How Age Affects Eczema

Eczema on face of newborn
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Eczema affects people of all ages, causing areas of skin that are typically very itchy, dry, crusty, scaly, and/or thickened. But where atopic eczema rashes occur differs depending on how old you are, and the locations are predictable for babies, toddlers, children, and adults. They can also change as a person gets older.

The most common form of eczema is atopic dermatitis. 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.

Age Group Common Eczema Rash Locations
Birth to 2 years Face, chest, back of the head
2 years to puberty Elbows, knees, wrists, hands, behind the ears, around the eyes and mouth
Teens and adults Elbows, hands, scalp, around the eyes, eyelids, nipples

Eczema in Babies (Birth 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 face 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 problems, you should always contact your pediatrician if your child develops a rash, especially in infancy.

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

Treating Eczema in Babies

For babies, medications are not often 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 do 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 prevent irritation. This includes their clothing, as well as your own. 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: You may consider using the same detergent you use on your baby's laundry for yours as well.
  • Put mittens on little hands to prevent scratching: Even small hands can do big damage to delicate skin. Mittens are a perfect way to keep infants and babies from scratching. (Putting socks over their hands can work in a pinch.)

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. It can start when a child is an infant or sometime thereafter, typically before age 5.

As kids age, they won't break out as much on the cheeks and outsides of the limbs. Rather, eczema in children 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 inside the elbows and behind the knees. These areas are known as flexural areas.

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

Many children outgrow eczema by the time they are 5 years old. In other cases, though, it's longer-lasting.

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 flares worse and causes damage to the skin.
  • Watch for signs of infection: While it can happen to anyone with eczema, children are especially prone to developing infections. 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 most people outgrow atopic dermatitis 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 it more vulnerable.

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

  • The creases 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, as well as 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.

Treatments for teens and adults with eczema include many of the same options 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, too, that good personal care is important to allowing eczema to heal and preventing flareups. For instance, 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.

And don't overlook things that may be contributing to skin irritation like perfumes and body sprays, makeup, laundry detergent, or fabric softeners.

A Word From Verywell

The location of eczema follows a fairly predictable location pattern depending on one's age. But whether someone is 1 or 91, keeping skin moisturized and away from possible skin irritants are essential to easing symptoms. 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.

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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.