Steroid creams and ointments commonly prescribed for eczema can cause adrenal damage in infants and children
Steroid creams and ointments are the most commonly prescribed treatment for eczema, but can have dangerous side effects, especially for infants. Steroids are easily absorbed through the skin, and children can absorb a high percentage of the drugs because their skin is thin and they have more skin in relation to their body size. Even short courses of treatment with steroids can cause damage to the adrenal glands, which regulate the body’s hormones.
Steroids work by interfering with the chemicals the body uses to signal inflammation. They turn off the inflammation response and cause tiny blood vessels called capillaries to constrict, reducing redness and swelling. Topical steroids also suppress the body’s immune system and can lead to an increased susceptibility to fungal or bacterial infections of the skin.
Before using a steroid medicine, caregivers should work with a pediatrician to see if the baby’s skin condition is caused by a nutritional deficiency, a food allergy, or irritation from soaps or moisturizers.
What causes baby eczema?
According to the National Institutes of Health, eczema affects up to 20% of infants and children in the United States. The rate of eczema has been rising for years, and is highest in industrialized countries. Hundreds of studies have been undertaken, linking eczema to food allergies, atopy (a triad of conditions including allergy, asthma and eczema), heredity (a child is more likely to get eczema if a parent has an atopic condition), household income (the rate of eczema seems to increase with higher income), houses that are too clean (the “hygiene hypothesis”), houses that are too dirty (dust mite allergy), urban upbringing vs. rural upbringing (kids who grow up on farms have the lowest rates of all atopic conditions)… the list goes on and on.
As eczema is a sign of an underlying condition and not an illness, the answer is probably “all of the above.” Eczema can be triggered by food allergies, by contact allergies (contact with irritating substances), by nutritional deficiencies, and as a side effect of other diseases like insulin resistance and diabetes. The eczema trigger is different for each person–and may depend a lot on genetics.
Early bathing may irritate newborn skin
Bathing routines and products we take for granted may interfere with the development of healthy infant skin. Babies are born with sterile skin, which is covered by a thick, creamy substance called vernix caseosa. Vernix has antimicrobial and antifungal properties that protect the baby’s skin in the womb and after birth, when the baby first comes into contact with bacteria in the outside world. World Health Organization (WHO) guidelines for newborn care specify that, to protect the baby, vernix should not be removed for at least six hours. Unfortunately, in modern societies this protective substance is immediately washed off in the hospital, leaving the baby’s skin vulnerable to colonization by bacteria and fungi.
Newborn skin is very thin and loses moisture rapidly. It takes a few weeks for infant skin to develop the “acid mantle,” a slightly acidic (pH about 5.5) mixture of sebum, sweat and “friendly” bacteria. (By adulthood, skin may be colonized by nearly two hundred different species of bacteria.) Ideally, over the first few weeks of life, a baby’s skin is colonized by beneficial bacteria picked up from close contact with the mother and family. These bacteria perform an important function: they keep skin healthy by preventing colonization by disease-causing microorganisms. If this important step is compromised, skin can be colonized by harmful bacteria. The skin of people with eczema tends to carry a high concentration of Staphylococcus aureus, bacteria which cause skin infections, pneumonia, and even Methicillin-resistant Staphylococcus aureus (MRSA).
Excessive bathing, soap, and moisturizer use can interfere with development of healthy skin
Infant skin will naturally develop a healthy acid mantle and strong immune defenses if it’s allowed to. But again, bathing routines and products we take for granted, including soaps and moisturizing lotions, can interfere with this process.
Infant skin is so delicate that even exposure to plain water disturbs it enough to dry it out. Soap accelerates this process by raising the skin’s pH and removing beneficial oils, resulting in impaired skin protection for hours after bathing.
Fragrance and preservative chemicals in soaps and moisturizers irritate skin further, and can actually affect the way skin develops. What’s worse, these chemicals can be absorbed through an infant’s skin into the bloodstream, potentially affecting the baby’s developing hormonal system.
A healthier way to care for infant skin
Babies’ skin doesn’t get very dirty for the first few weeks of life, so generally the less it’s interfered with, the healthier it will be. Adding a half-teaspoon of lemon juice–to reduce the water’s pH and add skin-friendly ascorbic acid–and a teaspoon of sunflower or safflower oil to the bathwater will keep baby clean without harming skin. If a moisturizer is needed, use a fragrance free baby oil containing sunflower or safflower oil, which are excellent moisturizers and have the added benefit of helping to prevent bacterial skin infections.
If your baby’s skin does become irritated, bathing with Epsom salts or Dead Sea salts is a safe and clinically proven way to soothe irritated skin. (Epsom salts are not salt at all, but magnesium sulfate, a natural mineral effective for soothing inflamed skin. Dead Sea salts are evaporated mineral salts from the Dead Sea in Israel.)
Some magnesium in an Epsom salts bath is absorbed through the skin and is a safe way to supplement this important mineral, while Dead Sea salts provide a whole range of vitamins and minerals essential for healthy skin, including magnesium, zinc, potassium, copper, and B vitamins. A teaspoon of bath salts is plenty for an infant bath.
For older kids and for gentle cleansing when soap is required, try a natural bar soap or highly diluted castile soap, like Dr. Bronner’s.
Nutrition affects infant skin
The nutritional value of the food we eat has changed dramatically over the past several decades. “Factory farming,” where fields are sown with the same vegetables year after year, fertilized with petroleum by-products and sprayed heavily with herbicides and insecticides, has reduced levels of key vitamins and minerals in vegetables. Meat and dairy animals are raised on huge feedlots, fed an unnatural diet of grain and animal by-products, and heavily dosed with antibiotics to keep them alive long