Winter can be especially challenging for little ones dealing with itchy, painful, dry patches that are the hallmark of eczema. This skin disorder is more bothersome and painful than the dry skin many of us experience during cold, dry winter months. There’s no single treatment that’s right for every person, so it can be a challenge to find the right combination of lotions and medications to keep flares under control.
What is eczema?
Eczema, also known as atopic dermatitis, is a skin condition that causes dry, itchy and red skin, usually in patches. The exact causes aren’t known. Most experts agree that a complex interaction between the immune system and the environment leads to symptoms. Eczema rashes typically come and go, depending on triggers. Most little ones are more sensitive to flare-ups in winter when the air is cold and dry.
Eczema is very common in infants and young toddlers. The chance of development increases by 40%-50% when one or both parents have a history of eczema or other allergies. Symptoms usually resolve by age 2 but may be a precursor to a diagnosis of asthma or allergies later in childhood.
Symptoms
The hallmark symptom of eczema is a dry, itchy rash usually described as patchy. In light skin tones, the patches are often red. The color may appear gray, dark brown or even purple in darker skin tones.
In babies, the rash is often on the cheeks or around the mouth. As they get older, toddlers and older children start to have patches in flexural areas-think the inside of the elbow or behind the knee. Hands and feet are common sites too.
Other symptoms parents may notice include fussiness or difficulty sleeping. When your skin is dry and itchy, it’s hard to be happy!
Managing eczema care
The cornerstones of eczema treatment are a consistent daily skincare routine and avoiding substances that trigger flare-ups.
Bathing and daily care
A consistent skincare routine helps improve the moisture barrier and provides comfort. Some general measures include:
Daily bath routine
- Use lukewarm water and keep the bath short; five to 15 minutes is enough. Use unscented, mild soap at the very end to clean the skin.
- Pat the skin dry with a soft towel.
- Immediately apply a thick moisturizing cream or balm to moisturize the skin.
- Allow it to dry a bit before putting on clean clothing. Cotton or other natural fibers are best.
Other measures
- Apply the moisturizer of your choice two to three times perday.
- Cool compresses may soothe irritation.
- Colloidal oatmeal baths are also soothing.
- Avoid scratching-keep those fingernails short!
The baby aisle is filled with lotions, creams and ointments/balms. How do you choose? During an eczema flare, look for an unscented ointment or balm with emollient and occlusive properties to hydrate and lock in moisture. Petroleum jelly and coconut oil are common ingredients. Lotions soak in quickly, while balms and ointments create more of a barrier.
Triggers
Young children’s skin is sensitive. Over time, you will likely recognize and understand what triggers your child’s flares. These can include:
- Moisture (sweat)
- Dry air (winter)
- Heat and sweating
- Scents in lotions, soaps and detergents
- Pet dander
- Dust
Medical treatments
When eczema flares do occur, your little one may benefit from medications that help soothe and lessen the irritation.
Steroid creams are a mainstay of eczema treatment. These anti-inflammatory creams decrease the inflammation, pain and itching on localized patches. Hydrocortisone is one steroid cream you can purchase over the counter. There are several other strengths and types of steroids that your child’s doctor might prescribe.
Phototherapy may help decrease symptoms in some children. This treatment is usually prescribed by a dermatologist.
Other medications decrease or alter the immune system’s ability to respond to certain triggers. These are reserved for challenging cases that don’t respond to other treatment options. They are usually prescribed by a dermatologist.
Superficial skin infections can also occur during flare-ups. Your health care provider may prescribe antibiotic treatment depending on the severity of the infection.
Eczema flares are miserable for little ones and their caregivers. If you’re concerned your child may have eczema, call your pediatrician for evaluation and advice. Although there isn’t a cure, several treatments help decrease the itch and pain caused by flares.
Joleen Sams is a family nurse practitioner who lives in Shawnee with her rowdy bunch of a family. Caring for children and families has always been a passion, and she loves the opportunity to share knowledge with wider audiences.
References
Johns Hopkins Medicine, “Managing Eczema in Winter and Year-Round“
National Eczema Association, “Eczema Treatment For Children“
American Academy of Pediatrics, “How to Treat & Control Eczema Rashes in Children“