Allergy is a chronic condition where the body’s immune system displays an abnormal response to an allergen, which is otherwise a harmless substance (1). Allergies can happen in any part of the body, including the skin, nose, lower airways, eyes and the digestive tract.
Skin allergies manifest as swelling, rashes, or itching of the skin (2). But there can be different types of skin allergies in babies. In this MomJunction post, we tell you about the common skin allergies in babies, symptoms, causes, and ways to manage the condition.
Common Skin Allergies In Babies
Here we have listed some of the common types of skin allergies seen in babies.
- Eczema or atopic dermatitis
- Hives or urticaria
- Papular urticaria
- Contact dermatitis
Each type of skin allergy has its own causes, medical management, and home remedies. Allergies may not always have a treatment but only a way to reduce the symptoms.
1. Atopic dermatitis or eczema
This chronic and relapsing inflammatory condition leads to itching and risks of skin infections. The most common parts of the skin to display the condition are the face and skin folds. Eczema affects about 10-20% of children in the US and Western Europe (3).
- Tiny red bumps on face, forehead, scalp, and later on the torso (4)
- Dry skin
- Red bumps on the forearm, knees, and ankles in infants who crawl (5)
- Inhalant allergens: Some allergens are house dust (the most common allergen), grass pollen, and animal dander from pets.
- Skin irritants: A few common skin irritants that trigger allergies are woolens, nylon, acrylic material, excess soap in bubble baths, and heavily perfumed soaps, lotions, etc. (5)
- Food allergens: Less than 10% of babies exhibit a food item as a cause for eczema.
The treatment of eczema focuses on the effective management of the condition and avoiding potential triggers. Do not provide any medicine to the baby without consulting the pediatrician.
- Topical corticosteroids of different types could be used for the management of eczema.
- Topical immunosuppressants could help address the symptoms of eczema, although more research is needed to prove efficacy (6).
- Antihistamines at bedtime are commonly prescribed for their sedative action to help relieve itching. More studies are needed to establish the safety and efficacy of antihistamines in babies (5).
However, the use of thick lubricant skin creams (non-medicated) may be useful. Also, avoiding rubbing the skin with a towel to dry it, touching it instead to absorb the water is quite useful.
Hives are also known as urticaria (7). It is a superficial swelling, which can appear on any part of the body.
- Development of lesions, which are bumpy, red, warm, and swollen. These lesions are also called wheals (7).
- Lesions might have a pink or red outline with a pale center (8).
- They might range in size from the diameter of half an inch to several inches.
- They are generally very itchy (9).
Allergy to one or more of the following items could lead to hives (8).
- Shellfish Dust
- Pets (pet dander and droppings)
- Medicines such as penicillin, sulfa drugs, ibuprofen, aspirin, antacids, eye and ear drops, laxatives, etc. (10)
- Certain viruses might causes hives as well
- Extreme temperatures
- In some cases there is no clear cause of hives
Hives are usually self-limiting and do not need extensive medical intervention. The symptoms usually heal by themselves. but the itch may diminish exposing the skin to lukewarm water through a bath. Your pediatrician might prescribe topical calamine lotion or oral antihistamines, if necessary.
3. Papular Urticaria
- Itchy and wheal-like papules on the skin.
- The bumps might usually appear in clusters in a specific area.
- They might be filled with fluid (13).
- Lesions usually disappear in a few minutes or a few hours but, in some cases, may be chronic and recurrent.
The main cause for the papular urticaria is the body’s hypersensitive reaction to insect bites (13). Checking the baby’s room and crib for potential pests like bedbugs and mites could help identify the insect. In some instances the use of an appropiate insect repellent (safe for babies) may be useful.
Papular urticaria is generally a self-limiting disease, and the symptoms subside eventually. Babies outgrow the disease. For severe itchiness, the doctor might prescribe topical corticosteroids or antihistamines.
4. Allergic contact dermatitis
It is a type of eczema that is triggered by skin contact with an allergen. Its prevalence is highest among babies up to the age of three years (14). Allergic contact dermatitis was earlier uncommon in babies, but there has been an increase in cases due to increased exposure to allergens at a young age (15).
- Mild to severe itchiness at the affected site.
- Red, dry, and scaly skin with visible borders.
- Fluid-filled sacs could also appear (16).
- Contact with metals like nickel, aluminum, cobalt, mercury, etc. Nickel is the most commonly identified metallic allergen.
- Rubber gloves used by the baby’s doctor or caretaker, while cleaning or examining the baby might also elicit an allergic response (17).
- Fragrances and dyes used in baby products might also be potential allergens.
- Identification and removal of the allergen.
- Use of a moisturizer.
- Cool water soaks.
- Topical corticosteroids and antihistamines prescribed by a doctor for acute cases with intense irritation (18).
