Tips for parents to manage children’s Eczema

Eczema 101

Particularly common in babies, atopic dermatitis—commonly known as eczema—is a chronic skin condition where the skin becomes inflamed, red, dry, itchy, and easily infected. The condition likely stems from several factors but is most likely caused by a combination of genetic and environmental factors. Children with family members who have a history of eczema or asthma are more likely to develop the condition. 

Signs and Symptoms 

Eczema is also known as “the itch that rashes,” as people will often begin itching before a noticeable rash appears. Eczema usually first presents as red, rough spots on the skin. Other common signs include dryness, scaly or leathery patches, areas that become crusty or weepy, and sensitive skin that is prone to irritation. 

Parents should be on the lookout for symptoms to present differently during various stages of a child’s life. In babies up to 12-18 months of age, a rash will usually first appear on the face, cheeks, or scalp. As children grow older, the rash may appear on the legs and arms, particularly the knees, elbows, wrists and hands.

Treatment Options

Your child may have every symptom or just a few, and they can develop at any age. The only way to diagnose eczema is to visit your pediatrician or pediatric dermatologist. They will check your child’s skin and ask about symptoms to provide an accurate diagnosis. If your child does have eczema, the physician will prescribe a simple skincare plan with home treatments to manage the symptoms and may recommend topical medications – either over the counter or by prescription, depending on the severity. They will also suggest avoiding known triggers and examine the skin to ensure that no infections are present. 

Skincare Best Practices 

There is no cure for eczema, but there are expert recommendations to help minimize this skin problem. In most cases, the symptoms can be managed by following a regular skincare regime with frequent moisturizing to prevent dry skin. 

Regular bathing: Bathe, not shower, your child daily or every-other-day in warm water for 5-10 minutes. Use a gentle, fragrance-free cleanser that does not strip away natural oils and inadvertently exacerbate dry skin.

Moisturize: Apply moisturizer containing ceramides immediately after bathing while the skin is still slightly damp. This allows a barrier seal to form and hold water into the skin. It is also recommended to moisturize a second or third time every day to keep the skin hydrated. 

Select the most effective products: Make sure to use a thick, bland cream or ointment for moisturizing. Typically, the thicker the moisturizer, the better the barrier it will provide. Avoid harsh, scented cleansers for bath products. A helpful rule of thumb to use when shopping for children’s skincare products is to look for terms including “fragrance-free” or “for sensitive skin.”

Avoiding Common Triggers

Some children have specific triggers that cause flare-ups of itchiness and rashes; however, it is important to understand that eczema is a chronic skin condition that can continue into adulthood, and triggers can change over time. Limiting exposure to products that cause irritation and allergens that have affected your little one in the past can help ease symptoms and lessen the frequency of flare-ups. Common triggers include excessive bathing without moisturization, emotional stress, excess sweat, and exposure to certain fragranced products. 

Parents will often ask about the link between food allergies and their child’s eczema. Although children with eczema can have food allergies, the allergies do not cause eczema. Children may develop hives or a rash from interacting with certain foods; however, these rashes tend to be irritation and not allergies or eczema. Particularly during the winter months, seasonal changes in temperature, humidity and wind can wreak havoc on sensitive skin and cause excess dryness, further aggravating the eczema. If possible, try to avoid drastic changes in temperature and remain indoors on especially cold, windy days.

Eczema can be frustrating, but there are methods to improve it. If your child’s skin is not doing well despite following skincare guidelines from your primary care doctor and using recommended topical medications, you should ask about a referral to a pediatric dermatologist for further treatment. Pediatric dermatologists are trained to treat severe eczema cases using topical steroids or systemic medications and can provide further consultation for your child.

About the author:

Douglas Kress, MD, local Pittsburgh based pediatric dermatologist and Society for Pediatric Dermatology