Baby Eczema FAQ (Part 1): Steroid Cream

Eczema is medically referred to as atopic dermatitis or atopic eczema, a common skin condition in infants. Dr Chantel Ng explains that baby eczema often appears as redness, swelling, dryness, or even oozing on the face or other body parts. And when babies experience eczema, it is usually accompanied by itchiness and discomfort, which can be distressing for both the baby and the parents.  

1. What Is Baby Eczema?

Baby eczema (which refers to eczema during the infantile period) is a non-contagious chronic skin inflammation that can appear within the first few months after birth. It causes redness, swelling, dryness, and itchiness, and in severe cases, it may lead to oozing or infections. Eczema in infants younger than 1-years-old most commonly affects the face, neck, scalp, outer knees, and outer elbows, but it can also spread to other parts of the body. 

2. What Are the Early Symptoms of Baby Eczema?

• Redness on the face or body, especially on the cheeks, forehead, and chin 
• Rough or dry skin, sometimes accompanied by mild flaking 
• Itchiness and rubbing, particularly at night 
• In severe cases, the skin may develop cracks, oozing, or scabbing

3. What Is the Difference Between Eczema and Other Common Skin Conditions? 

Baby eczema is a chronic inflammatory skin condition that commonly affects infants and young children. Parents may sometimes confuse it with other baby skin conditions. 

The symptoms and severity of the above skin conditions vary from person to person. Parents should consult a pediatrician based on the symptoms to receive an accurate diagnosis and appropriate treatment recommendations. 

4. What are the Causes of Eczema?

The causes of eczema usually involve multiple factors: 

• Genetic factors: If the parents have a history of eczema, asthma, or allergies, the baby has a higher chance of developing eczema 

• Environmental influences: Dry air, dust, and irritants (such as fragrances and soaps) can worsen eczema. 

• Immune system allergic reactions: The immune system may overreact to external stimuli. 

• Skin barrier damage: A baby's skin is thinner and loses moisture easily, leading to dryness and eczema. 

5. Does Baby Eczema Always Require Steroid Treatment? Will it Make the Skin Thinner?

Many parents hesitate to use steroid creams for treating eczema, worrying that they may thin their baby's skin or only provide temporary relief. Steroid creams have a long and safe history of use. When applied correctly under medical supervision—following the prescribed dosage and duration—they are generally safe and rarely cause side effects. 

For severe eczema, steroid creams can effectively reduce redness, itching, and inflammation, helping the skin recover. Mild eczema may only require a low-dose steroid or a non-steroidal anti-inflammatory cream. The duration of treatment depends on the individual case. If parents have concerns, they should consult a doctor to ensure safe usage. 

6. Baby Eczema Creams – What Are the Different Types and Strengths of Steroid Creams? 

According to the ‘Steroid Ladder’ provided by NHS Foundation Trusts, steroid creams are categorised into four levels: Very Potent, Potent, Moderate, and Mild. These are used for different severities of eczema and various skin conditions: 

Very Potent Steroid Creams 

• Indications: Used for severe eczema or skin inflammation, such as psoriasis or significantly thickened skin. Should only be used under medical supervision. 

• Examples: Clobetasol propionate 0.05% (Brand names: Dermovate®, Clobex® Shampoo) 

Potent Steroid Creams 

• Indications: Suitable for moderate to severe eczema with symptoms like thickened skin, inflammation, or intense itching. Should be avoided on sensitive areas (e.g., face, eyelids). 

• Examples: Betamethasone valerate 0.1% (Betnovate®), Mometasone furoate 0.1% (Elomet®) 

Moderate Steroid Creams 

• Indications: Used for moderate eczema with symptoms such as scaling, mild oozing, or persistent itching. Suitable for long-term inflammation control. 

• Examples: Clobetasone butyrate 0.05% (Eumovate®), Betamethasone dipropionate 0.05% + Salicylic acid 2% (Diprosalic®) 

Mild Steroid Creams 

• Indications: Suitable for mild eczema or sensitive skin. Can be used on infants and delicate areas such as the face or groin. 

• Examples: Hydrocortisone 1% (Hydrocortisone Cream/Ointment), Desonide 0.05% (Desowen® Lotion) 

The above information is only for reference, parents should use steroid creams as directed by a doctor and monitor for any side effects. If symptoms worsen, or if the skin develops redness, blisters, or other steroid-related side effects, stop usage immediately and consult a doctor. Do not self-medicate, purchase over-the-counter steroids, or use others' medications, as improper use may worsen the condition. 

7. How Should Parents Properly Use Steroid Creams? 

• Apply as instructed by the doctor to the affected areas. 

• Use with moisturisers to maintain a healthy skin barrier and reduce eczema flare-ups. 

Dr Chantel Ng explains that many parents try to minimise steroid use, stopping application as soon as the baby's eczema improves. However, it is recommended to continue applying the prescribed cream until the affected skin fully recovers. Otherwise, the eczema may recur quickly, requiring repeated treatments. Improper use of steroid creams may prolong the condition, leading to the need for stronger steroid treatment in the long run.

8. When Should You Take Your Baby to the Doctor for Eczema?

Parents should seek medical attention if they notice: 

• Signs of infection: Presence of pus, yellow crusts, or abnormal redness/swelling 

• Severe impact on sleep or daily activities: The baby is constantly scratching or crying excessively 

• Home care is ineffective: Moisturisers or over-the-counter creams do not improve the condition 

• Eczema spreads or frequently recurs 

Although baby eczema can frustrate parents, proper understanding and treatment can effectively relieve discomfort. Dr Chantel Ng, our paediatrician with a special interest in paediatric dermatology, suggests that parents should monitor eczema symptoms and seek medical advice when necessary to ensure their baby receives the best care. If you have further questions about baby eczema, feel free to book an appointment with your pediatricians for personalised treatment recommendations. 

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