Tricks for Managing Eczema in Children

Winter is here and as a mom to a 2-year-old son with eczema, I am here to share some information and at-home tricks for managing eczema in children! Eczema is a common skin condition causing red, itchy and cracked skin that affects 10 to 20% of children. The itch can be so severe a child cannot sleep, and scratching can lead to skin infections. Babies in their first year of life typically develop eczema as dry and scaly patches on the cheeks, scalp and forehead, while toddlers develop eczema on the creases of their elbows and knees. Other common places for the rash to appear are the neck, wrists, ankles, and creases between the buttocks and legs.

Researchers are still studying what causes eczema, but we know genetics, environmental exposures, and difficulties with the permeability of the skin play a role. Children who get eczema usually have family members who have eczema, asthma or hay fever. Foods do not cause eczema, but some studies suggest that food allergies can make eczema worse. Children with eczema often have food allergies to milk, foods that contain milk, nuts and shellfish.

Managing eczema is important to prevent it from getting worse, calm the skin to relieve pain and itching, prevent infection and stop the skin from thickening over time. It is important to avoid eczema triggers by using scent-free and color-free fabric softener and laundry detergent, shampoo and soap. When eczema is flared, treatments include topical steroids and other non-steroid creams like Elidel®, Protopic® and the newest approved topical prescription Eucrisa® (crisaborole 2% ointment). When flared, I typically use steroid twice daily on my son for 2 weeks and then switch over to a non-steroid medication to prevent worsening eczema. Oral anti-histamines and oral steroids can also be used in severe cases. For prevention, barrier repair creams and moisturizers such as Vanicream™ Moisturizing Skin Cream (16oz), Avène Cicalfate Resorative Skin Cream (1.4oz), and Cetaphil® Restoraderm should be used at least twice daily to maintain the skin barrier. I find using a barrier repair cream in the form of a foam makes my son more willing to participate in his moisturizing routine. Foam is more fun!

Lastly, data shows bleach baths twice per week with one capful of bleach in a full tub of water for 5 to 7 minutes can kill bacteria on the skin associated with eczema and prevent infection. Adding a teaspoon of bleach to a water bottle sprayer and spraying your body before taking a shower is another alternative to soaking in a bleach bath.

Eczema can be very disruptive to a child’s growth and development. Fortunately, most children outgrow eczema as teenagers, but about 25% go on to have it into adulthood. Controlling the symptoms is possible, and the providers at Advanced Dermatology are here to help you and your family members with all of your eczema needs!