“Eczema” is a general term used to refer to a group of skin conditions characterized by itchy, red rashes. Le Bonheur's Chief of Pediatric Dermatology, Teresa Wright, MD, helps patients and families with these issues of a daily basis, and here, she breaks down the basics of diagnosis and treatment.
Has your child been diagnosed with eczema? The term eczema is often used when referring to the skin condition known as atopic dermatitis. Atopic dermatitis is a red, itchy rash that may occur in association with allergies and/or asthma. It is extremely common.
The cause of atopic dermatitis is not well-understood. People with atopic dermatitis have skin that appears abnormal. The skin is like a brick wall with holes that allow moisture to escape and environmental irritants to get in. Therefore, people with atopic dermatitis tend to have extremely dry and sensitive skin.
Atopic dermatitis cannot be cured, but it can be controlled. Most children with atopic dermatitis will gradually improve and many will outgrow it. For optimal control over the condition, a proper daily skin care regimen is extremely important.
A daily bath or shower is recommended! It is a common myth that daily bathing worsens dry skin and eczema. This is not true. Bathing puts moisture in and rinses irritants and germs off of the skin. The bath or shower should be short (less than 10 minutes) and not too hot. The skin should be washed with small amounts of gentle, fragrance-free, dye-free cleanser. Dove™ for Sensitive Skin and Aveeno™ fragrance-free cleansers are good choices. After bathing, the skin should be patted dry with a soft cotton towel and a thick moisturizer should be applied to all skin to seal in the moisture.
The type of moisturizer used is very important. It is best to use an ointment (like plain unscented Vaseline™ or Aquaphor™) or a heavy cream (examples include Vanicream™, CeraVe™ cream, Cetaphil™ cream, or Aveeno™ Baby Eczema Therapy Moisturizing cream). Lotions are poor choices because they are thin and often contain ingredients that cause stinging or irritation.
Moisturizer should be applied to the skin at least twice daily, but more often if the child’s skin is unusually dry or if the eczema is more severe. If you have been given prescription topical medications for your child’s eczema, those products should be applied sparingly to the affected areas prior to the application of moisturizer. I typically recommend application of topical medications twice daily, but you should follow the instructions given by your child’s doctor. It is very important that medications are applied only to areas of active eczema and never to areas of normal skin. However, moisturizer should be applied to all skin, including over the areas where you have applied medication.
In my practice, I see many children with atopic dermatitis on a daily basis. I understand that dealing with this chronic skin condition can be very challenging and frustrating for parents. If your child has eczema, you may feel like you have tried “everything,” but nothing works. The basic recommendations I have outlined here are often very helpful.