Eczema is a skin condition marked by dry, itchy, and inflamed skin. After childbirth, eczema may flare up due to the demands of child care and hormonal changes in the body.
During pregnancy and after giving birth, many people experience skin changes, including eczema. This may be due to hormonal changes, frequent handwashing, or other triggers.
Adults usually experience eczema outbreaks in areas of the body different from children. Eczema may appear:
- around the eyes
- on the face
- on the back of the neck
- in areas that flex, such as the inside of the elbows or the back of the knees
Individuals who have given birth may also develop it in the genital area.
Symptoms of eczema may include extremely dry skin or skin that is prone to irritation. Scratching can lead to open sores that ooze clear fluid or bleed.
This article describes the causes and triggers of postpartum eczema, treatments, and tips for breastfeeding with eczema on the nipples.
Changes to the body’s hormone levels and immune system function can cause eczema to develop or flare up during or after pregnancy.
Before pregnancy, the body is Th1 dominant in terms of immunity. Th1 cells fight off foreign bodies such as bacteria and viruses. Since half of a baby’s genetic code comes from a male, Th1 dominance would mean the immune system would attack that half as a foreign body inside the pregnant person.
Therefore, the body shifts to Th2 dominance for immune function during pregnancy. Th2 cells work to fight off toxins and allergens outside the cells. As a result, the pregnant individual is temporarily more sensitive to allergens and possibly more prone to eczema.
Even after the baby is born, it can take
If a person breastfeeds, additional hormone changes occur to produce milk.
A common problem for people caring for babies is developing eczema symptoms due to frequent handwashing. Routinely changing diapers, cleaning spit-up, and preparing feeds requires extra handwashing, which can impair the skin barrier.
The American Academy of Dermatology suggests caring for and preventing dry skin on the hands by:
- washing the hands with lukewarm water and soap for at least 20 seconds
- applying moisturizer immediately after washing the hands to lock in moisture
- using fragrance- and dye-free moisturizers that contain mineral oil or petrolatum
If hand eczema symptoms persist, a person can ask a doctor or dermatologist for advice. They may prescribe a topical corticosteroid to help.
While some factors are uncontrollable, such as genetic predisposition to eczema, people may be able to avoid other factors. These include environmental triggers and behaviors that may irritate the skin.
Some everyday items may irritate the skin and cause an outbreak. If people notice that particular soaps, lotions, detergents, cleansers, or fabrics cause redness, dryness, or itching, they may wish to stop using them.
Other triggers to look out for include the following:
- dry air, and extreme heat or cold
- fragrances
- metals, particularly nickel
- formaldehyde, which is an ingredient in certain cosmetics and toiletries
- isothiazolinones, which are an antibacterial ingredient in personal care products such as baby wipes
- cocamidopropyl betaine, which thickens shampoos and lotions
- paraphenylenediamine, which can be found in leather dyes and temporary tattoos
Stress is also a trigger for eczema, so people can try to minimize stress to reduce the severity of flare-ups.
If a person has eczema on the nipples while breastfeeding, they can take care of their skin using moisturizers to maintain the skin’s barrier and reduce itching and pain.
If a person has nipple eczema while breastfeeding that does not respond to other interventions, they can try topical corticosteroids. It is best to apply the medication immediately after breastfeeding, allowing at least an hour for the medication to absorb. They should wipe the breast completely before breastfeeding again.
A person can express a little breast milk to wipe over the nipple. The fat in the milk may help retain moisture in the nipple and reduce dryness.
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Learn more about the benefits of breast milk for eczema here.
Avoiding triggers is the
Treatment may include:
- avoiding scratching irritated skin
- using moisturizers alongside topical steroid creams or ointments
- keeping fingernails short to prevent damaging the skin
- wearing gloves or socks over the hands if scratching is a problem at night
- using a humidifier
- avoiding irritants such as fragrances, detergents, soaps, and certain fabrics
- avoiding excessive heat or changes in temperature
- not scrubbing the skin too hard or for too long
- applying lubricating creams or ointments to damp skin to trap moisture
Can I pass eczema on to my baby?
There is no way to know whether a baby will develop eczema, even if one or both parents have it. According to the National Eczema Society, no clear evidence suggests that lifestyle changes before conception or during pregnancy prevent eczema in children.
The chance of a baby developing eczema if neither the parents nor any other children have eczema, asthma, or hay fever is 1 in 10.
The chance of a baby developing eczema if only one parent has eczema, asthma, or hay fever is 1 in 4. The chance of a baby developing eczema if other children in the immediate family or both parents have eczema, asthma, or hay fever is 1 in 2.
Eczema is noncommunicable, so a baby cannot contract it through touch after birth.
How can I treat eczema on my face?
Treatments for facial eczema reduce the irritation from cosmetics, lotions, or soaps. A person should try using a gentle skin care routine and treating eczema with topical steroids and emollients.
Other steps to take include:
- patting the skin dry rather than rubbing
- avoiding soap, detergents, exfoliants, and toners
- applying bland emollient twice daily to dry or sore areas
- avoiding cosmetic moisturizers
- avoiding products labeled “natural,” “dermatologically tested,” or “hypoallergenic,” as they can be irritating and cause allergic reactions
- looking for mineral makeup, which is usually less irritating for eczema
- using an emollient to remove makeup
- using a mild-potency steroid cream once daily or as a doctor prescribes, which is typically at night before bed
- using stronger-potency steroids only under the guidance of a doctor, as they can cause skin thinning if used incorrectly
Topical calcineurin inhibitors may be good options for long-term facial eczema treatment, as they do not promote skin thinning. However, they make skin light-sensitive, so people may wish to use them at night. People using these medications should always use sun protection.
With the right treatment, people can manage their postpartum eczema, but finding what works may take trial and error.
For some people, eczema will calm in the postpartum period as hormone levels begin to normalize, but for others, eczema may linger.
Changes to the body’s hormone levels and immune system during pregnancy can cause postpartum eczema.
Eczema in adults generally occurs on the:
- face
- neck
- bend of the arms or legs
- skin around the eyes
In individuals who have given birth, it can also occur on the genitals. Caregivers who frequently wash their hands may also develop it on the hands.
Emollients and lifestyle modifications can treat eczema. There is currently no cure, and relapses often occur.
For people who have nipple eczema and are breastfeeding, topical steroids are an option, as long as there is one hour between application and the next feed, and they wipe the nipple before nursing. Wiping breast milk on the nipple may reduce dryness.