If eczema itchiness is uncomfortable for adults, it’s probably extra annoying for babies. If your little one starts developing red, itchy patches, how should you choose the best baby eczema cream for them? One pediatrician says it’s about choosing a moisturizer that’s thick and free of unnecessary ingredients that irritate the skin.

Peily Soong, M.D., pediatrician at Children’s of Alabama, tells Romper in an interview that eczema tends to pop up on babies’ elbows, behind the knees, and other places where their skin folds. Depending on how adorably chunky your baby is, that could mean other areas, too.

“Eczema is just dry skin,” Soong explains. “It could be due to weather or environmental conditions, allergies, or too-frequent bathing of children, so there’s a wide range of what can cause the dry skin. It becomes worse when kids start to scratch at it. It’s known as the itch that rashes, because if it just stays dry and they don’t scratch it, it’s just a dry patch, but when they itch, it flares up and gets red.”

Before doctors prescribe any special ointments or medications, they want parents to try moisturizing dry skin first. It’s also important to assess how often you’re laying on the lotion, and maybe add it into your routine more often.

“If you can control the dryness with moisturizers, that’s the key. The biggest issue I see with patients is a lot of times they don’t moisturize enough. Once a day will sometimes be OK, but sometimes you need to do it two, three, or four times a day. If you do have more issues where over-the-counter lotions aren’t controlling the eczema, call your doctor and they may be able to provide some sort of prescription medication,” Soong says.

When you head to the store to find a lotion, cream, or ointment for your baby’s eczema, you may find yourself staring at a shelf full of options unsure which is best. It’s important to know what to look for in a treatment so you can narrow down your choices. Soong recommends focusing on the quality.

“You want to get one that’s hypoallergenic. You want it to be really thick — not necessarily greasy, but it should feel like it stays on and feels like the skin is moisturized for a longer time. Sometimes spending a little extra on a thick moisturizer that stays on is worth it because you won’t have to apply as much,” he says.

You can search for products that are approved by the National Eczema Association (NEA), or check to see if the cream you just bought is on the list, meaning they’re free of known irritants. If you or your partner have eczema and use a cream that works well, it’s OK to use on baby, too, if you check for a few things first.

“A parent that has eczema and has a moisturizer that works for them, it’s fine to use as long as it doesn’t have any perfumes or scents, which can irritate the skin more,” Soong says. “I would avoid anything that’s got lavender or tea tree oil in it. While there’s no definitive proof, there’s some theoretical worries in the pediatric community that they can lead to early pubertal development. It’s one of those things where if you can avoid it, why not?”

Soong says if your child’s eczema is widespread, their skin feels leathery, or is not responding to OTC moisturizers, you should call your pediatrician to make an appointment. But before placing that call, try one of the moisturizers below that hits all the high notes outlined by Soong here.

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