Baby eczema in Australia: a practical guide

Eczema is one of the most common reasons parents end up at the GP in the first year. It is itchy, persistent and exhausting — for the child and the whole household.

It is also manageable. Most children improve with a simple, consistent skin routine and prompt treatment of flares. This guide explains what to do, what to avoid and when to get help. It is general information, not a prescription.

What eczema is#

Eczema, also called atopic dermatitis, is a chronic inflammatory condition that makes the skin dry, itchy and inflamed. It is not contagious. It is not caused by dirty skin, bad parenting or a food your child ate.

Eczema often runs in families with eczema, asthma or hay fever. The skin barrier is less effective at holding in moisture and keeping irritants out, so the skin becomes dry and inflamed.

In babies, eczema commonly appears on the cheeks, scalp, chest and outer limbs. In older children, it often settles into the skin creases — inside the elbows, behind the knees, around the wrists and ankles.

What a flare looks like#

Eczema can look different from child to child. Common signs include:

• dry, rough or scaly patches
• red, inflamed skin
• intense itching, especially at night
• small bumps or blisters
• oozing or crusting
• thickened, leathery skin from repeated scratching
• broken skin from scratching

If you are unsure whether a rash is eczema, see your GP. Other conditions can look similar, and the treatment may be different.

The daily routine that does the heavy lifting#

Consistency matters more than expensive products. The basics:

Moisturise, a lot#

Emollients are the foundation of eczema care. Apply a generous layer at least twice a day, and after every bath or shower. Ointments are often better for very dry skin; creams are lighter and easier for daytime. Ask your pharmacist for help choosing.

Apply within three minutes of getting out of the bath, while the skin is still damp. Smooth it on in the direction of hair growth rather than rubbing vigorously.

Bathe gently#

• Use lukewarm water, not hot.
• Keep baths short — around five to ten minutes.
• Use a soap-free wash or plain water. Avoid bubble baths, fragranced products and harsh soaps.
• Pat dry gently with a soft towel. Do not scrub.
• Apply emollient immediately afterwards.

Dress for comfort#

• Choose soft cotton clothing and bedding.
• Avoid wool, scratchy tags and tight elastic.
• Dress in layers so you can adjust for temperature.
• Use gentle, fragrance-free laundry detergent and skip fabric softener.
• Keep nails short and smooth to reduce scratching damage.

Avoid known irritants#

Common irritants include fragranced lotions, wet wipes with alcohol or fragrance, pet dander, dust mites, overheating and rough fabrics. Everyone's triggers are different. Keep a simple diary if you are trying to work out a pattern.

Sun and heat#

Eczema skin burns easily and can sting under some sunscreens. Keep your child in the shade and cover them with loose cotton clothing and a hat, then patch-test a fragrance-free SPF50+ sunscreen on a small area before using it widely. Our sun safety guide explains UV, sunscreen amounts and why a pram should never be covered with a cloth.

Treating a flare#

A flare needs more than moisturiser. See your GP or pharmacist for a plan. Treatment usually includes:

• Topical corticosteroids to reduce inflammation. Use the prescribed strength and amount, and follow the step-down plan.
• More frequent emollient during and after the flare.
• Antibiotics if the skin is infected.
• Antihistamines only if your doctor recommends them for sleep or severe itch. They are not a routine eczema treatment.

Do not use a steroid cream from a friend or an old prescription. The strength and duration depend on the body part, the age of the child and the severity of the flare.

Signs of infection#

Eczema skin is more vulnerable to infection. Seek medical advice promptly if you see:

• oozing, weeping or yellow crusting
• increased redness, swelling or warmth
• pain that is getting worse
• a fever
• a rapidly worsening rash, especially with blisters
• your child is unusually sleepy, unwell or not feeding

If your child has a fever and is under three months old, go to the nearest emergency department. For urgent advice, call healthdirect on 1800 022 222.

Food, allergies and eczema#

Some children with eczema also have food allergies. Food can trigger flares in a small group, especially babies with moderate to severe eczema. But food is not the cause for most children, and removing foods without advice can cause nutritional problems.

See your GP or an allergist if:

• your baby has severe eczema, especially in the first few months
• there is a clear reaction after a specific food
• your child has known food allergies
• you are considering eliminating foods

Do not delay introducing common allergens because of eczema unless your doctor advises it. In fact, early introduction is often recommended for babies with eczema, but it should be planned with your care team.

Sleep and itch#

Eczema itch is often worse at night. That can wreck sleep for everyone. Practical steps:

• Moisturise before bed and keep the bedroom cool.
• Use cotton bedding and avoid overheating.
• Keep nails short; cotton mittens can help a baby who scratches.
• Follow the flare plan early rather than waiting until bedtime.
• Ask your GP about sleep and itch if it is affecting the whole family.

Child care, preschool and school#

Give educators a simple written plan:

• what moisturiser to use and when
• what to do if the skin flares
• signs of infection
• any food or environmental triggers
• emergency contact details and any allergy action plan

Ask them to help with handwashing and to avoid fragranced products. Most services are experienced with eczema and will work with you.

When to get help#

See your GP if:

• the rash is not improving with emollient
• your child is scratching until they bleed or cannot sleep
• you need a flare plan
• you suspect a food trigger
• the skin is infected
• eczema is affecting your child's mood, sleep, feeding or daily life

Call 000 or go to the emergency department if your child has a rapidly worsening rash with blisters, a fever and is very unwell, or has trouble breathing. These can be signs of a serious infection or a severe allergic reaction.

If you are about to introduce solids, our baby food allergy guide explains how eczema changes the advice and when to see a specialist.

The bottom line#

Eczema is common, chronic and manageable. Moisturise generously, bathe gently, treat flares early with the plan your doctor gives you, and watch for infection. Do not eliminate foods or try intense home remedies without advice. If sleep is falling apart, ask for help — that is a medical issue, not a parenting failure.