Soothing Your Child’s Eczema
Posted on Aug 27, 2013
If you see dry, red, scaly patches on your child’s skin, he or she may have eczema, a condition caused by inflammation. Also called atopic dermatitis, eczema often runs in families and is linked to allergic conditions such as asthma and hay fever. Unfortunately, eliminating certain things from your child’s diet or environment may not necessarily improve eczema.
Although there is no cure for eczema, your child’s skin will often improve substantially by the time he or she has reached school age (usually around 4 or 5), and many children outgrow this uncomfortable condition.
Palo Alto Medical Foundation’s pediatric dermatologist Amy Gilliam, M.D., provides tips on managing your child’s eczema and offers answers to some of the most common questions she hears from patients.
How can I ease symptoms for my child?
Eczema flares up, subsides and often gets better on its own. The rough, scaly and occasionally oozing patches that signal eczema usually appear on babies’ cheeks, forehead and scalp around 3 or 4 months of age. Older children typically have the patches inside their elbow creases and wrists, at the back of the knees and on their necks.
There are several effective steps you can take to prevent and ease the uncomfortable, itchy symptoms.
- Moisturize, Moisturize, Moisturize: Apply a cream or ointment-based moisturizer twice a day if possible, even when the skin looks good. Products that contain ceramides (natural lipids) that repair the skin barrier, such as CeraVe and Cetaphil, can be particularly effective. Other options include products from Aquaphor, Aveeno, Eucerin and Vaseline.
- Calm with Steroid Creams: Use an over-the-counter hydrocortisone cream twice a day to control itchiness and reduce inflammation. Your child’s doctor can prescribe a stronger steroid cream if the itching or rash is severe.
- Ditch the Itch with Antihistamines: Calm itchiness with an over-the-counter oral antihistamine, like Benadryl, especially if the itching is disrupting your child’s sleep.
- Choose the Right Sunscreen. Avoid products with chemical blockers. Instead, pick a sunscreen that contains zinc oxide or titanium dioxide as the main active ingredient and that does not include a long list of other ingredients.
- Avoid Irritating Fabrics and Softeners. Don’t dress your child in wool or synthetic fabrics, as these can irritate the skin. Avoid fabric softener sheets such as Bounce or Snuggle.
My baby son has eczema but loves his daily bath. Will the water further dry out his skin?
Water is actually hydrating for the skin, so your son can have a bath as often as needed. Make sure the water is lukewarm rather than hot and apply moisturizer all over his face and body within minutes of getting out the bath. If you are also using a steroid cream for your son’s skin, apply this first, then the moisturizer.
For washing, use a mild soap from companies such as Aveeno, California Baby, CeraVe, Cetaphil or Dove, only on the areas where it’s needed, such as around the neck, the armpits and diaper area.
My daughter scratches her skin when she has an eczema flare-up and some patches now look infected. What’s the right treatment?
Eczema is a skin barrier deficiency so having the condition means that your child is probably also more prone to skin infections. Scratching compounds the problem, making the skin vulnerable to staph and other infections. It’s extremely important to address the infection as quickly as possible so it does not spread. Your child’s doctor can prescribe a topical antibiotic cream or oral antibiotic for this.
Regular diluted bleach baths can also be very effective in controlling eczema flare-ups, sterilizing the skin and preventing infections. Add one-eighth or one-quarter cup of regular bleach to the bathwater in a full-sized bath tub three times per week.
My son has severe eczema. Are there any treatment options that can make a significant difference?
Wet-wrap therapy before bedtime can help. After bathing and applying moisturizer and steroid cream, put your son in a barely damp pair of pajamas, then add a pair of dry pajamas over the top. This can help him get a more restful night’s sleep and improve his eczema.
Under the supervision of the doctor, children older than 3 or 4 with chronic and severe eczema can also benefit from ultraviolet light therapy as well as other oral medications, which are used to reduce inflammation of the skin over the long term.
Amy Gilliam, M.D., is a board-certified pediatrician, dermatologist and pediatric dermatologist at the Palo Alto Medical Foundation’s Dublin, Fremont and Palo Alto Centers. Advice is not intended to take the place of an exam or diagnosis by a physician.