Have you ever looked at your child’s skin and wondered if the dry redness you were looking at was eczema or just dry skin? While dry skin may be irritating to your child and yet simple to manage, eczema can present a different set of challenges when it comes to caring for your child’s skin. Eczema is a very common skin condition seen in about 10-15% of pediatric patients, usually starting before age 5. It is a chronic inflammatory condition of the skin that tends to run in families and occurs often with allergies and asthma. As we head into the winter months and drier air, our skin can become more vulnerable to general dryness, and children who suffer from eczema tend to have it worse.
A good routine can keep your child’s dry skin healthy. Skin becomes dry when it has a hard time retaining moisture. Moisturizers are the cornerstone of a good skincare routine. The drier your skin gets, the thicker your moisturizer should be. You should avoid lotions that are dispensed with a pump as these tend to contain alcohol, which can dry out your skin. Another important factor is water. Anyone who washes their hands multiple times per day will know that frequent washing in hot water is a fast way to dry out your skin. Opt for luke-warm water rather than hot, and always remember to moisturize after you wash.
When your child has eczema, the routine suggested above won’t be enough, especially during eczema flares. Eczema is also known as “the itch that rashes.” Dry skin begets itching, itching begets redness and thickened skin, and thus you have what is classically seen as an eczema flare: those thick, red patches of skin with a scaly appearance and vertical lines called excoriations that are a sure sign of your child scratching. The first line of defense against an eczema flare is to have a solid daily lubrication routine down. Since your child already has dry skin, try using a thicker moisturizer such as Aquaphor, Aveeno, or CeraVe once to twice daily, even during times between eczema flares. You may even opt for the greasiest – and messiest – of them all: vaseline. Moisturize the entire body once or twice daily, increasing as necessary with drier weather or worsening rashes.
For children with eczema, a common bathing technique called the “soak and seal” is an excellent bathtime routine. This method helps your child’s skin retain the moisture from the bath, and adds moisture to the skin via a thicker moisturizing ointment such as one mentioned above. First, start with lukewarm water. Allow your child to soak for 10-15 minutes in the tub before washing them with soap at the end of the bath. For children with particularly sensitive skin, try using soap just a couple of times per week, and only on visibly dirty skin, the groin, and the armpits. and bathe your child as you regularly do. Avoid any soaps with dyes or fragrances. Anything with “Baby” on the label will surely have some additive to give it a scent or color that we associate with babies, so steer clear of these if your child tends towards dry skin or eczema. Once bathtime is over, rather than drying your child off completely, simply dab away water from their skin so that beads of water still remain. While still covered in these beads of water, use vaseline, Aquaphor, Aveeno, or CeraVe to seal in the moisture from the remaining water and provide additional moisture to the skin. Do this with each bath to encourage skin hydration. Additionally, you may choose add colloidal oatmeal to the bath water and allow your child to soak in this for 15-20 minutes before sealing in the moisture.
Of course, even the best laid out plans are not fool-proof and some children will still get those inflamed red patches of eczema. When this happens, there are different strengths of prescription steroid creams and ointments that may be necessary to help clear up your child’s skin. If these red patches start to ooze or your child develops a fever, they may have an infection of their eczema rash. If you are concerned about any of these things, bring your child in to see one of our pediatricians here at Canyon View Pediatrics and we can help determine the best treatment plan.
Some children who have eczema also have allergies. Avoidance of allergens will help control your child’s eczema. Occasionally, we encounter an eczema rash that doesn’t improve despite using prescription strength steroid ointments. When this happens, we as pediatricians start to think about other factors which may be exacerbating your child’s inflammatory process. After careful evaluation, certain allergies may be discovered that, once treated or avoided, make your child’s eczema more easily managed.
If you are concerned about your child’s skin or are having trouble controlling their eczema with over the counter creams and lotions, visit one of our pediatricians at Canyon View Pediatrics to discuss different options.
By Jennifer Menon, MD
Canyon View Pediatrics