Eczema is overly dry skin. It may be rough, pink skin or thick and itchy plaques of cracked skin. It is the most common skin problem in pediatrics. Eczema sometimes results in generally dry skin and sometimes is seen only in small “thumb print” sized patches. Eczema runs in families, and it is especially common in children with allergies or asthma. Children with eczema have broken skin and are thus more likely to get other skin infections.
Eczema can be worsened by very wet or very dry environments. Some children have eczema on their feet from sweaty shoes. Most healthcare providers have eczema on our hands from frequent hand washing. Eczema may also be worsened with rubbing. A child might get a dry, rough patch from scratching or where clothing rubs.
WHAT TO DO:
- Moisturize, moisturize, moisturize! Choose an unscented emollient, such as Eucerin, Aquafor, CoCoa Butter, Aveeno, Vaseline, etc. The alcohol in scented lotions is drying, so avoid them. Dermatologist and allergists recommended moisturizing the dry patches 3 times per day or more.
- Seal the skin after bathing. Warm bathwater pulls oil from the skin, yet water prevents infection and can be hydrating. Either bathe children without soap or with a mild soap like Dove. When you take your child out of the tub, immediately pat them dry and seal moisture in the Skin with a good emollient or lotion.
- Keep fingernails short to prevent scratching.
- Hydrocortisone 1% over the counter may be applied twice per day to dry, rough, itchy skin that has not responded to moisturizers for 5-7 days. Then moisturize on top of hydrocortisone.
- For severe eczema consider wet to dry dressing overnight. Bathe your child, apply hydrocortisone and emollients, and cover affected skin with damp cotton clothing (a onesie or t-shirt, cotton leggings, socks, etc.). Then put regular pajamas over the damp layer. As odd as this sounds, the children stay warm and the skin gets rehydrated quickly.
WHEN TO CALL:
Never emergent – During office hours if:
- Skin is red, itchy, cracked, or thickened despite treatment
- Skin looks infected – red, pus or wet-looking, painful
- For other concerns