Eczema & Skin Conditions - Questions & Answers With An Expert

Hear advice from a children's skin expert

Watch the video live chat recording to hear Diana, a children's skin doctor, give answers to some common eczema and skin care questions from parents.

Below are the topics Diana covers, and some of her key messages (with edits).

General skin care and bathing babies (0:56 - 3:15 on the video)

Caring for your child's skin is quite simple

People tend to think skin care is quite complicated. Actually it is very simple and doesn't have to be a big burden for busy families. You don't need a lot of expensive fancy products to look after your child's skin well.

Babies are born with a natural skin barrier

• newborn babies are born with a lovely cheesy stuff on their skin - it's called vernix
• vernix is like nature's moisturiser - a natural skin barrier, a kind of waterproofing layer which is really helpful
• the layer stays on them for the first week

Keep it very simple when bathing young babies

The most important thing with bathing a baby is don't let their head go under the water.

• it's best not to bath babies too much - don't use soaps and detergents when babies are very young
• you just need a little bit of water to wash off any poos and wees and milk and all that sort of stuff
• babies just need very gentle care - a gentle wash - you don't need to use flannels or harsh things, just your hand
• keep it very simple - not too long, just a few minutes
• babies love going in the bath - it's a really important part of a baby's routine
• bathing once a day does seem to be very helpful at keeping the skin healthy and reducing the risk of getting infections
• remember, no soap - soap is drying and often can be a bit irritating
• bathing once a day with simple water is enough for most babies

How long would you wait after birth to start daily bathing? (3:15 - 4:28 on the video)

There are no fixed rules on this and there's not a lot of research.

But when babies are first born, in their first day, they do need wiping down, at least with a towel.

After that, you don't need to bath them every day in the first week. They still have quite a lot of trouble with their temperature regulation. But once they get to 2 or 3 weeks, most people will be bathing every couple of days. When you get to more like 2 or 3 months, every day is fine. Another person in the family can do this - it doesn't have to be the mum. The mum's doing everything else! It can be the dad or granny who does the bath. It can be a really special time for them to do that. 

Is there an age to start using soap? (4:45 - 6:02 on the video)

Dermatologists don't recommend soap for anyone!

Anything that foams and bubbles works by lifting the layers of oils off your skin. If you're dirty, like if you've got mud or grass or oil stains, yes you might need some soap to wash that off. But if you've just been doing normal daily things, a rinse off is often enough. If you are going to use a cleanser, there are a lot of soap-free washes which you can use now. You can get these at the supermarket. Some people even use a moisturiser instead of a soap.

So people use prescription moisturisers like Sorbolene or Non-Ionic Cream or Cetomacrogol with Glycerol - the ones in the pumps. They often use those instead of a soap for washing because it doesn't strip the oil so much from the skin.

Can I use Sorbolene on my child's red, dry and flaky face (6:10 - 7:20 on the video)

Dry, red and flaky skin usually means that the skin is a bit irritated. There are a whole lot of reasons why that can happen. Sorbolene or any of the other prescription moisturisers are generally quite low in perfumes and fragrances. (Perfumes and fragrances can often irritate babies). You can usually use these prescription moisturisers without any problems.

There is no guarantee any particular moisturiser will work for everyone. But Sorbolene is very popular and most people have no problems with it. It's one that's easily available for families. You can get a prescription through your GP or a prescribing nurse. It's really easy to get hold of. You can buy it over the counter as well if you want to.

Should we use shampoo for newborns to 2 months old? (7:26 - 9:30 on the video)

Diana: " I don't recommend it usually ... I certainly didn't use shampoo on my kids until they were about 3 or 4 years old. It depends what they get in their hair of course. I mean there are times when you need it if they've got food in there".

A lot of shampoo is detergent - it's foaming and it often can be quite irritating.

Sometimes you can use shampoo for young babies who have quite a bit of cradle cap. Cradle cap is where you get thick greasy scales forming on the scalp. That's quite common, quite a normal thing for babies to have. It can sometimes be a bit irritating for babies but often it doesn't bother them at all. But a little bit of a massage with shampoo can be quite helpful but if you get the shampoo over the rest of the baby, it can be a bit drying.

Diana: "I see a lot of babies with quite sensitive skin and they don't tolerate shampoo very well ... so often if you're going to shampoo, I would say once once a week maybe twice a week maximum. And I would suggest wrapping the baby in a towel and holding them, just holding their head over the basin or the tub so that when you're rinsing off the shampoo, it's not going over the body of the baby. And that way you've also got good control of their head ... so that you're not getting lots of shampoo in the eyes". 

The longer you can avoid using a lot of products, the better.

Other questions, topics and timings on the video

Would you advise not to use aqueous cream as a soap substitute for babies with eczema?  (9:37 - 10:50)

How can you tell the difference between dry skin and eczema in babies? (10:51 - 12:26)

Managing eczema when it's very itchy in a baby (12:30 - 15:36)

Daily baths and eczema (15:49 - 16:43)

Eczema on the scalp (16:47 - 17:26)

Oils in the bath and for cradle cap (18:26 - 21:00)

Do children grow out of eczema? (21:03 - 24:56)

Can you do anything when pregnant to prevent eczema? (24:58 - 26:25)

Are there any links between eczema and what foods children eat? (26:27 - 31:50)

Ichthyosis (31:54 - 32:58)

Washing powder (33:08 - 34:20)

Molluscum (34:27 - 36:06)

Bleach baths (36:07 - 37:53)