It is an allergic reaction that causes swelling of deeper layers of the skin. It might occur along with hives or might manifest by itself (19).
- Swelling can happen anywhere but is most prevalent around eyes, hands, feet, and mouth.
- Stomach cramps might occur.
- Severe cases might cause difficulty in breathing and swallowing due to the swelling of tissues.
Allergic reaction to one or more of the following might cause angioedema.
- Insect bites
Very rarely, hereditary angioedema (HAE) is also seen. It might cause recurrent and severe allergic reactions, requiring immediate medical intervention. (20)
- Identification and removal of the allergen.
- Regularly changing and washing the baby’s bed sheets, pillow covers, and blankets to get rid of dust.
- Severe cases might require medicines like antihistamines and corticosteroids prescribed by the doctor.
- Home remedies like oatmeal bath and creams containing lanolin or cetomacrogol might help. Consult a doctor before trying any home remedies.
Tips To Prevent Skin Allergies
The following are some ways to avoid skin allergies in babies (21).
- Identify and avoid the allergen to prevent recurrent infections.
- It is also recommended to avoid exposure to foods that have a high potential for allergy babies. It is good to consult a doctor before introducing foods such as eggs, fish, soy, etc.
- If the baby is confirmed to be allergic to a particular food, then a breastfeeding mother may consider avoiding the food.
- Keep pets and carpets clean to avoid allergies due to fleas and bed bugs.
- Avoid the baby’s exposure to metals like nickel, to avoid allergic contact dermatitis.
- Discuss with the pediatrician if you can keep any emergency medicines at home as a response to allergic reactions.
When To See A Doctor?
It is good to see a doctor when you notice symptoms, and you suspect the baby has a skin allergy. The doctor may recommend an epinephrine auto-injector to keep handy for anaphylactic shock, a condition where the baby has a severe allergic reaction.
Certain allergies, like hives, might be mild and occasional, seldom requiring prompt medical attention. However, if the condition occurs repeatedly or sustains for more than six weeks, then you must take the baby to a doctor (9).
Skin allergies in babies may come and go, and you need to keep a watch for any recurring symptoms. If diagnosed early, skin allergies can be managed better and avoided too. Your baby may eventually grow out of the allergy, but until then, it is essential to identify the allergen and keep the baby away from it.
Have something to share about skin allergies in babies? Let us know in the comment section below.
2. Skin Allergies Definition; American Academy of Allergy, Asthma and Allergy
3. Megan A. Moreno,Atopic Diseases in Children; Journal of JAMA Pediatrics
4. Jocelyn M. Biagini and Gurjit K. Khurana Hershey,Eczema in early life: Genetics, the skin barrier, and lessons learned from birth cohort studies; The Journal of Pediatrics.
5. Ross St C Barnetson and Maureen Rogers; Childhood atopic eczema; The BMJ.
6. Alan B. Fleischer Jr.,Treatment of atopic dermatitis: Role of tacrolimus ointment as a topical noncorticosteroidal therapy; The Journal Of Allergy and Clinical Immunology.
7. Meeyong Shin and Sooyoung Lee,Prevalence and Causes of Childhood Urticaria; Allergy, Asthma and Immunology Research.
8. Hives; American Academy of Pediatrics
9. S J Deacock,An approach to the patient with urticaria; Clinical and experimental Immunology.
10Hives, Children’s Hospital of Philadelphia
11. Evelyne Halpertet al.,Prevalence of papularurticaria caused by flea bites and associated factors in children 1–6 years of age in Bogotá, D.C.;The World Allergy Organization Journal
12. Sanjay Singh and Baldeep Kaur Mann; Insect bite reactions; Indian Journal of Dermatology, Venereology and Leprology
13. Papular Urticaria; Primary Care Dermatology Society
14. Paolo Pigattoet al.; Contact dermatitis in children; Italian Journal of Pediatrics
15. Yasmeen JabeenBhat, Saniya Akhtar, and Iffat Hassan,Contact dermatitis in pediatric age group: Indian scenario; Indian Journal of Pediatric Dermatology
16. Richard P. Usatineand Marcela Riojas; Diagnosis and Management of Contact Dermatitis; American Family Physician
17. Taru Garget al.,Allergic contact dermatitis in children: Culpable factors, diagnosis and management; Astrocyte Medical Journal
18. Patrick B. Murphy et al.,Allergic Contact Dermatitis; National Center for Biotechnology Information
19. Hives and Swelling; Riley Children’s Health
20. Giuliana Ferranteet al.,The care pathway for children with urticaria, angioedema, mastocytosis; The World Allergy Organization Journal
21. Zave Chad,Allergies in children; Journal of Pediatrics Child Health
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