Eczema (Atopic Dermatitis)




What is eczema?

Eczema is an inherited type of sensitive, dry skin. Eczema often starts on the cheeks at 2 to 6 months of age. The rash is most commonly found in the creases of the elbows, wrists, and knees. Sometimes eczema also occurs on the neck, ankles, and feet.

The rash is red and itchy. If scratched, the rash becomes raw and weepy.

What is the cause?

If your child has asthma or hay fever, or other family members have eczema, it is more likely that your child will have eczema. Flareups occur when there is contact with irritating substances (for example, soap or chlorine). Hot baths or showers also contribute to eczema in children.

In 30% of infants with eczema, certain foods cause the eczema to flare up. If you suspect a particular food (for example, cow's milk, eggs, or peanut butter) is causing your child's flareups, feed that food to your child one time (a "challenge") after avoiding it for 2 weeks.

How long does it last?

This is a chronic condition and may go away during adolescence. The goal is control, not cure.

How can I take care of my child?
  • Steroid creams or ointment

    Steroid creams or ointments are the main treatment of the itch of eczema.

    Rescue steroid cream. Your child's rescue cream is _______________________. Apply this cream ________ times a day for severe itching or rash. Never apply this more powerful steroid cream to the face.

  • Keep the skin from getting too dry.

    Your child should have a bath every other day and use soap only 2-3 times a week. Water-soaked skin is less itchy, but it must be covered by a moisturizing cream within 3 minutes of getting out of the bath. Eczema is very sensitive to soaps, especially bubble bath. They can use a nondrying soap such as Cetaphil, Dove, Neutrogena, Tone, or Caress for these areas. Keep shampoo off the eczema. Also, a dermatology approved bath oil, Robathol, is great for moisturizing in the bath tub. Use 2 tablespoons in 1 foot of water and soak for 20 minutes at least 2-3 times a week. Robathol is available at most stores by asking the pharmacist.

  • Lubricating or moisturizing cream

    Apply a lubricating cream once daily (twice a day during the winter) every day. Some lubricating creams are Eucerin, Vanicream, or Cerave (available at CVS). Children with eczema always have dry skin. After a 10-minute bath, the skin is hydrated and feels good. Help trap the moisture in the skin by putting lubricating cream all over the child's body while still damp (within 3 minutes of leaving the bath). Apply it after you have put steroid cream on any itchy areas. Do not use ointments, petroleum jelly, or vegetable shortening because they can block the sweat glands, increase the itching, and worsen the rash (especially in warm weather).

  • Itching

    At the first sign of any itching, apply the preventive steroid cream to the area that itches. Keep your child's fingernails cut short.

  • Antihistamine Medicine

    An antihistamine pill is needed at bedtime for itching that is keeping your child from getting to sleep or causes your child to wake up during the night. Your child's antihistamine is ___________________. Give _________ at bedtime for _____________ days.

What can be done to prevent eczema?
  • Avoid wool fibers and clothes made of other scratchy, rough materials.
  • Wear clothes made of cotton or cotton blends as much as possible.
  • Avoid synthetic fibers and materials that hold in heat. Also avoid overdressing. Heat can make the rash worse.
  • Avoid triggers that cause eczema to flare up, such as a lot of heat, sweating, excessive cold, dry air (use a humidifier), chlorine, harsh chemicals, and soaps.
  • Never use bubble bath. It can cause a major flare-up.
  • Keep your child off the grass during grass pollen season (May and June).

 
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The information contained in this website is to provide information of a general nature about the
practice and pediatric medical conditions. Neither Dr. Leonhardt nor Bee Well Pediatrics, P.A. is engaged in rendering medical
advice or recommendations. You should always consult your doctor for advice.