Eczema or atopic dermatitis very commonly affects kids.
Few conditions are as frustrating for parents and pediatricians, because even when properly treated, you can expect eczema to flare up from time to time after it gets better. Eczema is even worse when it isn’t properly treated though.
What Triggers Your Child’s Eczema?
Like other things that are supposed to have triggers, like asthma and migraines, it is often hard to figure out what triggers a child’s eczema.
Dress in soft, breathable clothing and avoid itchy fabrics like wool, that can further irritate your eczema.
National Eczema Association
Common eczema triggers to avoid might include:
- harsh soaps and cleansers, shampoos, and body washes, including those with fragrances
- food allergy triggers – milk and eggs
- environmental allergy triggers – dust mites and animal dander
- low humidity
- temperature extremes – either getting too hot or too cold
- skin infections
And anything else that might make your child’s skin dry and itchy.
Eczema Treatments for Kids
Although there is no cure for eczema, it is usually possible to control your child’s eczema, including getting rid of all or most of her eczema rash and decreasing how often your child has eczema flares.
These basic treatments include:
- using lukewarm water for daily baths and showers
- using a soap substitute or cleanser that is unscented, fragrance-free, and dye-free – Cetaphil, Dove, Aveeno
- using a tar-based shampoo if your child’s scalp is red and itchy – T-Gel
- daily use of moisturizers, especially within a few minutes of taking a bath or shower (soak and seal therapy)
- prompt use of a moderate strength prescription topical steroid (like traimcinolone acetonide 0.1% cream) as soon as your child has a flare, with red, rough itchy skin
- as needed use of oral antihistamines to help control itching during flares – Benadryl
- keeping your child’s finger nails short to minimize damage from scratching
A written eczema action plan can make sure that you understand how and when to do each of these treatments.
Best Moisturizers for Eczema
Everyone seems to have their favorite eczema moisturizer.
Which is best?
The best moisturizer is probably the one that your child will use and which works to keep his skin from getting dry. In general though, ointments are better than creams, which are better than lotions.
Some favorites include Aquaphor (too thick and greasy for some people), Vanicream Moisturizing Skin Cream, CeraVe Moisturizing Cream, Eucerin Original, and Cetaphil Moisturizing Cream.
Whichever moisturizer you use, be sure to apply it to your child’s skin within three minutes of his soaking in a bath or shower so that you can seal in the moisture (soak and seal therapy).
Treating Hard To Control Eczema
What to do you do when basic treatments aren’t working?
Although a pediatric dermatologist can evaluate your child to see if she needs a systemic medication, phototherapy, or other treatment, most kids with hard to control eczema simply need more education to make sure they are using standard treatments correctly.
- Is your child bathing correctly?
- Are you putting on the right moisturizer, using enough moisturizer, and using it often enough?
- Is your soap too harsh?
- Are you afraid to use a topical steroid?
- Are you applying a steroid over a moisturizer, which can make it less effective?
- Could you be doing more to avoid triggers?
- Could stress be triggering your child’s eczema?
A Staph skin infection might be a problem. In addition to oral antibiotics, weekly dilute bleach baths might help if this is an issue for your child.
Your child with hard to control eczema might also benefit from:
- using more moisturizer over his entire body – don’t spot treat the areas that you think are a problem
- using a thicker moisturizer – put your jar of Aquaphor in the freezer or refrigerator if your child doesn’t typically like using a moisturizer or complains that it stings or burns
- a prescription barrier cream to control itching – Atopiclair, MimyX
- a prescription topical Clacineurin Inhibitors – Elidel, Protopic
- a 504 school plan
- changing your laundry routine – wash new clothes, use mild, dye free laundry detergent and rinse twice after washing
- using sunscreen and rinsing after swimming in a pool or excessive sweating, applying a moisturizing quickly afterwards
- allergy testing to better identify triggers
You might also talk to your pediatrician about wet wrap therapy. With this treatment, you have your child take a bath or shower, applying a topical steroid to the affected areas and a generous amount of moisturizer to the rest of your child’s skin. Next, cover the area in wet cotton clothing or a wet dressing, and lastly, dress your child in dry cotton clothing, removing them all once the clothing dries out. You can then repeat the whole process or start again the next night, continuing until your child’s eczema is under better control.
Wrap therapy can be done with wet pajamas if you have to cover a big area, tube socks with the end cut off if you just have to do his arms, or cotton gloves for hard to control hand eczema. Some experts even recommend using a chilled wet dressing, putting the wet clothes in the refrigerator for a short time before using them on your child.
If you are at the point of considering wet wrap therapy, seeing a pediatric dermatologist might also be a good idea.
What To Know About Treating Hard To Control Eczema
While eczema can usually be controlled and most kids eventually outgrow having eczema, you may need some help to really understand how to really manage your child’s eczema effectively.
More Information About Treating Hard To Control Eczema
- Eczema Tips
- Atopic Ezcema
- AAD – Caring for a Child with Eczema
- AAD – Tips for Managing Eczema
- AAD – Eczema Action Plan
- National Eczema Association – Understanding how to manage my eczema by bathing
- Eczema : How to Help Your Child Avoid the Itch
- Pediatrics Clinical Report – Atopic Dermatitis: Skin-Directed Management
Last Updated on November 30, 2016 by Vincent Iannelli, MD