Key Takeaways

• Barrier-first problem: Eczema is like a house with hairline cracks – both in the skin and the gut.
• Skin: Water (skin moisture) escapes; allergens and irritants get in. Result: dry, itchy, inflamed skin. 
• Gut: Leaky gut allows allergens and irritants into blood stream.  Result: higher levels of systemic inflammation with an immune system primed to overreact.
• Genetics set the stage; Deficiencies in a mortar-like skin barrier protein called filaggrin and low levels of lipids, ceramides and Natural Moisturization Factor (NMF) raise risk of leaky skin barrier; 
• Environment cues the drama: Pollution, pets, soaps, fragrances, fabrics, overheating, and microbes (yeast, molds, staph, bacteria) can fan the flames.
• Gut imbalance and leakiness: lack of keystone species like Bifidobacteria weaken gut wall and increase permeability leading to higher food allergies with age
• Core plan: Hydrate and seal (emollients for skin; pre and probiotics for gut), smart bathing, gentle cleansers, cool cotton layers, trigger-spotting, ensuring food allergens are eliminated, plus medications only as needed under pediatric guidance.
• Do babies grow out of eczema? Many improve with age, but not all. Early barrier care for skin and gut may help reduce flares and protect quality of life.
• Nutrition & the skin wall: Research has found that L-histidine may help the skin’s “mortar mix” via the filaggrin/NMF pathway; early pilot studies (including in young children) showed reduced eczema severity with supplementation so discuss with your child’s pediatrician. 
• Nutrition & the gut wall: Research found that pre- and pro-biotiocs may help restore the gut barrier by producing butyrate, a key energy source for gut cells; early pilot studies are showing the supplementation during pregnancy or at 3 months may reduce eczema severity so discuss with your child’s pediatrician.

 

Introduction [1]

Infant eczema (a.k.a., atopic dermatitis) is a skin barrier and immune condition with roots in genetics (ex. filaggrin protein deficiency), environment (pollution, dry air, irritants, microbes), gut barrier and microbiome dysbiosis (food allergies and missing keystone species) and the way a baby’s immune system learns to “tolerate” the world. Think of the skin as a brick wall: the “bricks” are skin or gut cells and the “mortar” is proteins and lipids.

In some babies, the skin mortar is crumbly, so moisture leaks out and irritants sneak in leading to dry skin patches, redness, and a lot of scratching. Daily skin barrier care, trigger-management, smart bathing, and pediatrics-guided therapy represent the current benchmark of child eczema treatment. Emerging research is beginning to focus on “nutrition” that supports barrier biology, such as L-histidine (an amino acid) to “feed” the filaggrin pathway, but one should always consult their pediatrician first. 

 

 

What Exactly Is Infant Eczema?

 

Atopic dermatitis (AD), often referred to as eczema, is a chronic, itchy, inflammatory skin condition. In babies, it tends to appear as baby dry skin patches that are red, rough, and sometimes weepy. The hallmark is itchiness, followed by scratching, followed by more inflammation, i.e., a vicious loop that can disrupt sleep, feeding, and family rhythms.

-          How it differs from other rashes: Unlike transient heat rash or contact irritation that’s isolated to one area, infant eczema is recurrent, intensely itchy, and typically shows up on the cheeks, scalp, trunk, and extensor limbs in babies (then flexural creases in toddlers like the insides of knees, elbows and wrists). It reflects barrier fragility and immune reactivity, not just “dryness.”

-          Who’s most affected: Eczema typically peaks in early childhood for approximately 13–20% of kids, contributing to sleep loss and stress for the whole household.  Eczema affects African American and Hispanic populations most.

 

Why Do Babies Get Eczema? (The “Brick-and-Mortar” Story) [2]

 

Imagine your baby’s skin as a brick wall. When the mortar (proteins like filaggrin, plus lipids, ceramides, and NMF) is thin or crumbly:

• Moisture leaks out triggering skin dryness and micro-cracking
• Irritants/allergens sneak in through the cracks causing the immune system’s alarm bells to ring
• pH shift making the skin more prone to bacterial infections (like Staphyloccocus)
• Microbial balance then shifts leading to more inflammation

 

1) Genetics & the Filaggrin Pathway

Filaggrin starts as a “histidine-rich” precursor protein in the skin’s upper layers. When processed, it helps corneocytes (bricks) “stack” tightly to form a strong wall and later breaks down into natural moisturizing factor (NMF), i.e., small molecules that hold water and support healthy skin acidity. Differences in filaggrin production (often genetically inherited) are major risk factors for eczema susceptibility. 

