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About 1 in 5 babies have a skin condition called atopic dermatitis or eczema, which is very common for asthma, hay fever, and other allergies. In some cases, it begins within the first few months of life. Usually, it does not become evident until after a child has started crawling around on the floor and putting their hands in their mouth when they contact dust mites, pollen, and other allergens. As a result â€“ these allergens also irritate the skin â€“ making the child scratch more often, leading to skin infections from bacteria which causes even further inflammation. In severe cases â€“ children may not sleep well because scratching at night means they are more likely to wake up crying from pain – both from itching and the pain from their skin being red, swollen, warm, or tender.
Who gets atopic dermatitis?
Doctors may refer to it as “atopic dermatitis” or “eczema.” Atopic Dermatitis is a chronic inflammatory disease that typically occurs in persons with atopy (inherent tendency to produce IgE antibodies). It appears to be inherited and often runs in families where parents have other allergic diseases such as asthma, hay fever, food allergies, etc. According to studies, 3 – 7% of children are affected by eczema before they are one year old â€“ this increases up to 17% by two years of age. Children between 3 months and two years are most likely to develop eczema.
For parents, it can be heart-breaking because everyone wants their children to be healthy, happy, and free from discomfort â€¦ but no matter how hard you try, you’re not always able to prevent your child from catching viruses or having respiratory allergies, or developing atopic dermatitis.
Why does eczema appear in the first place?
There are several theories on why eczema happens, but no one yet knows exactly what causes it. One idea is that the child may have inherited a tendency to develop allergies combined with specific environmental exposures during infancy, further inflaming their skin. These children tend to produce more IgE antibodies than normal children, which attach to allergens and trigger an immune reaction resulting in skin inflammation. The inflammation also seems to cause changes in the structure of your skin, making it dryer, thinner, less flexible, and more likely to crack, leading to irritation by itching, heat, scratching, etc. This cycle makes symptoms get worse over time. Eczema tends to get better and then become worse over time.
What triggers or worsens eczema?
- Dry skin. This occurs in 50% of all children with eczema. When the skin becomes dry, it cracks, resulting in itchiness and redness.
- Temperature changes. Many babies develop eczema in areas that get very hot or cold such as the face, groin area, etc. May also include bathing suits area is covered with ‘plastic/vinyl’ material known to trap heat against the body.
- Sources of allergic reactions can include milk products (from breastfeeding), soaps, perfumes, laundry detergents.
- Skin infections – Scratching leads to redness and swelling, which can lead to bacterial infection, particularly Staphylococcus aureus
5 . Inhalant allergies â€“ such as pollen, dust mites, mold spores â€“ cause a type of eczema called ‘atopic dermatitis’ or ‘allergic contact dermatitis.’
- In rare cases, particular drugs may trigger inflammation in the skin.
What are the symptoms of eczema in children?
In general, the symptoms of eczema in infants and children are:
- Redness of skin that comes and goes
- Dry or scaly at times with tiny bumps that may be very itchy
3 . Small blisters on hands, feet, ankles, knees, elbows, wrists, neck
4 . Vesicles may appear after scratching, which turn into weeping sores filled with fluid (crusts over within a few days)
5 . Some people develop a condition called ‘allergic shiners’ from eye swelling from dust mites, leading to an allergic reaction on the face around the eyes called periocular dermatitis. This appears as very swollen eyelids/crow’s feet – this can be a sign of an allergy and can be associated with other allergies such as food or pet allergies.
What do I need to know about eczema in children?
There is no cure for atopic dermatitis/eczema, but it may worsen over time, and the symptoms tend to decrease in adulthood. You can’t predict how your child’s skin will react from one flare-up to another because things that trigger one person’s eczema may not affect someone else. Some people have seasonal outbreaks related to dust mites, pollen, etc.; some are started by dry air indoors or outdoors, some are only triggered by stress or sweating after exercise. Everybody reacts differently. Eczema is a chronic inflammatory disease that will flare up from time to time.
What are the most important things I can do for my child with eczema?
The best way to treat your child’s atopic dermatitis is to prevent flare-ups by avoiding anything that triggers it. If your child’s atopic dermatitis gets better with treatment, avoid using soaps or detergents on the skin. Instead, use warm water and a gentle cleanser for bathing.
1 . Keep your child’s skin clean and moisturized. Keeping the skin clean is probably one of the best things you can do for your child, especially if she has a yeast infection secondary to topical steroid use. Keeping the skin moist with ointments or creams prevents cracking, allowing bacteria inside, leading to diseases.
2 . Use gentle soaps only when needed â€“ most likely, this would be after bathing or swimming in chlorine pools. You want to remove sweat, acids that have formed on top of the skin due to sweating, but not all soap residue as some people are sensitive to this.
3 . Avoid perfumed soaps, bubble baths, lotions with alcohol because these will dry the skin. The skin needs to be hydrated to prevent cracking, which allows bacteria inside, leading to infection.
4 . For severe cases of atopic dermatitis that do not resolve with gentle soap and moisturizing creams, consider using a medicated wash such as EpiCeram (by prescription) or Cetaphil Restoraderm body wash/liquid you can use on the face/body for eczema.
5 . Keep fingernails short â€“ if your child is scratching her itchy, you need to stop this behavior right away by keeping nail beds trimmed back no longer than just straight across and keeping fingertips moisturized with creams.
