Atopic dermatitis (eczema) in children

Atopic dermatitis, or eczema, is the most common skin disease in children. It can be severe and life-altering. Fortunately, in many cases, it lessens with age. In infants, it most commonly involves the face and scalp, but sometimes all of the skin is involved. The itchiness induces scratching and rubbing (called the itch-scratch cycle), which in itself worsens the inflammation and itch, leading to sores and sometimes skin infection. Most children "outgrow" eczema, but in some cases, flares continue and reoccur throughout their lives.

Emotional pain and isolation

Growing up with eczema causes a severe amount of emotional hardship for both the parents and the child sufferer because of its impact on appearance. The chronic discomfort limits nighttime sleep (for both the child and parents), which can interrupt focus and lead to sleepiness at school. Furthermore, school-age children with this condition are often subject to ridicule by classmates. The persistent itching and visible inflamed sores may lead children to isolate themselves from others in order to avoid further embarrassment. This often results in a loss of self-esteem or lower productivity at school.

Parents and caregivers face many challenges when caring for and nurturing children with eczema. They often must make many life changes including giving up family pets, replacing carpets with wood floors, avoiding sea water beach vacations and altering social plans when children are suffering. They must also be aware of the potential emotional problems caused by the condition and proactively discuss concerns and solutions with their child and his/her teachers.

Current treatment

Parents and doctors usually work through a range of current treatments to find the best way to help these children. Common treatments include:

• Antihistamines
• Topical prescription steroid creams and ointments
• Antibiotics for skin infections

For severe cases, treatments include:

• Systemic corticosteroids
• Phototherapy (ultraviolet A or B)
• Photochemotherapy

Many dermatologists report that patient dissatisfaction with these therapies often result in patients becoming frustrated with and discontinuing their treatment programs.

Tips to help your children

In order to help control the itching associated with eczema and its inflammations, parents, caregivers and sufferers must establish a regular skin care routine with a physician. Tips to minimize inflammations include:

• Wear cotton or non-irritating clothing to avoid common skin irritants.
• Keep the bedroom cool to avoid sweating during the night that could trigger flares.
• Take brief, lukewarm baths and showers using mild soap or non-soap cleansers.
• Gently wash and pat the skin dry with a soft towel as opposed to wiping skin dry after cleansing.
• Apply lubricants (creams or ointments) and anti-inflammatory medications (as prescribed by a doctor) to affected areas immediately after drying.
• Cut the child's nails short to avoid scratching and risk for infection.
• Educate teachers and other caregivers on the child's condition. Inform them that they may need to administer medications during school.

During the first year, at least one third of children with eczema will have allergies to particular foods. While some foods may trigger attacks, most researchers agree that eliminating them is not a cure. Always consult with a physician first before altering an infant or toddler's diet.