enough to control eczema.

If emollients aren't doing the trick, your doctor may suggest over-the-counter hydrocortisone creams or, in severe cases, prescription medications. Only very mild steroids are used in babies, because of the risk of side effects.

Other things you can to help control your baby's eczema include:

  • Avoid rough, scratchy fabrics. Keep everything that comes in contact with your baby's skin as soft as possible to avoid irritating their delicate skin. This includes your clothing, too. For example, don't allow your baby to rest their head on the shoulder of your nubby sweater; drape a baby blanket over your shoulder first.
  • Don't use soap. Even soaps and washes marketed for babies can be too irritating. Instead, wash your baby in plain water. If you must, a fragrance-free, lipid-free cleanser can be used.
  • Use gentle, fragrance-free laundry detergents. Again, don't forget about your clothing. Remember, your young baby probably spends a lot of their time being held by you and other caregivers and their skin comes in contact with your clothing (and whatever detergent you washed it in). You may consider using the same detergent you use on your baby's laundry for yours too. For other caregivers, ask that they drape a blanket over their clothing before holding baby.
  • Put mittens on little hands to prevent scratching. Babies and can't be told not to scratch, obviously, so caregivers must be creative in keeping small hands from scratching and doing damage to delicate skin. Mittens are perfect to keep infants and babies from scratching. You may have to try a few different styles to find one that stays on your little one's hands if they're masterful at getting them off.

If you can't get your baby's eczema under control with home treatment, let your child's pediatrician know.

Eczema in Children (Age 2 Years to Puberty)

Eczema is a very common childhood skin problem. If your child has had eczema since infanthood, you'll notice as your child grows the location of the eczema rash changes. You'll notice your child doesn't break out as much on the cheeks and outsides of the limbs.

For children who have developed eczema for the first time, the rash typically appears before age 5.

In children, eczema tends to develop:

  • In the creases of the elbows
  • On the wrists or hands
  • Behind the knees
  • Behind the ears
  • Around the eyes and mouth

Eczema tends to reach a peak of intensity between the ages of 2 and 4 years old.

During this time, it most commonly affects the skin in front of the elbows and behind the knees. These areas are known as "flexural areas."

It can also begin to affect areas of the body, such as the lower legs and feet, that begin to come into contact with more surfaces as children become more mobile.

Many children outgrow eczema by the time they are 5 years old. In other cases, though, it's longer-lasting and can continue throughout childhood and sometimes into adulthood.

Treating Eczema in Children

As your child ages, keeping the skin well-moisturized and avoiding irritants is still an important step in managing eczema. Apply creams or ointments several times per day (in the morning, after returning home from school, and before bed is a good routine). Again, always moisturize immediately after bathing or showering.

Treatment options for children include:

  • Topical steroids (both over-the-counter and prescription)
  • Topical calcineurin inhibitors, such as Elidel and Protopic
  • Antihistamines to relieve itch
  • Antibiotics in cases of infection

Other tips for controlling childhood eczema include:

  • Keep baths and showers short. Some kids love to spend time in a bath, but soaking for too long can strip the skin of moisture. Keep baths under 10 minutes. Also, don't add bubble bath products as they can be irritating. Oatmeal baths are OK, and can help relieve itching.
  • Keep your child's nails trimmed short. Scratching makes eczema flareups worse and causes damage to the skin.
  • Watch for signs of infection. While it can happen to anyone with eczema, at any age, children are especially prone to developing an infection. If you see notice increased redness, swelling, draining of fluid, or warmth coming from the rash, or if your child complains of increased pain, call a doctor.

Eczema in Teens and Adults

While atopic dermatitis is usually considered a condition of childhood (typically appearing during the first year) and most people outgrow it by the time they are teenagers, it can persist into adulthood. For others, childhood eczema that had cleared up years prior may reemerge.

Eczema can also develop for the very first time in adulthood; this is called adult-onset eczema. Some of the prime years for developing adult-onset eczema include middle age and older. Skin naturally becomes drier as people age, leaving the skin vulnerable to developing eczema.

In teens and adults, the location of eczema classically involves:

  • The crease of the elbows
  • Behind the knees
  • Hands
  • Scalp
  • Around the eyes or on the eyelids
  • Nipples

Eczema most often affects areas exposed to allergens or irritants, and also the flexural areas that are easily scratched. Adults may find their skin becomes thickened and leathery-looking in areas affected by the rash.

There are other skin conditions that look very similar to eczema, including contact dermatitis, psoriasis, and rosacea. It's important to see a doctor if you develop rash symptoms for the first time as an adult to ensure you get the correct diagnosis and treatment.

Treating Eczema in Teens and Adults

As with young children, keeping the skin well moisturized is key to controlling eczema in teens and adults. Apply emollients often throughout the day. Ointments are very effective at sealing in moisture, but because they're heavier and leave your skin a bit greasy, you may want to save application of these for nighttime.

Treatment options for teens and adults with eczema include many of the same treatments used for children, namely topical corticosteroids, topical calcineurin inhibitors, and antihistamines for itch-relief.

In addition, biologics can be used in those 12 years and older in cases where eczema isn't improving with traditional treatments.

Remember that good home care is important to allow eczema to heal and help prevent flareups.

Don't overlook things that may be contributing to skin irritation like perfumes and body sprays, makeup (including eye makeup), laundry detergent, or fabric softeners.

Also, make sure your shower or bath water isn't too hot. Very hot water can strip the skin of its natural oils. Aim for lukewarm water temperatures for your shower.

A Word From Verywell

The location of eczema follows a fairly predictable pattern of location depending on the age of the person. Babies are more likely to have eczema on their cheeks, adults more likely on their hands or eyelids.

No matter the age, though, the basic tenets of treatment comes down to keeping the skin moisturized and away from possible skin irritants. If you can't get your, or your child's, eczema under control on your own, call your doctor. Although eczema can't be cured, it can be effectively managed with the right treatments.

Was this page helpful?

Article Sources

  • Piliang M, Schneider S. Atopic Dermatitis. Cleveland Clinic. Published July 3, 2019.

  • Strathie Page S, Weston S, Loh R. Atopic dermatitis in children. Aust Fam Physician. 2016 May;45(5):293-6.

  • Weston WL, Howe W. Pathogenesis, clinical manifestations, and diagnosis of atopic dermatitis (eczema). In: UpToDate. Corona, R (Ed). UpToDate.