 

2) Environmental Triggers

 

• Dry indoor air, winter weather (pulls water out of the wall)
• Fragrances, harsh detergents/soaps, and too much washing/bathing
• Wool/scratchy fabrics, overheating, sweat
• Allergens (dust mites, pet dander, pollution like car exhaust)
• Microbial shifts (e.g., more S. aureus on skin) resulting in skin microbiome dysbiosis

 

3) Immune Maturation

 

Infant immunity is developing based on interactions with the environment. If the skin barrier is leaky, external triggers get amplified, nudging skin toward chronic itch/inflammation. This is why “baby scratching a lot” can be both a symptom and an exacerbating factor if the scratching further deepens the cracks in the wall.

Signs & Symptoms to Spot Early

• Dry, rough, scaly patches (on cheeks, scalp, trunk; later, on elbow/knee creases)
• Redness and intense itch (watch for night waking/crying, rubbing on bedding)
• Weeping/crusting if the barrier breaks down and becomes severely compromised
• Post-inflammatory color change (lighter or darker) as spots heal

Differentiation tips:

• Cradle cap is waxy/yellow and less itchy.
• Contact rash is typically limited to where an irritant was touched by the child.
• Food reactions often add hives, GI symptoms, or widespread flares but make sure to ask your pediatrician before eliminating any foods.

 

Core Skin Care Plan for Child Eczema Treatment

 

Hydrate + seal + calm + prevent:

 

1. Bathe smarter by quickly soaking and then sealing in moisture

• Take short, lukewarm baths/showers (5–10 minutes).
• Use fragrance-free, non-soap cleansers only on soiled spots.
• Within 3 minutes of pat-drying, apply a thick, fragrance-free emollient (ointment/cream) head-to-toe.

 

2. Moisturize like it matters (because it does)

• Twice daily as a baseline; more during flares/winter.
• Choose petrolatum-rich ointments or ceramide-rich creams for “mortar support.”

 

3. Calm inflammation under medical guidance

• Pediatricians may recommend low-potency topical steroids for limited courses (typically limit to 5 days), or non-steroidal options (like calcineurin inhibitors) when appropriate. Good technique and limiting use can minimize side effects.

 

4. Triggers: find, fix, and fence off

• Switch to free-and-clear detergents; double-rinse clothes.
• Favor soft cotton layers, keep nails short, consider scratch mitts at night.
• Keep nursery cool and humidified in dry seasons.

Wipe drool/milk gently and re-moisturize around the mouth.

5. Microbiome-friendly habits

• Avoid over-sanitizing skin; gentle cleansing (pH balanced) coupled with emollients support a healthier skin microbiome.
• Use a biome modulation gel to reset the skin microbiome if you suspect staph

 

Research Spotlight on L-Histidine [3]

 

Filaggrin, the skin barrier mortar helper, is “histidine-rich.” In lab and clinical research reviewed in a 2020 Journal of Nutrition article, L-histidine (an amino acid humans obtain from diet) was found to rapidly be incorporated into the filaggrin pathway in skin models, with supplementation being found to improve skin barrier function metrics to, in turn, significantly reduce eczema-related symptoms.

 

In a placebo-controlled pilot study in young children (mean age ~3.5 years) with mild-to-moderate eczema, 0.8 g/day of L-histidine was orally administered for 12 weeks leading to an almost 50% reduction in a clinician-scored eczema severity index, whereas the placebo group showed no significant change. Reported adverse events were minor and not clearly attributable to L-histidine.

 

Do Babies Grow Out of Eczema?

 

Most children improve with age as their skin barrier matures and families master prevention routines. Some, unfortunately, continue to have sensitive, drier skin or experience intermittent flares as they age. That said, early, consistent skin barrier care involving diligent skin moisturization, coupled with trigger control awareness, is a practical way to stack the odds in your favor.

 

How to Prevent Eczema in Newborns: Practical Steps

 

• Moisturize daily from week three (fragrance-free, microbiome-friendly formulas).
• Gentle laundry & clothing (free-and-clear detergent; cotton layers).
• Short, lukewarm bath routine coupled with immediate emollient application.
• Keep your baby cool & not too dry (consider a humidifier if indoor air is arid).
• Watch for early hotspots (cheeks, scalp) and treat dryness before it spirals.

These basic steps help to reduce the “irritant load” the skin faces, thereby helping to lower the chances of a small crack becoming a big flare.

 

Myths vs. Facts

• Myth: “Eczema is just dry skin.”
  Fact: It’s a barrier + immune condition. Dryness is the spark, not the whole fire.
• Myth: “Frequent scrubbing keeps it clean and better.”
  Fact: Over-washing strips lipids (natural oils) from the wall leading to cracked skin.
• Myth: “All natural oils are safe for babies.”
  Fact: Some oils (those high in oleic acid) can disrupt skin barrier lipids, hence, stick to evidence-based emollients for infants.
• Myth: “Supplements cure eczema.”
  Fact: There is no “cure” for eczema. Some supplements, like L-histidine, have shown promise in the clinic for supporting barrier function and relieving eczema symptoms.   Other supplements, like pre- and probiotics can also help reduce eczema symptoms, but are not a “cure”.

