Given the amount of hay fever and asthma in my and my husband's family, and my own struggles with eczema, it's not a surprise that my kids deal with it, too. It's one of those "gifts" of heredity, you might say. Throw in the cold and dry air of winter, and we are an itchy, scratchy lot. Lovely.
Winter is prime time for certain skin issues. Dry skin may be just that - dry skin. Sometimes it's more - in which case a good relationship with your dermatologist and persistence in treatment are essential. And some serious compassion, too; if skin issues are frustrating to you, just imagine how frustrated your 4 year old might be.
Is it dry skin or something else?
Only a doctor can tell you for certain that you or your child has eczema, but there are some strong clues:
- An itchy rash, that may be rough, red, scaly, or oozing. Or all of those things.
- It comes and goes, or becomes more or less intense, seemingly without reason.
- Family history or eczema or hay fever and allergies.
My kids are "fortunate" enough to have all those clues. The dermatologist could have said it was contact dermatitis, or some other kind of rash, but she didn't. She said, "Yes, it's eczema." But with all the possibilities, it's important to work with you doctor on this.
Can I prevent it?
In our family, we don't seem to be able to prevent eczema flare ups, but we do take steps to mitigate them. Simple, somewhat obvious things help us deal with it. They include (but aren't limited to) these:
- Some eczemas have an allergic component. Watch for flare ups after eating certain foods. I knew one little girl who would get awful flareups after eating oranges. My kids don't seem to have these food associations however.
- Stick with soft natural fibers close to the skin. Rough fibers irritate eczema patches.
- Try to avoid potentially irritating substances, such as bubble-bath.
- Baths shouldn't be too hot, thus further drying out the skin, and be very careful about the soaps you use. Eczema can be very sensitive to soaps. Use the least amount possible.
- Make sure you have humidifiers to try to combat the very dry air of winter.
- Moisturize, moisturize, moisturize. I'm constantly urging the kids to use good quality lotions (without perfumes). I also have special tricks. I have a stick of cocoa butter that I swipe across their cheeks on particularly cold, dry, and/or windy days.
- Keep fingernails short to impede itching.
How can I treat it?
If eczema gets really bothersome and preventative steps aren't helping much, there are further steps you can take in consultation with your doctor.
- Steroid creams, prescribed by your doctor, can be very effective. It's important to use them consistently. While they may never cure the eczema completely, they really do help. There are also some newer non-steroid creams that may be effective for you.
- After baths, get a moisturizing cream on the body immediately. (The lotions should go over any steroid cream.) Not only does it help manage the eczema, it feels really good. Look for creams without perfumes. Your doctor probably has a list of particularly good ones; we use a fair bit of Cetaphil in this house.
- If the itching is really bad and your child is having trouble sleeping because of it, your child might need an antihistamine. Consult with your doctor if this is appropriate in your case.
- In spite of efforts and treatments, flare ups do happen. Keep a close eye on them, and keep them clean. If you suspect an infection has developed, call your doctor immediately.
The good news about eczema is that many kids outgrow it. Not all, but many. In the meantime, management and control are the goals.