Eczema, also known as atopic dermatitis, is a chronic skin disorder characterized by intermittent flares. These flares tend to subside as the child ages. We don’t know exactly what causes eczema, but it seems to be related to the immune system and often patients will also have seasonal allergies, asthma or other allergic conditions.
The goals of treatment will be to hydrate the skin, reduce redness, control itching, and eliminate aggravating factors.
HYDRATING THE SKIN – the goal is to restore the natural barrier functions of the skin. Daily warm water baths (at least one per day) with a small amount of an emulsification agent, such as Aveeno Colloid Oatmeal, RoBathol, Maypo, or Mineral oil. Use any of the following mild cleansing creams or soaps: Creams: Cetaphil or Diprobase Soaps: Dove, Purpose, Aveeno, Oil of Olay, Camay, or Caress. Shampoo: Any mild baby shampoo After bathing, pat the skin dry. Apply a moisturizing agent within approximately 3 minutes to seal in the moisture. Use any of the following: Ointments: tend to be greasy but really work — Petrolatum (Vaseline), Crisco, or Aquaphor. Cream based alternatives: tend to be more expensive and less effective–DML Forte, Moisturel, Aveeno, Curel, Purpose or Neutrogen. Frequent application of moisturizers throughout the day will help maintain a high level of hydration. We recommend at least 3 times a day.
REDUCING REDNESS – When your child’s skin is actively inflamed, we will recommend using a topical anti inflammatory medicine – a corticosteroid ointment or cream. These corticosteroids should not be confused with anabolic steroids sometimes used by athletes. Although corticosteroids are powerful medications and must be used with care, we will prescribe an appropriate strength and tell you exactly how long to use the medication.
CONTROLLING ITCHING – Scratching can damage the already delicate skin, increasing inflammation and opening the door to infection. An important aim of treatment is to break the “itch-scratch” cycle. Loose fitting clothes can help. Also, closely clipping fingernails or light cotton mittens at night can help control scratching. Diphenhydramine (Benadryl) Elixir can help decrease itching. Common side effects are excessive fatigue and sometimes, excessive hyperactivity.
ELIMINATING AGGRAVATING FACTORS – Stress, environmental factors such as an overheated bedroom, perfumes, antiseptics, wool clothing and allergens can aggravate eczema. Efforts should be made to eliminate these factors. Eczema flare-ups can be very difficult for child and parent alike. It may seem like a lot of work to comply with the management plan. Rest assured that the plan is designed to speed healing and that a simpler routine will follow once the eruption has subsided.