Eczema, also known as atopic dermatitis, is a good example of a common and exasperating condition of childhoodcommon because around 10 percent of kids in the U.S. have this skin disease, according to the National Institutes of Health. And exasperating because there's no cureand it can be tricky to treat. It's a little like a boomerang: Although it's possible to get the rash under control, it's likely to come back periodically in what is called an eczema flare.
The telltale symptom of eczema is anitchy rashthat typically makes a debut in early infancy but can first show up as kids as old as 5. It's sometimes mistaken for other rashes, such ascontact dermatitis,heat rash,seborrheic dermatitis, and psoriasis, but it does have unique characteristics. A rash caused by eczemausually looks like patches of rough, red, itchy skin on the forehead, cheeks, arms and legs of infants, and in the creases or insides of the elbows, knees, and ankles of older kids.
On the bright side, if your child has eczema now in all likelihood he won't have to deal with it forever. For most kids, it eases up or even disappears entirely as they get older. In the meantime, there are plenty of treatment options as well as strategies for preventing rashes from flaring up.
How you deal with your child's eczema will depend in part on how old he is. Of course, you'll want your pediatrician to steer you toward the best medication for your child, but here are some helpful things to know about each one.
Topical steroids.These are a go-to for eczema flares. They range from over-the-counter hydrocortisone creams, which are so mild you can use them on your child's chubby little cheeks, to stronger mid- and super-potent ones that require a prescription. If used for too long, though, these can cause thinning of the skin and stretch marks. Prescription topical steroids should never be applied to the face or be covered by a bandage or diaper.
Immunomodulators. These topical eczema medications are also applied directly to skin (twice a day) and can be used anywhere on a child's body, including his face. They have another advantage too: They sometimes can snuff out a pending flare if used at the first sign of itching or a rash. The most common of these steroid-free medications are Elidel (pimecrolimus cream) and Protopic (tacrolimus ointment).
Antihistamines. If itching is keeping your child awake at night, a sedating antihistaminesuch as Benadryl (diphenhydramine), may help him get his beauty rest. (An angry itch also can be tamed with cold compresses or wet dressings.)
For stubborn eczema that doesn't respond to any of the standard treatments, there are more aggressive ones, including oral steroids, ultraviolet light therapy, and immunosuppressive drugs, like cyclosporin. Sometimes kids get skin infections along with stubborn eczema, in which an antibiotic may be needed.
Eczema flares are especially likely to happen inwinterwhen the air is dry, and in summer if a child spends a lot of time swimming or gets overheated. During the periods of time when your little one's eczema is most likely show up, the first step you can take to prevent that from happening is to avoid anything you know is likely to prompt a flare. Common triggers for eczema include harsh soaps,dust mites,foods your child may be allergic to (often kids with eczema also have seasonal allergies or asthma), overheating and sweating, and wool and polyester clothing.
The second strategy for preventing eczema flares is to keep your child's skin moist and supple. Overly dry skin is like an open invitation for eczema to settle in, so do all you can to prevent it. Here are the steps to take:
Give your child adaily bath. Use lukewarm water and a mild, moisturizing soap or soap substitute. Hot water and harsh soaps can exacerbate dry skin. Keep him in the water for 10 minutes or so.
Lather on the moisturizer. Do this as soon as you lift your little one out of the tub. Blot him with a towel so he's isn't dripping wet, but don't rub him completely dry. Apply moisturizer while his skin is still dampwithin two or three minutes. If you're also using a topical medication, apply that first.
Choose the right product. A greasy ointment, such as petroleum jelly, will work best. Some creams can do the trick, but steer clear of lotions and oils. You may have to try a variety of products to find the one that works best for your child. If you can't find an over-the-counter product you like, your pediatrician may prescribe a non-steroidal cream.
Moisturize multiple times.Besides after a bath, grease up your kid at least once or twice more during the day.
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