What is eczema?
Eczema is a chronic dry, itchy, sometimes red rash of the skin. In infants it often involves the face and creases of the elbows, knees, and ankles, but can affect the entire body. In older children, it usually concentrates in the creases. Eczema is usually caused by an allergic condition. It can be worsened by contact with irritating substances such as, soap, by friction of the skin with clothing or bedding, or if your child is allergic to some foods, by ingesting these foods.
Eczema is a chronic condition and it CANNOT be cured. It can flair up and subside at times. We can help you control your child’s eczema so he or she can be comfortable.
What can I do for my child’s eczema?
- Avoid triggers. Loose, cotton clothing may help. Keeping your children cool in the summer and keeping the air moist in the house can help (use a humidifier during the months you use your heater or A/C). Avoid harsh chemicals and soaps. Don’t give bubble baths. Don’t put soap in your child’s bathwater until you are ready to get them out. If you have been told that your child is allergic to a certain food such as dairy or soy, you must eliminate or significantly reduce these foods in your child’s diet.
- Moisturizing the skin is the MOST important thing you can do. Children with eczema always have dry skin. Bathing (without soap or using a skin cleanser such as, Cetaphil Skin Cleanser) daily or twice a day for 5 to 10 minutes will hydrate the skin. Immediately after bathing, pat your child dry and liberally apply a moisturizer to all the affected areas. This seals in the moisture and provides the building blocks for the skin to repair itself.
- Currently, dermatologists recommend moisturizers that contain lipids and ceramides, natural skin building blocks that the skin needs to heal. A couple of relatively inexpensive over-the-counter products that contain these ingredients are CeraVe and Cetaphil Restoraderm. Other good moisturizers are Eucerin, Cetaphil, or Aveeno. Use the thick creams and not just the lotions because the creams will work better. Avoid using petroleum jelly because it can block the sweat glands, causing irritation.
- Steroid creams or ointments can be used to treat the redness, itching and irritation of eczema when moisturizers don’t control the rash alone. The strongest over-the-counter hydrocortisone cream (such as Cortaid or Cortisone) is usually sufficient to control flare-ups. Apply a thin film to red, itchy area twice daily until it improves. Use your steroid cream immediately when redness and itchiness develops because as your child scratches, the rash will worsen and become harder to control.
- More on bathing. Use a soap free skin cleanser for bathing such as, Cetaphil Skin Cleanser or Dove. When the rash is bad, bathing 2 to 3 times per day to hydrate the skin may be necessary. Dry, irritated skin is broken skin and broken skin allows bacteria to get in which causes more irritation. To combat this, at least once a week bathe your child in tub water with added laundry bleach: to 6 inches of water in the tub, add ¼ cup of laundry bleach. This will reduce the bacteria on the skin and is safe, even for babies. In addition to this, use laundry bleach when washing your child’s clothes.
- Treat the itching. At the first sign of itching, apply the steroid creams as mentioned before. Keep your child’s fingernails cut short. You may give Benadryl (diphenhydramine) for itching too. NEVER use topical Benadryl or Benadryl cream.
When should I call the office for more help?
Call during regular hours if:
- The rash becomes severe (raw, bleeding, open sores) in places
- The rash looks infected (draining pus, hurts to touch)
- The rash hasn’t improved in 5 to 7 days with aggressive home treatment
Brad Mercer, M.D., is located at 3200 Riverfront Drive, Ste. 103, Fort Worth, TX 76107. To make an appointment with him or one of his partners, call 817-336-3800. Like him on Facebook.