How to identify and treat eczema in kids | Ask the Pediatrician

The glorious Northwest summer is here! I hope you’re out there soaking it up.

Unfortunately for some people, just as we are getting into shorts and T-shirts, so comes the bumpy, itchy, red skin. Eczema and other skin irritations go hand in hand with swimming, heat and allergy season. The good news is that eczema comes and goes and can be treated or controlled when it flares.

Learn how to tell the difference between eczema and irritated skin and how to avoid and treat eczema attacks.

More than 10% of children have eczema at some point in their first 10 years. It most often shows up in the first 6 months to 5 years, appearing as itchy, dry skin that can turn into a bumpy, red rash. Eczema often runs in families where others have other so-called “atopic” conditions like seasonal allergies or asthma.

Aside from the itch and discomfort, eczema can make kids feel really self-conscious about their skin. Reassure them that it can’t spread to others and that home care will usually help the itch and the look of the skin fairly quickly.

Dry, itchy skin or eczema?

We don’t think about function of skin much, probably because it works so well! But skin is a protective barrier between your body and the environment. With eczema, your child’s skin gets irritated and that protection breaks down, making it harder for skin to heal itself, leading to a nasty cycle of irritation.

Dry skin can be rough or reddish, but eczema often shows up as a rash that can be lighter, darker or reddish, feel bumpy or scaly and have a crust, and it’s always itchy. It’s most common where skin folds — like the elbows, knees or neck — but can turn up other places too, including the face and around the mouth.

Most home remedies for eczema are also helpful for dry, itchy skin in general so you can go ahead and treat the symptoms even if you aren’t sure it’s eczema.

How to treat eczema in kids?

Since eczema or a skin irritation is a breakdown of the barrier of the skin, you want to restore the protective barrier by:

• Changing bathing routines. Hot water and harsh soaps can break down natural oils on the skin, so use warm, not hot, water when bathing and switch to soothing, mild soaps and shampoos. Sorry, but bubble bath is a definite no-go for eczema.
• Replacing natural oils. Use creams like Cetaphil or CeraVe, or ointments like Vaseline or Aquaphor, regularly after bathing or swimming. Creams and ointments (from a tub) tend to moisturize better than lotion.
• Managing flare-ups. Topical steroids like cortisone can be applied to the area twice a day for up to two weeks. After two weeks, you need to stop for at least a week even if there are still symptoms. Allergy medicine can help with itching at bedtime, but consult your provider first. If your child has been around animals, pollen or other conditions that seem to cause flareup, showering (with warm water only) afterward can stop an attack.
• Finding the trigger. Been in the pool or lounging in the grass? Some people never figure out what causes their child’s skin to become irritated, but if you can find triggers, you can avoid them. Pollen, food allergies, pets, scratchy materials like wool or even drool in babies can trigger eczema. Sweating and heat can cause flare-ups and so can very dry air and extreme cold.

When should I seek help?

If you’ve tried home treatments and your child is still itchy and bumpy or has other symptoms, or the itching flare-ups occur often, talk with your clinician about diagnosis and treatments including more advanced therapy options like prescription medications.

If your child’s eczema is very painful to touch, looks infected, or is still itching severely after 48 hours of using a steroid cream, contact your provider. If your child has skin that looks infected with redness, pus or scabs and a fever, or you’re seeing a fever in a baby less than 12 weeks old, seek care immediately.

Most people with eczema manage it well and get out there to enjoy shorts, swimming and all the Northwest summertime has to offer by maintaining the skin’s natural barriers and avoiding flare-ups.

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