6 . If your child has secondary yeast infections on hands or feet, consider using Canesten hydrocortisone 1% cream to help clear the condition up quickly. Hence, the skin is not constantly being irritated by it. You can also use powders on feet or crushed cornstarch between toes to prevent chafing/blisters, which are sometimes helpful for children with sweaty feet.
7 . To reduce itching, consider using Cetaphil moisturizing lotion for babies instead of baby oil because some infants are sensitive to baby oil and will develop a bumpy rash, redness on their cheeks that is very itchy around the mouth, nose, eyelids. This condition usually resolves once you stop the baby oil.
8 . For older children, consider using Eucerin Calming itch relief creme on hands/feet before bedtime to reduce itching. At the same time, you sleep and increase the exposure time to anti-itch medications such as Cetaphil moisturizing lotion or Aveeno Oatmeal bath treatment. These products contain colloidal oatmeal, which provides a physical barrier of protection from the elements and calms dry, irritated skin, so it doesn’t itch.
- Keep fingernails short â€“ if your child is scratching her itchy, you need to stop this behavior right away by keeping nail beds trimmed back no longer than just straight across and keeping fingertips moisturized with creams.
10 . In some kids, it can be helpful to use a low-dose antihistamine such as Claritin as needed for itching but check with your doctor before using any antihistamines on children under age 12.
11 . Keep baths cool or lukewarm â€“ not too hot as the heat will dry out the skin more, causing further irritation/itching/pain. Also, avoid chemicals found in bubble bath solutions that may irritate eczema even more because of the additives, perfumes, etc.
When to visit a doctor for eczema in children?
- If the eczema is not getting better after at least one week of treatment, you should talk to your doctor. This is especially important if there are any blisters present because these can be signs of infection. Â
- If the rash is on the face and begins to spread down the neck and any blisters present, you need to be seen by a doctor to rule out herpes virus infection (cold sores). Your child must see your doctor within 24 hours if he has this type of skin reaction to start antiviral treatment ASAP.
3 . Most children have ‘flexural eczema,’ which shows up on skin folds of the body where skin rubs together â€“ behind knees, underarms, etc. If your baby develops flexural eczema early on, they may have more severe allergies later in childhood involving foods or medicines that most kids do not experience until much later.
4 . If your child has redness on their legs after being exposed to warm weather and she seems allergic to heat, it’s possible she may also be allergic to diapers/diaper detergent. You can switch to hypoallergenic disposable diapers for babies under age one year, and you should use a cool-water wash cycle instead of hot water when laundering cloth diapers.
5 . If your child’s rash does not respond to over-the-counter hydrocortisone cream or moisturizers (Cetaphil lotion), please see a pediatrician who will probably prescribe an antibiotic ointment for secondary bacterial infections and antihistamines like Elidel/Protopic to reduce itching and inflammation!
When to start eczema treatment in children?
- If your child’s skin gets red and itchy between the legs/buttocks, especially after exposure to heat such as warm bath water or playing outside in hot weather, consider using hypoallergenic disposable diapers instead of cloth for babies under age one year and use cool-water wash cycle in the laundry instead of hot water for laundering clothes. Delicately clean the diaper area with water or hydrocortisone cream formulated for babies.
2 . If your child’s rash looks like it’s starting to become infected, you must give appropriate antibiotics as directed by your pediatrician as soon as possible to prevent the spread of the infection and further damage to the skin barrier.
3 . When your child’s eczema starts to flare-up is when you need to begin using moisturizing creams daily. You can keep one in the kitchen, one at your bedside table, and maybe one for a school bag/locker. If you’re unsure which brands are best for your child, talk with their pediatrician about what ingredients to look for on labels (i.e., oatmeal or green tea extract, etc.).
Early treatment will lead to better management of the condition during childhood and help prevent flares from occurring in adulthood.
Eczema treatment for children with eczema: What’s next?
1 . Quickly treat secondary infections with antibiotics prescribed by your doctor! If it’s a more severe infection, your child may need to be hospitalized and given IV broad-spectrum antibiotics through a vein in the arm or a PICC line (peripherally inserted central catheter).
2 . Next, your child will need to be seen by a dermatologist for referral to an excellent pediatric allergist. Your child must see an allergist because they have expertise in eczema, food allergies, and asthma. They can do a scratch or patch test on the skin where eczema flares up to determine what is causing the skin reaction.
3 . Once the proper allergens are determined, you’ll be given a treatment plan that may include: allergy shots (your child gets tiny amounts of what they are allergic to and in time, the body builds up resistance), use of over-the-counter or prescription topical creams, oral medications or combination treatments.
- Homeopathic treatment for eczema is also one of the best ways to treat child eczema as it uses natural ingredients which is less likely to cause adverse effects. Homeopathy doctors will also give you a diet plan, which you can follow along with homeopathic medicines. The homeopathic treatment for eczema will help your child to lead a life without allergies and eczema flare-ups.
Finally, if your child has asthma and allergies to food or environmental allergens like dust mites, their eczema will need to be carefully managed. Homeopathic treatment for eczema can help children to have an increased immunity against various allergies. Eczema treatment for children is very important because it can help avoid further complications resulting from eczema. For more information, you can book an appointment with a homeopathy doctor through OHO Homeopathy now!