Eczema (Atopic Dermatitis)

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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.

Over-the-counter 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
relief
—May give fast relief of dry, itchy skin with few
side effects. Some of these medicines contain alcohol, which can cause a
burning sensation.

Oral
antihistamines
—May help relieve the itch (particularly the
kind that makes some people sleepy).

Prescribed medicines

Topical
steroids
—Used 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
antihistamines
—Come in several prescription types that may
be more effective in certain children.

Oral antibiotics—May
be prescribed if there is a secondary infection caused by scratching.

Oral steroids—Are
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.

Remember

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

www.aaaai.org

American Academy of Dermatology

www.aad.org

American College of Allergy, Asthma & Immunology

www.acaai.org

National Eczema Association

www.nationaleczema.org

National Institute of Arthritis and Musculoskeletal and Skin
Diseases

www.niams.nih.gov

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.