Supporting a Child with Eczema

Caring for a child with a chronic skin problem is not an easy task. It is often frustrating because you want a healthy child with good clear skin and yet he has this rash that simply won’t go away. 

The best way to help your child is to know exactly what you are dealing with. Arm yourself with knowledge regarding the skin condition of your child. Understand what eczema is, how it is treated, what causes it to flare or worsen, and and why certain treatments work. This way, you can better care for your child's skin. 

The medical name for eczema is atopic dermatitis. Dermatitis and eczema are synonymous and both terms mean inflammation of the skin. Atopic dermatitis is an inflammatory skin condition were there are patches in the skin that are red, dry, and very itchy. The exact cause is unknown although there are many theories, like the lack of the fillagrin gene or other external and internal factors. Children with atopic dermatitis always have a positive family history of either asthma, allergic rhinitis, or atopic dermatitis. 

Infantile atopic dermatitis can start as early as two months, usually involving the face, causing the infant to be irritable and restless. As the child gets older (childhood atopic dermatitis), the itchy rashes typically localize in certain areas like the insides of the elbows, knees, and ankles. At this point, the rashes are not just red and itchy but may become dry, thick, and dark because of frequent scratching and rubbing. This constant itch-scratch cycle can create tears in the skin where bacteria may enter and cause an infection. When rashes become red, irritated, and emit tender and ooze fluid, a bacterial skin infection should be suspected. 

Children with atopic dermatitis have dry, sensitive skin. Therefore, caring for their skin is of utmost importance. Preventing eczema means knowing what triggers the flares and avoiding them. Examples of triggers include harsh soaps, detergents, dust mites, food allergies, and sweating. Since there is no real cure for atopic dermatitis, our goal is to decrease the number of eruptions, control the flares and help relieve the intense itching. 

Eczema maybe mistaken for some other skin condition, so consulting a dermatologist is a wise decision.  A dermatologist will be able to differentiate your child's condition from other skin diseases, like  contact dermatitis, seborrheic dermatitis or psoriasis. After a correct diagnosis is made, the dermatologist will prescribe an appropriate treatment regimen which may include oral and topical medications. The dermatologist will also recommend a skin care regimen that is best for your child. 

Often, the dermatologist will prescribe a corticosteroid ointment or cream. This is important to decrease the itch and inflammation of the eczema. The use of moisturizers is a MUST in the regimen. Antihistamines may improve the itch and help the child sleep through the night. 

Here are some skincare tips:

1. Take daily lukewarm baths. Short baths are preferable. 

2. Use a mild moisturizing soap or soap substitute.  Avoid bubble baths or fragranced soaps. There is no need to scrub the skin with a washcloth or loofah. Use your hands to lather. 

3. Use a moisturizer after applying the prescription medication. The moisturizer may be applied two or three times a day, to help avoid dry skin. A trick is to apply the moisturizer within two or three minutes after his bath to keep the skin well hydrated. 

If your child’s skin is not improving, follow up with your dermatologist for other specific treatments. Topical calcineurin inhibitors, oral steroids, phototherapy, and immunosuppressive drugs like cyclosporine are used to treat difficult and severe cases of atopic dermatitis but only under the close supervision of a dermatologist. 

Hopefully as your child grows older his condition improves and he outgrows it. But some children have eczema until adolescence or even adulthood. 

Caring for a child with a chronic skin condition can be demanding. Be patient. Children can be emotionally affected, specially when they are teased by their siblings or schoolmates. Try to explain in simple terms what his condition is.  Add some fun in the treatment. You can draw funny faces on his/her skin while applying moisturizer or sing a song together. The best way is to give your love, understanding, and tender loving care.