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Eczema (Atopic Dermatitis)

The exact cause of eczema is not ful­ly under­stood. Eczema is not an aller­gy itself, but aller­gies can trig­ger eczema. Some envi­ron­men­tal fac­tors (such as exces­sive heat or cold, scent­ed skin prod­ucts, etc.) can also trig­ger eczema.

Eczema most com­mon­ly caus­es dry, red­dened skin, although the appear­ance of eczema varies. Intense itch­ing is often the first symp­tom. Chil­dren often try to relieve the itch­ing by rub­bing or scratch­ing the affect­ed areas, which can make eczema worse and can even­tu­al­ly lead to thick­ened, brown­ish areas on the skin.

While any region of the body may be affect­ed by eczema, it typ­i­cal­ly occurs on the face, neck, and the insides of the elbows, knees, and ankles. In infants, eczema typ­i­cal­ly occurs on the fore­head, cheeks, fore­arms, legs, scalp, and neck.

Eczema symp­toms tend to wors­en and improve over time, with flare-ups occur­ring peri­od­i­cal­ly. Although there is no cure, many chil­dren either out­grow their eczema, or it at least gets bet­ter as they get older.

What exact­ly is eczema?

Eczema is a chron­ic, recur­ring skin dis­or­der char­ac­ter­ized by dry, inflamed, and itchy skin. Unfor­tu­nate­ly, there is no cure for eczema; how­ev­er, there are many ways to con­trol the dis­ease by prac­tic­ing good dai­ly skin care.

What are some of the best ways to con­trol eczema symptoms?

One of the most impor­tant parts of car­ing for eczema-prone skin is reg­u­lar use of a mois­tur­iz­er. Fra­grance-free mois­tur­iz­ers such as Cer­aVe, Cetaphil, Aveeno, Eucerin, Vani­cream, or Aquaphor (all avail­able over-the-counter) are great options. Creams are more effec­tive than lotions. Mois­tur­iz­er should be applied to the skin on a dai­ly basis, espe­cial­ly imme­di­ate­ly after bathing. Choos­ing a gen­tle soap is just as impor­tant as choos­ing an effec­tive mois­tur­iz­er. We rec­om­mend cleansers such as Dove, Cer­aVe, Cetaphil, or Aveeno. Take care to use warm, rather than hot, water when bathing. When fin­ished, gen­tly pat the skin dry and apply mois­tur­iz­er while the skin is still damp.

What are some oth­er steps that can be tak­en to man­age eczema?

One impor­tant tip is to avoid scratch­ing or rub­bing the skin. Keep­ing the fin­ger­nails short can help pre­vent dam­age due to scratch­ing. Anti­his­t­a­mines, such as Benadryl, may reduce itch­ing to a cer­tain degree. Cool gel packs can also pro­vide some itch relief. Wear­ing gar­ments that allow air to pass freely to the skin can be help­ful as well. Loose-fit­ting, cot­ton cloth­ing is a good option. Try to avoid mate­ri­als that can be irri­tat­ing to the skin, such as wool. When out­doors, be sure to wear sun­screen and avoid sun­burns. Find a sun­screen that is not irri­tat­ing to the skin, such as a zinc oxide or tita­ni­um diox­ide-based prod­uct. Do not be afraid to get in the pool – swim­ming pro­vides hydra­tion to the skin; how­ev­er, be sure to take a quick show­er imme­di­ate­ly after swim­ming in order to remove resid­ual chlo­rine or oth­er chem­i­cals. And, as always, apply mois­tur­iz­er when finished.

Per­form­ing good dai­ly skin care goes a long way in con­trol­ling eczema. Some­times, though, these steps alone are not enough to man­age one’s symp­toms. If this is the case, sched­ule an appoint­ment with a der­ma­tol­o­gist to dis­cuss pre­scrip­tion med­ica­tion options. But remem­ber, the need for pre­scrip­tion med­ica­tion can be reduced when good skin care is prac­ticed on a reg­u­lar basis.

How to help a child with eczema

While there is no cure for eczema, you can take steps to man­age your child’s symp­toms and lessen the sever­i­ty of out­breaks. Try to fol­low these suggestions:

Give your child a dai­ly brief skin sur­vey for any appear­ance of eczema.

For Infants and Tod­dlers, bathe dai­ly or every oth­er day using a cleanser only 1 – 2 times a week when actu­al dirt is present. Use petro­le­um type mois­tur­iz­er (Aquaphor, Cetaphil, Cer­ave) ide­al­ly with­in 2 – 3 min­utes of bathing.

For School Aged and Ado­les­cent chil­dren), bathe/​shower dai­ly. Lim­it show­ers to 10 – 15 min­utes. Use cleanser when actu­al dirt is present at/​in neck, axil­lary and groin areas. Apply mois­tur­iz­er or emol­lient creams 2 – 3 times dai­ly, even if a bath/​shower was not taken.

Avoid using scent­ed soaps, deter­gents, fab­ric soft­en­ers, bub­ble bath, etc.

Avoid exces­sive scrub­bing and tow­el­ing after bathing your child. Instead, gen­tly pat your child’s skin dry.

Avoid dress­ing your child in harsh or irri­tat­ing cloth­ing, such as wool or coarse­ly woven materials.

Apply cool com­press­es (such as a wet, cool wash­cloth) on the irri­tat­ed areas of skin to ease itching.

Keep your child’s fin­ger­nails short to min­i­mize any skin dam­age caused by scratching.

Oth­er adju­vant ther­a­py – bleach baths: ¼ — ½ cup of house­hold bleach added to ¾ full stan­dard tub and soak for 5 – 10 min­utes, 2 times a week.

Wet preps.