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Eczema and Children (Eczema)
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Eczema and Children

J. Bergman, MD, FRCPC and D. R. Thomas, MD, FRCPC

Eczema is an extremely common skin condition, especially among children. Symptoms, such as itchy scaling of the skin, begin before the age of two. It tends to become milder or disappear later in adulthood. The most common form of eczema is called atopic dermatitis, where the skin becomes red and irritated, often becomes dry and cracked. Small pus filled bumps can sometimes be present. Eczema often run in the family, so if your family members have eczema, you are more likely to develop this skin condition. The chronic nature of eczema, and the itching that is present can frustrate adults. For children, proper treatment is essential, as the constant itching can be distracting and an ongoing source of frustration for a developing child.

These are typical signs and symptoms of eczema:

  • Itching or burning of the skin.
  • Dried up skin.
  • Location of the rash: In children, eczema often produces rashes at the bends of the elbows, at the back of the knees, backs of the wrists and ankles, and at times at the side of the neck and the earlobes. For infants, the face, arms, and legs are most commonly affected.
  • The affected skin will often become dry, scaly, and crusty. Scratching can make the condition worse.
  • Infections are common.

These are things to watch out for if your child has eczema:

  • Avoid foods that flare up your child’s skin condition. If you notice a correlation between your child’s diet and their skin, visit an allergist who can determine any triggers using a patch test.
  • As best as possible, avoid potential environmental triggers. They can include contaminated air, dust, pet hair, or dust mites.
  • Avoid hot baths or bathing your child too often as it can remove moisture from the skin, making it prone to rashes and itching.
  • Avoid products that include perfume or fragrances as these are often irritants to the skin.
  • Use a mild cleanser.
  • Use a moisturizer, especially after showering or bathing.
  • Use in-shower moisturizers.
  • Antihistamines can also help the skin.
  • Use the prescribed medications such as hydrocortisones on the affected area.
  • Mild soap or non-soap cleansers such as  Cetaphil®, Spectroderm®, Spectrojel®, and plain white Dove® are useful alternatives to more irritating cleansing methods. For more information on mild cleansers, visit www.mildcleanser.ca.

Itching can be extremely hard to resist even for adults who know that scratching will only make their skin condition worse. Eczema can be extremely frustrating, and severe cases of itchy skin can disrupt your child’s life considerably. Parents can also become frustrated, watching their child suffer through the symptoms of eczema. Antihistamines such as hydroxyzine (Benadryl®) can be taken before bedtime, which can help relieve your child’s itching considerably.

Anti-inflammatory medications and their introduction:

Topical Corticosteroids or TCS:

  • Standard treatment for eczema used to prevent flare-ups and control the rashes.
  • The doctor will subscribe the lowest potency that still has effect on the skin.
  • Never use the topical medication any longer than specified by your doctor. Negative side-effects can occur from using the drug too often, or too much.
  • Low potencies are used for areas of the skin that are thin and absorb the steroids easier such as the face, neck, and other skin folds.
  • Medium to high potency may be required to treat areas where the skin is thicker, or where the flare-ups are more severe.

Topical Calcineurin Inhibitors:

  • These are new medications that do not contain steroids and are used when other treatments have little or no effect on the skin condition.
  • Use these medications immediately upon the arrival of symptoms, then use as necessary once the symptoms subside.
  • These medications are only recommended for children over the age of two.
  • Burning or stinging sensations are common where the medication is applied.
  • Pimecrolimus (Elidel™ 1% cream) and Tacrolimus (Protopic™0.03% and 0.1%ointment) are examples of this type of medication.

Finally, children and teens with eczema are more susceptible to skin infections in general. If your child has a fever, and you notice an infection which is warm, and often red with bumps, take your child to a doctor immediately. Antibiotic medications should control the infection. Eczema, while common, can be a great source of distress to a developing child and should not be taken lightly. Contact your doctor, and manage your child’s skin condition properly. For more information, visit www.eczemaguide.ca.

Related:

atopic dermatitis,   child skin care,   eczema,