How Do I Know If My Child Has Eczema

In kindergarten, Caroline had painful, itchy patches between her fingers. It really hurt, and using hand sanitizer at school seemed to make it worse. After talking with her pediatrician, her mom asked teachers to encourage hand-washing instead of sanitizer. The family also switched to a more gentle, perfume-free hand soap at home. Avoiding these triggers, combined with a prescription hand cream, brought Caroline’s eczema under control. More than 10 percent of babies and kids experience eczema. It can be uncomfortable, itchy and painful and can cause sleep disruption. Eczema flares can also get infected when kids scratch itchy patches. Parents often ask how to distinguish eczema from other rashes and skin conditions–and how to prevent flares.

What Is Eczema?

Eczema applies to conditions (in children and adults) that cause the skin to become dry, itchy and inflamed. Atopic dermatitis is one of the most common types of eczema in children, causing painful, itchy rashes. Eczema is caused by an inflammatory response to triggers–either within or outside your child’s body. It’s a common childhood diagnosis, affecting more than 10 percent of kids. However, eczema can look different in kids at various ages, with symptoms ranging from red bumps to dry, scaly patches. That’s why it’s best to have your pediatrician take a look if your child has a persistent or recurring rash or dry skin.

What Causes Eczema In Children and Babies?

Unlike some childhood skin conditions, eczema is not contagious. Instead, it generally stems from a combination of genetics and environmental triggers. Some triggers include:

• Dry skin caused by bath products or dry air.
• Some synthetic fabrics may irritate the skin.
• Using bath products and laundry products with perfumes and dyes.
• Allergies to pollen, dust and pet dander
• Sensitivity to certain foods.
• Saliva from drooling can cause eczema on the face in babies and infants.
• Stress can cause flares. Parents may notice flares when children experience anxiety and new situations like changing schools or daycares.

What Does Eczema Look Like In Babies and Children?

Eczema can look very different depending on your child’s age. In younger infants, we often see it on the face, including cheeks, chin, forehead and scalp. As babies get older and start crawling, we see eczema on the elbows and knees. In toddlers, we often see eczema on the elbows, knees, and hands, as well as around the mouth and eyelids. As children reach school age, the hands and feet are focal points, as well as elbows and knees. In babies and toddlers, eczema usually starts out looking like red bumps, but it may become infected and get yellow and crusty. In older children, eczema often takes on a dry, scaly look known as lichenification because it resembles lichen on trees.

Is Eczema Serious?

If you think your child has eczema, it’s a good idea to check in with your pediatrician. The discomfort your child experiences may affect their sleep patterns and ability to focus in school. We also want to prevent infection by limiting scratching. Schedule an appointment with your pediatrician if the rash doesn’t go away. For persistent cases, you may also need additional support from a dermatologist or allergist.

How Can We Prevent Eczema?

Identifying products and conditions that cause flares for your children is one of the best ways to prevent eczema.

• Bathe and moisturize with gentle products. The “soak and seal” method of bathing, drying, and immediately moisturizing to lock in moisture helps soothe skin and reduce flares.
• Use additional moisturizer throughout the day.
• Avoid detergents and skin care products with perfumes and dyes. The National Eczema Association offers a list of ingredients to avoid.
• Switch to cotton sheets and clothing if synthetic fabrics cause irritation.
• If you think certain foods may trigger your child’s eczema, talk with your pediatrician about allergy testing.

What Treatments Are Available For Eczema?

• For mild cases, your pediatrician may recommend an over-the-counter product like hydrocortisone ointment or cream to reduce itching and inflammation.
• Children can also benefit from topical medication by prescription. Corticosteroids are the most common, but there is also a list of new non-steroid medications with different active ingredients. According to the American Academy of Pediatrics, these non-steroid products can be helpful for mild to moderate eczema and on delicate areas of skin like the eyelids, armpits and groin. Talk with your pediatrician about which topical medications are best depending on your child’s age and the extent and location of their eczema.
• We often recommend wet wraps to soothe flare-ups. After applying moisturizers or medications, wrap a damp towel around the affected area and leave it on for at least 30 minutes. You can even put your child in damp pajamas under dry pajamas for whole-body relief.
• Diluted bleach baths with chlorine levels similar to a swimming pool can soothe itching and prevent infection. Add a small amount of plain bleach to bathwater two or three times a week.
• Your pediatrician may recommend phototherapy (treatment with ultraviolet light) for severe eczema that hasn’t responded to topical treatments. It can be especially effective on hands and feet.
• Oral antihistamine medications before bedtime can reduce itching and help your child sleep.
• Finally, new treatments are approved for children with severe cases that don’t respond to topical creams. Biologic therapies given by injection target the elements of the immune system that cause eczema rashes. Oral JAK inhibitors also regulate the skin’s immune system to provide relief. Talk with your pediatrician about these options if traditional treatments don’t help.

How Can My Pediatrician Help With Eczema?

Simply put, eczema is no fun. It can make everything from school to bedtime more stressful and uncomfortable for your child. Fortunately, we now have lots of tools in our toolbox to bring needed relief. At Loudoun Pediatric Associates, we support patients by offering recommendations for daily skincare routines and changing clothing and product choices to avoid flares. We have several effective topical medications and work to find the best option for your child. If creams and ointments don’t work, we can explore oral or biologic treatments to bring relief. Let’s work together to help your child get comfortable and at ease without the pain and itching of eczema flares.