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Understanding childhood eczema: Causes and helpful treatments

Chances are that your child or a kid you know suffer from eczema – also called atopic dermatitis. Learning more about eczema will help you treat your child’s symptoms and flares more effectively. Dr. Tania Phillips, a dermatologist at SkinCare Physicians near Boston, explains the basics about this common skin condition, and offers helpful treatment instructions.

What is eczema or atopic dermatitis?

Dermatitis means inflammation of the skin.  Atopic dermatitis or Eczema is a common skin disorder that affects 10 – 20% of children.  It results in a rash and skin that is dry, itchy, inflamed and infected.

What causes eczema or atopic dermatitis?

Many children with atopic dermatitis do not have enough of a special skin protein called “filaggrin”.  Filaggrin helps the skin to form a strong barrier between the body and the environment.  Without this barrier the skin cannot hold onto water, so it becomes dry and itchy and is unable to keep out irritants like dust mites and bacterial. This then leads to more skin irritation and infections.  Scratching the rash usually aggravates the symptoms and may introduce a secondary infection.

How can atopic dermatitis be treated?

There is no cure.  Your goal is to prevent dry skin, decrease itching and control the rash.  Atopic dermatitis tends to be a chronic condition that may clear completely or flare if aggravated.  During the “flare” you can help your child’s skin heal faster by following the instructions below.  It is important to see your dermatologist who will treat all four of the skin problems at once:  dryness, itchiness, inflammation and infection.

Helpful treatment for eczema flares:

• Take a 10 minute bath in lukewarm water every day.
• No soap is needed, but if necessary, use unscented Dove or Cetaphil.
• For two weeks all baths should be bleach baths (bleach baths are like swimming pools, they will help to treat skin infections and also prevent future infections by reducing bacteria on the skin).
• Add ½ cup of plain bleach to a tub full of lukewarm water and stir the bath.
• Have your child soak their entire body, from the neck down, in the bleach bath for 10 – 15 minutes.
• After bathing, pat the skin dry.
• Apply medications prescribed by your dermatologist.
• Follow with a thick moisturizer like Vaseline or Aquaphor ointment. Use this moisturizer, even if no bath it taken.
• Avoid lotions as these can sometimes irritate the skin in eczema flares
• At night, follow with wet wraps (Wet wraps can help put water back in your child’s skin and calm the skin. They also help decrease the itch and help your child sleep. You will use wet wraps AFTER bathing and applying medications and moisturizers.)
• Wet Wrap – take one pair of pajamas, or onesie, and soak it in warm water. Wring out the pajamas (or onesie) until they are only slightly damp.
• Put the pajamas (or onesie) on your child. Then put the damp pajama (or onesie) on top of the wet one.
• Make sure that the child’s room is warm enough!
• Once your child no longer has an itchy, red or scaly rash, you can start to decrease the use of the treatments.

It is important to see your dermatologist if your child’s skin is not improving.  Since atopic dermatitis is a long lasting disorder, it is important to continue daily bathing and moisturizing.  This will help prevent your child’s atopic dermatitis from getting worse.

Please feel free to contact SkinCare Physicians’ office with any additional questions or concerns about your child’s eczema.