Childhood Eczema: What Parents Need to Know

What Are the Warning Signs?

In making a diagnosis, a physician will use clues from a family's history of allergic disorders, allergies, or asthma in the child and will look for the characteristic rash in a typical distribution. The location of the rash tends to change with age. In infants, the face is usually affected. By childhood, eczema distributes itself mostly on the extensor surfaces, behind the knees and the inner arm where it bends at the elbow. Eczema tends to come and go, just like its allergic counterparts asthma and seasonal allergies—and while there is yet no cure, commonsense strategies and the right medicines can keep it under control.

How Is Eczema Managed?

There are four broad components to eczema management:

Education: Eczema is a chronic condition with expected remissions and relapses. Parents should look to their heathcare providers for information about the condition, everyday care for eczema-prone skin, how to look for and eliminate triggers, and how best to manage flare-ups promptly. The emphasis is on good control and a normal lifestyle.

Moisturizing: An important function of the outer skin layer is to act as a barrier, both to keep germs out and to lock moisture in. Eczema-prone skin does not provide as good a barrier, and moisture leaks out more readily, making moisturizing the skin essential. The "soak and seal" method is popular: after a 10- to 15-minute, warm (but not hot) bath, pat your child's skin gently until it is almost dry. Then apply a high-quality moisturizer. Skin absorbs water during the first ten minutes of a bath, but a long bath causes moisture loss, as anyone who has soaked to the point of wrinkled fingertips knows. The idea is to absorb water while in the tub, get out, and trap that moisture in with an ointment that provides a barrier against moisture loss. Ideally, moisturizer should be applied within a few minutes of emerging from the tub.

The type of moisturizer used is important, too. Thicker ointments are more effective barriers than creams, and lotions are the least effective. Commonly recommended ointments are Vaseline, Aquaphor, Crisco (yes, Crisco), Nivea, and Eucerin. In hot, humid weather, ointments can feel uncomfortable, in which case creams such as PMLForte, Moisturel, Curel, Aveeno, or Purpose are acceptable alternatives. Since soaps can be irritating, their use should be minimized. Only truly dirty areas such as the face, hands, and bottom need to be soaped—and then only sparingly. Less irritating soaps include Dove, Oil of Olay, Aveeno, Caress, or a baby shampoo.