Eczema in Infants and Children
When my youngest son was a baby he developed an itchy red scaly rash primarily on his face and scalp. It was clearly visible in all his baby pictures. In some areas the skin was “weeping” which means that he had scratched his skin so much that there was infection of wet and oozing pus filled blisters. The skin would turn a crusty golden color as it scabbed. If you have an infant or child who has eczema or atopic dermatitis you can empathize with how difficult this skin condition can be for the child and for the parent. Needless to say, my son had much trouble calming himself and getting to sleep with all that itching going on. When we went to the doctor he gave us the following recommendations: Bathe him much less frequently, buy a humidifier for the winter months, use the gentlest type of soap for sensitive skin -free of allergens or perfumes, cut his fingernails so he cannot scratch, and use hydrocortisone cream for his itchy patches.
While these recommendations helped some, my son’s eczema continued into his toddler and childhood years. One thing we had not known when my son was a baby was that sometimes food allergies and intolerances can aggravate eczema. First we discovered that our son was allergic to dairy and replaced cow’s milk with soy milk. Then we found that he had an intolerance to soy and ended up giving him rice milk which he continues to drink today as a teen. Physical symptoms such as his eczema and chronic loose green stools prompted us to seek help from an allergist who did the skin prick test on my son. I watched as multiple welts formed on his back (a sign of possible allergy or food intolerance). In addition to having anaphylaxis to peanuts (we found this out earlier) he had a reaction to dairy, soy, and wheat. My son also has autism and we kept hearing about the gluten casein free diet for children on the autism spectrum. I finally implemented this diet for my son especially after we got the allergist’s report.
After implementation of a diet which eliminated the foods which caused a reaction from the skin prick test, my son’s eczema began to clear up. I wish I could say that it has totally disappeared but it does come back periodically especially in dry winter months or after he has taken too many showers or baths. He is especially sensitive to things like bubble bath which he loves, but causes his skin to erupt into a rash once again. In addition to maintaining his special diet, we do pretty much the same types of preventive measures now that we had done when he was much younger. We limit his time in the shower or bath, he doesn’t use very hot water which can dry out the skin, he uses a gentle soap, he uses a moisturizer right out of the shower, wears non-scratchy clothing (nothing wool), and uses hydrocortisone cream to help control the itching when his eczema flares up.
The thing I wish to point out is that every child’s eczema is different with different triggers for what makes it worse. If you suspect that your infant or child has eczema it is your best bet to ask your child’s pediatrician for guidance. Your child’s doctor is going to know best how to treat your child’s eczema.
Here are some quick facts and tips about childhood eczema:
- The National Eczema Association reports that childhood eczema is a very common condition affecting approximately 10% of all infants and children. Atopic Dermatitis is the type of eczema most common in infants and children. This type of eczema usually begins during the first year of life and almost always within the first five years of life.
- Atopic Dermatitis or eczema is not contagious or infectious. You need not worry that one of your children can give it to a sibling or anyone else. Although my youngest son has had to deal with eczema his whole life, my other son has never shown any signs of this skin disease.
- Heredity seems to play a big factor in Atopic Dermatitis. Physicians use a term called the “Atopic Triad” to describe allergic conditions including asthma, hay fever, and atopic dermatitis. It is quite common for these three ailments to run in the same family. It is certainly true for our family. The National Eczema Association cites the statistic that if one parent has one of the three conditions in the atopic triad (atopic dermatitis, hay fever, or asthma) the chances are about 50 percent that their child will have one or more of these conditions.
- It is reported that most of the babies who have atopic dermatitis will outgrow this condition by adolescence. But some people who had eczema as an infant will have it well into adulthood although there can be remissions which last for years. Dry skin may continue to be a problem in the adult years.
- Some typical triggers for childhood eczema include: Allergies to pollen or dust mites, catching a cold or virus, wearing scratchy clothing such as wool, dry skin, fragrances or dyes added to soaps or laundry detergents, prolonged exposure to water, feeling too hot or too cold, and stress. In some children food allergies or intolerances do play a part in triggering eczema. These foods typically include: Dairy, peanuts, eggs, or wheat. Please talk to your child’s doctor for a referral to see an allergist if you suspect that your child may have an allergy or intolerance to certain foods.
- In addition to environmental changes such as limiting the time your child is in the shower or bath and keeping their fingernails short to prevent scratching, medications may also be part of the treatment regimen for children who are older than two who suffer from eczema Topical corticosteroids are often suggested or prescribed by the physician. These topical creams come in a range of strengths and as they become more potent, there can be side effects. So we opted to try the mildest topical medication, hydrocortisone cream, to start. Other medications may include antibiotics, antihistamines, and a new family of topical medications called Topical calcineurin inhibitors (TCIs). TCIs work to inhibit the skin’s inflammatory response. Ask your child’s doctor about the risks of using a TCI medication as it can suppress the skin’s immune system.
Now it is your turn Do you have a child who suffers from eczema? What triggers seem to cause a flare up of eczema? What things have helped? Please share your tips and suggestions here. You could help someone else in the process.
References and Resources:
Health Central’s My Skin Care Connection: Eczema Information Page
The National Institutes of Health, Medline Plus : Atopic Eczema