Eczema is a chronic skin problem that causes dry, red, itchy skin. It is also called atopic dermatitis or AD.
Who Gets Eczema?
Eczema is the most common skin problem treated by pediatric dermatologists. About 65% of patients develop symptoms before age 1, and about 90% of them develop symptoms before age 5. Many babies outgrow eczema by age 4. Some children outgrow eczema by the time they are young adults, although their skin remains dry and sensitive. A few may have it all their lives, but there are ways to relieve the symptoms.
Eczema often runs in families with a history of eczema or other allergic conditions such as hay fever and asthma. It is not contagious.
Because eczema is a chronic skin problem, these symptoms can come and go. There are times when the symptoms are worse (called exacerbations or flares) followed by times when the skin gets better or clears up completely (called remissions).
The symptoms of eczema are different with each child. Common symptoms include dry, red, itchy skin and rashes. These rashes can be oozing or very dry.
Eczema can appear anywhere on the body or in just a few areas.
- In babies, a rash often appears on the face and scalp.
- In teens and young adults, a rash often appears on the hands and feet.
How to Prevent Flare-Ups
One of the most helpful things you can do is to prevent flare-ups before they happen.
- Keep your child's skin moisturized. Moisturizing should be a part of your child's daily treatment plan.
- Use fragrance-free moisturizers. Cream or ointment is more moisturizing than lotion.
- After a bath, gently pat the skin with a towel and then apply moisturizer to the damp skin.
- Apply moisturizer at least once a day or more often if needed. Moisturizer should be applied to the face and entire body.
- Avoid irritants. People who are sensitive to scratchy fabrics or chemicals in soaps and detergents should
- Wear soft fabrics such as 100% cotton clothing.
- Use mild, fragrance-free body cleansers.
- Take short baths with room temperature water.
- Use mild laundry detergent with no dyes or perfumes.
- Skip using fabric softener in the dryer.
- Remind your child not to scratch. Scratching can make the rash worse and lead to infection. Also, the more your child scratches, the more itchy the area will be. Keep your child's fingernails short and smooth, and try to distract your child from scratching.
- Ask your child's doctor if allergies could be a cause of the eczema. Sometimes allergies, such as ones to food, pets, pollens, or dust mites (in bedding), can trigger the rash or make it worse. If your child's eczema is caused by an allergy, avoid the trigger, if possible.
- Ask your child's doctor about other things that can trigger a flare-up. These things include overheating or sweating and stress.
Your child's doctor may recommend medicines to help your child feel better and to keep the symptoms of eczema under control. The type of medicine recommended will depend on how severe the eczema is and where it appears on the body. Eczema medicine can be given in 2 ways:
- Applied to the skin (topical)—Available as creams or ointments.
- Taken by mouth (oral)—Available in pill or liquid form.
Before you give your child any medicines, be sure you know how to give them. Talk with your child's doctor if you have questions or concerns about giving your child medicines.
- Topical steroids (hydrocortisone creams or ointments)—May help relieve itchy skin and decrease inflammation. They work best for mild eczema.
- Steroid-free topical itch relief—May give fast relief of dry, itchy skin with few side effects. Some of these medicines contain alcohol, which can cause a burning sensation.
- Oral antihistamines—May help relieve the itch (particularly the kind that makes some people sleepy).
- Topical steroids—Used to reduce pain, redness, and swelling and to stop the itch. Uncommon side effects, including thinning of the skin, stretch marks, or acne, may occur if not used as recommended and if used for long periods.
- Topical immunomodulators (steroid-free medicines)—Used to reduce inflammation and stop the itch. They are a new class of medicines shown to work in 80% of studies done in children older than 2 years. Studies are currently being done to test the safety of their use in younger children.
- Oral antihistamines—Come in several prescription types that may be more effective in certain children.
- Oral antibiotics—May be prescribed if there is a secondary infection caused by scratching.
- Oral steroids—Are rarely recommended, especially for young children, because they pose many health risks. Also, after patients stop taking these medicines, they often have rebound flare-ups.
Eczema is a chronic skin problem, so it can come and go. It requires ongoing management by you, your child, and your child's doctor. If your child's eczema is not improving, talk with your child's doctor about your concerns.