Dry Skin or Eczema? Here’s what to do.
By Jennifer Seawell, MD, FAAP
It is the time of year when the weather starts getting a bit cooler and those with sensitive skin start experiencing dry itchy skin. Whether or not you have been diagnosed with eczema or just seem to be easily itchy, there are things you can do to help your skin.
What is Eczema?
Eczema is a skin condition where the skin gets patches which are dry, red, and irritated. Sometimes the cause is known, but often there is not a definite trigger. Eczema can show up anywhere on the body, but it particularly likes the creases of elbows and backs of knees. It also commonly occurs on the face and neck.
What causes eczema?
Most of the time, we just don’t know. I’m sure you all hate that answer about as much as we like giving it. We do know that in most cases, eczema has a genetic as well as an environmental component. So if you have eczema or lots of others in your family have it, you are much more likely to have a kid with it. There can be many environmental triggers for eczema. For those with seasonal allergies, outdoor triggers can be an issue. Some kids are sensitive to certain perfumes and other additives to cleaning products. For many, a drop in temperatures outside is all it takes.
This is a hot topic right now as parents are desperately looking for a cause for their kids’ itchy skin. There is a definite association between eczema and other allergic disorders (like asthma, seasonal allergies, food allergies). But just because your child has sensitive skin, does not mean they have food allergies. If you notice that your child’s skin seems to worsen after eating certain foods, it is worth a discussion with your doctor. But if you go thru the testing process and nothing comes up, don’t despair.
One of the most common irritants for kids with eczema is laundry detergent, soaps, shampoos, and lotions. For many kids, that lovely smelling laundry detergent may actually make things worse. So if anyone in your family has a tendency towards itchy skin, try washing all the laundry in one of the “free” detergents. There is a lot of competition between brands, so most of the major brands now have their own “free” versions.
Soaps and shampoos are also common irritants for kids. If your kiddo tends to suffer with itchy or sensitive skin, make sure to stay with the hypoallergenic or sensitive skin soaps and shampoos. Same goes with lotions. Keep it simple.
Many eczema kids find that their skin flares up after playing outside. This certainly doesn’t mean that they shouldn’t play outside. But it does mean we should take some extra precautions. Consider lightweight long pants for outside play so that your youngster minimizes the amount of direct contact with grasses and weeds. Once they are inside, a quick wash-down will remove any remaining irritants from the skin.
How do I fix it?
Unfortunately, there is not a cure for eczema. However, many will find that their skin does improve with time. And many who had significant issues as a toddler will even seem to have outgrown it by the teen years. There are luckily a lot of things we can do at home to minimize the symptoms from eczema.
We used to recommend that kids with eczema bathe only once or twice per week to minimize the drying effects of a bath. However, current thought is that more frequent bathing may actually be preferred, especially when there is a lot of outdoor play. So bathe when needed. But make sure that the bath water is not super hot and keep the baths short and sweet. Stick to hypoallergenic soaps and shampoos.
Moisture, moisture, moisture
Once your kiddo’s bath is done, pat them dry and be extra generous with moisture. Again, stick with the hypoallergenic lotions. Applying lotion while the skin is still moist from the bath will actually lock in the moisture. There is not one lotion or cream that is better than the others although we all have our favorites. Don’t be afraid to try several different things and see what works best for your kids. If you don’t know where to start, ask your pediatrician. They very likely have a bunch of favorites as well. Moisturize skin at least 2 times daily, and even a 3rd if needed. You are not going to overdo the moisturizing.
What if this isn’t enough?
If you’ve already made changes to hypoallergenic products and have been laying on the lotion all to no avail, it may be time to talk to your pediatrician. There are several medications that can be used to help out for particularly troublesome areas. Your doctor may consider a topical low potency steroid cream or an antihistamine. In very resistant cases, a referral to an allergist or dermatologist may be needed as well.
The Pediatric Ninja
This article is the professional opinion of its author and is not intended to take the place of medical advice, diagnosis or treatment from your personal physician.