The term eczema, or atopic dermatitis, refers to red itchy skin with scaling and dryness typically starting in childhood. Babies develop rashes on their cheeks, whereas toddlers typically have eczema on the creases of their elbows and knees. More severe cases can involve part or all of the skin on the arms, legs and torso.
In most cases eczema is genetic (although sometimes family members have allergies or asthma and not eczema), but many factors can influence whether eczema is active or not. Almost anything that can irritate the skin can make eczema worse: heat (due to sweat on the skin), cold (due to low humidity in the air and dry skin), fragrance, and wool (scratchy). Foods are a trigger for a minority of kids with eczema. The good news is that most children grow out of eczema when they are teenagers, but about 25% go on to have it the rest of their lives, some very severe, and some with localized hand dermatitis.
There are no known cures for eczema, but currently available treatments address multiple factors that may contribute to inflammation in the skin. When the eczema is acute, the treatments include topical antiinflammatory prescriptions (topical steroids and other non-steroid creams like Protopic or Elidel) and anti-histamines or even oral cortisone. For prevention, maintaining the skin barrier (which is not normal in people with eczema) requires careful choices of moisturizing creams (Trixera Emollient Cream,Vanicream, and Restoraderm are good), avoidance of triggers (wear cotton, use fragrance free fabric softener and laundry detergent, as well as shampoo (Free and Clear) and gentle soaps (Surgras Lipikar Bar) and use a humidifier in the house. Finally, there are more bacteria on the skin in people with eczema, and although it seems the opposite of common sense, it is good to take bleach baths twice per week (one capful of bleach in a full tub of water) for 5-7 minutes. The bacteria may increase the rash.
Atopic Dermatitis is disruptive to a healthy growing child's life. Controlling the symptoms is possible and beneficial for any child's health.