Your pediatrician can recommend measures to help clear up the rash and itching of eczema. Antihistamine medication may be prescribed to relieve the itching and help break the itch-scratch cycle (which leads to more itching, scratching, and possibly infection). Your pediatrician may advise giving the medication at night; some antihistamines have the side effect of mild drowsiness, which can help the child sleep better and suppress the urge to scratch during sleep. A non-sedating anti-histamine can be used during the day when your child needs to stay alert for school. Long-sleeved sleepwear may also help to prevent nighttime scratching.
A cortisone medication will be prescribed to reduce inflammation. This usually needs to be applied regularly (once or twice a day) to control the rash. Cortisone creams and ointments are available in various strengths. Some are too strong to be applied to the face and certain other parts of the body. These and all medications must be used exactly as prescribed to prevent side effects.
Warm (never hot) showers may be preferable to baths. In addition, moisturizing baths in lukewarm water for 20 minutes add moisture to the epithelial layer and cleanse the skin by lowering the number of bacteria. Gently pat your child dry after the shower or bath to allow some water to remain on the skin. Apply a moisturizer or lubricating cream to the whole body within 3 minutes, while the skin is still moist. This helps to keep the skin from drying out. Your child may also benefit from wet wraps, particularly if your child is an infant or a toddler.
The more your child scratches, the greater the risk of the skin becoming infected. An antibiotic given by mouth or in the form of an ointment to rub on the skin may be necessary to clear up the infection. Antibiotic treatment may help to improve the rash as well, since the staphylococcus bacteria that commonly cause skin infections also trigger eczema in some cases. Keep your child’s fingernails clean and short to reduce the risk of injury from scratching and prevent contamination of open scratches. Call your pediatrician promptly if your child’s rash gets worse or recurs despite treatment.
As the name implies, wet-wrap therapy involves wrapping wet bandages around the affected skin. This is generally done before bedtime.
The benefits of wet-wrap therapy include
- Skin rehydration
- More restful sleep
- Reduced redness and inflammation
- Less-frequent itching
- Decrease in the Staphylococcus aureus (staph) bacteria found on the skin
The basic technique is as follows:
- The patient soaks in a bath with bath oil.
- After bathing, pat the skin partially dry with a towel.
- Apply moisturizer and eczema medication (eg, steroid crème, ointment) to rash areas.
- Moisten bandages (eg, tubular bandage, wrap gauze bandage, athletic sock) by soaking them in water or applying moisturizer. When treating an infant or a very young child, moistened pajamas may be used instead of wet wraps. Special care must be taken to prevent these children from becoming chilled.
- Wrap the wet bandages on the area to be treated. Wet bandages can be used on any area of the body that the patient will tolerate, including the face.
- Lock in moisture by applying dry bandages over the wet ones.
The bandages should be left overnight but for no longer than 24 hours.