Eczema (Atopic Dermatitis)
Eczema is a chronic skin problem that causes dry, red, itchy skin. It is also called atopic dermatitis or AD. Anyone can get eczema, but it is most common in babies to young adults.
Your child's doctor can help you and your child relieve the symptoms and keep them under control. The following information from the American Academy of Pediatrics is about eczema and how to help your child avoid "the itch."
Who gets eczema?
Eczema is the most common skin problem treated by pediatric dermatologists. About 65% of patients develop symptoms before age 1, and about 90% of them develop symptoms before age 5. Because eczema is a chronic skin problem, these symptoms can come and go. There are times when the symptoms are worse (called exacerbations or flares) followed by times when the skin gets better or clears up completely (called remissions).
Many babies outgrow eczema by age 4. Some children outgrow eczema by the time they are young adults, although their skin remains dry and sensitive. A few may have it all their lives, but there are ways to relieve the symptoms.
Eczema often runs in families with a history of eczema or other allergic conditions such as hay fever and asthma. It is not contagious.
What are the symptoms?
The symptoms of eczema are different with each child. Common symptoms include dry, red, itchy skin and rashes. These rashes can be oozing or very dry.
Eczema can appear anywhere on the body or in just a few areas. In babies, a rash often appears on the face and scalp. In teens and young adults, a rash often appears on the hands and feet.
How to prevent flare-ups
One of the most helpful things you can do is to prevent flare-ups before they happen.
Keep your child's skin moisturized. Moisturizing should be a part of your child's daily treatment plan.
Use fragrance-free moisturizers. Cream or ointment is more moisturizing than lotion.
After a bath, gently pat the skin with a towel and then apply moisturizer to the damp skin.
Apply moisturizer at least once a day or more often if needed. Moisturizer should be applied to the face and entire body.
Avoid irritants. People who are sensitive to scratchy fabrics or chemicals in soaps and detergents should
Wear soft fabrics such as 100% cotton clothing.
Use mild, fragrance-free body cleansers.
Take short baths with room temperature water.
Use mild laundry detergent with no dyes or perfumes.
Skip using fabric softener in the dryer.
Remind your child not to scratch. Scratching can make the rash worse and lead to infection. Also, the more your child scratches, the more itchy the area will be. Keep your child's fingernails short and smooth, and try to distract your child from scratching.
Ask your child's doctor if allergies could be a cause of the eczema. Sometimes allergies, such as ones to food, pets, pollens, or dust mites (in bedding), can trigger the rash or make it worse. If your child's eczema is caused by an allergy, avoid the trigger, if possible.
Ask your child's doctor about other things that can trigger a flare-up. These things include overheating or sweating and stress.
Use of medicines
Your child's doctor may recommend medicines to help your child feel better and to keep the symptoms of eczema under control. The type of medicine recommended will depend on how severe the eczema is and where it appears on the body. The medicine can be given in 2 ways: applied to the skin (topical) or taken by mouth (oral). Topical medicines are available as creams or ointments; oral medicines are available in pill or liquid form.
Medicines that only a doctor (and some other health professionals) can order are called prescription medicines. Over-the-counter (OTC) medicines are available without a doctor's order. This does not mean that OTCs are harmless. Like prescription medicines, OTCs can be very dangerous to a child if not taken the right way.
Before you give your child any medicines, be sure you know how to give them. Talk with your child's doctor if you have questions or concerns about giving your child medicines.
Topical steroids (hydrocortisone creams or ointments)May help relieve itchy skin and decrease inflammation. They work best for mild eczema.
Steroid-free topical itch reliefMay give fast relief of dry, itchy skin with few side effects. Some of these medicines contain alcohol, which can cause a burning sensation.
Oral antihistaminesMay help relieve the itch (particularly the kind that makes some people sleepy).
Topical steroidsUsed to reduce pain, redness, and swelling and to stop the itch. Uncommon side effects, including thinning of the skin, stretch marks, or acne, may occur if not used as recommended and if used for long periods.
Topical immunomodulators (steroid-free medicines)Used to reduce inflammation and stop the itch. They are a new class of medicines shown to work in 80% of studies done in children older than 2 years. Studies are currently being done to test the safety of their use in younger children.
Oral antihistaminesCome in several prescription types that may be more effective in certain children.
Oral antibioticsMay be prescribed if there is a secondary infection caused by scratching.
Oral steroidsAre rarely recommended, especially for young children, because they pose many health risks. Also, after patients stop taking these medicines, they often have rebound flare-ups.
Eczema is a chronic skin problem, so it can come and go. It requires ongoing management by you, your child, and your child's doctor. If your child's eczema is not improving, talk with your child's doctor about your concerns.
For more information
American Academy of Allergy, Asthma & Immunology
American Academy of Dermatology
American College of Allergy, Asthma & Immunology
National Eczema Association
National Institute of Arthritis and Musculoskeletal and Skin Diseases
Listing of resources does not imply an endorsement by the American Academy of Pediatrics (AAP). The AAP is not responsible for the content of external resources. Information was current at the time of publication.
Copyright © 2007
American Academy of Pediatrics, Updated 10/2013
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