 

FAQ (Evidence-Informed, Parent-Friendly)

 

1) What is the number one cause of eczema in babies?

There isn’t a single cause. The most important underlying factor is a weakened skin barrier (often tied to filaggrin pathway differences from genetics), which lets moisture leak out and irritants get in. Environment and immune maturation then amplify inflammation. 

 

2) What causes a baby to be born with eczema?

Babies aren’t “born with eczema” per se, but genetic tendencies (like filaggrin pathway differences) can set the stage; early-life environment—dryness, irritants, microbes—can trigger visible disease.   A lack of gut keystone species like Bifidobacteria can also increase eczema risk.

 

3) What deficiency causes eczema in babies?

There isn’t a universally accepted “single deficiency.” That said, histidine is integral to the filaggrin → NMF pathway supporting barrier hydration. Research has explored L-histidine supplementation as a barrier-support strategy in eczema, including a pediatric pilot study; ask your pediatrician before considering supplements. 

 

4) What not to do with baby eczema?

• Don’t use fragranced products or harsh soaps.
• Don’t over-bathe or scrub.
• Don’t skip post-bath emollients.
• Don’t overdress or let baby overheat.
• Don’t start supplements or eliminate major foods without pediatric guidance.

 

5) What exacerbates baby eczema?
Dry air, pollution, pet dander, fragrances, wool/scratchy fabrics, sweat/heat, harsh cleansers, disrupted sleep (more scratching), and infections can all worsen eczema. Keep fingernails short and moisturize consistently. 

 

Final Thoughts on Infant Eczema (because it’s that important):

• Child eczema treatment: Daily emollients plus trigger management form the foundation; medications and adjuncts should only be  added with pediatric oversight.
• Baby scratching a lot: Itch is central to the condition so be sure to use mitts, keep nails short, maintain a cool sleep environment, and moisturize before bed.
• Do babies grow out of eczema: While many improve, a subset continues to have sensitive skin with early intervention being helpful.
• Baby dry skin patches: As the earliest sign it’s important to respond fast with gentle bathing and emollient “sealing.”
• How to prevent eczema in newborns: Moisturize daily, use gentle detergents plus cotton layers of clothing, manage indoor climate, and avoid fragrances from day one.

 

Call to Action

Codex Labs has recently launched its clinically tested BIA INFANT AND TODDLER SKIN BARRIER SUPPLEMENT to help bring much needed relief to both kiddos and their families suffering from this devilish condition.  This daily dietary supplement meant for children ages 3 months to 3 years fortifies the skin barrier to reduce water loss, smooth dry patch roughness, and strengthen the barrier (wall) to stop allergens and pollution from penetrating. This unflavored powder contains the amino acid L-Histidine that has been clinically shown to help build the skin barrier protein filaggrin and natural moisturization factor (NMF). 

For those with older kiddos (4-12 years), we have the BIA KIDS SKIN BARRIER SUPPORT L-HISTIDINE SUPPLEMENT which contains the same clinically proven L-histidine amino acid, but is intended to be taken daily at a slightly higher concentration. Available in gummy form, these gummies are as tasty as they are effective.

To fully optimize the benefits of these gummies, we highly recommend using them in combination with two of our other eczema treatment hero products, both of which have been approved by the National Eczema Association. The first is our BIA UNSCENTED SOAP, a fragrance-free, pH balanced, microbiome-friendly handmade soap that gently cleanses, protects, and softens your little one’s precious skin without irritation. The eczema relief process is then completed with application of our BIA ECZEMA RELIEF LOTION hero product which has been purposefully developed to bring soothing, calming relief to dry, itchy, sensitive skin suffering from the symptoms of eczema. We call this symptom-calming bundle our SKIN BARRIER ECZEMA RELIEF SYSTEM for KIDS, that tackles eczema symptoms from both inside and outside our kiddos bodies. This one-two punch has been proven to bring much needed relief to both children suffering with the symptoms and their parents who want nothing more than to see their little ones happy and healthy.

Eczema is no laughing matter, especially when it’s a parent’s precious little one doing the suffering. But fear not, because Codex Labs has just what the doctor ordered. How can we be so sure? Because we have the clinical results to prove it!

 

References:

1.      https://nationaleczema.org/children/

2.      https://my.clevelandclinic.org/health/diseases/23408-baby-eczema

3.      https://pubmed.ncbi.nlm.nih.gov/33000160/