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A Parent's Guide to Managing Childhood Eczema: Practical Tips and Care Routines

by Yuyu. Published on .

Is your child's eczema making everyday life a challenge? Imagine gentle, effective strategies that soothe their skin and bring peace to your routine. Welcome to our comprehensive guide on managing childhood eczema—packed with practical tips and care routines tailored just for your little one.

Eczema can feel overwhelming, but there’s hope. From choosing the perfect moisturizer to identifying and avoiding triggers, we'll equip you with the knowledge to manage flare-ups and keep your child's skin happy and healthy. We’ll dive into special bathing routines, stress the importance of clothing choices, and explore how to handle eczema at school.

Ready to transform your approach to eczema care? Read on to discover tried-and-true methods and create a comforting environment for your child.

Eczema in baby
Credit: Aisylu Ahmadieva / Shutterstock

Bathing and Moisturizing Routines

Bathing is an essential part of managing eczema in children. The key is to use lukewarm water and gentle, fragrance-free cleansers.

Hot water can dry out and further irritate the skin. Opt for a non-soap cleanser formulated for sensitive skin and avoid using heavily fragranced bubble baths or soaps.

Gently cleanse the skin using your hands, a soft washcloth, or a soft sponge. Be extra gentle on active eczema patches. After bathing, pat the skin dry with a soft towel. Avoid vigorous rubbing as this can trigger flare-ups.

Moisturizing immediately after bathing helps seal in moisture while the skin is still damp. Choose an unscented moisturizer designed specifically for eczema-prone skin. Look for formulas containing ceramides, hyaluronic acid, colloidal oatmeal, and shea butter. These ingredients help repair the skin's moisture barrier and provide relief from itching. Thicker ointments and creams tend to work better than lotions.

Establish a consistent routine and make moisturizing a habit.

Apply moisturizer liberally over the entire body immediately after bathing and pat it in gently. You may need to apply a couple coats to help the skin retain more moisture. Continue moisturizing your child's skin at least twice a day.

Identifying and Managing Triggers

Eczema flare-ups can often be triggered by certain irritants and allergens. By identifying your child's specific triggers, you can take steps to avoid or minimize exposure.

Some of the most common triggers for childhood eczema include:

Fabrics - Rough, scratchy fabrics like wool can cause skin irritation. Stick to soft, breathable fabrics like cotton and silk. Remove labels from clothing and wash new clothes a few times before wearing.

Weather - Cold, dry air in the winter tends to worsen eczema. Use a humidifier and keep your child's skin moisturized. Overheating in the summer can also trigger flares.

Food - Common food allergens like eggs, dairy and wheat can provoke eczema. Work with your doctor to identify any food sensitivities and eliminate trigger foods.

Irritants - Soaps, detergents, chlorine, dust mites and pet dander are potential irritants. Use gentle, fragrance-free cleansers and laundry detergents. Vacuum and dust regularly.

Stress and emotions - Stress and strong emotions may exacerbate eczema. Help your child manage stress through relaxation techniques.

Infections - Bacterial or viral infections can lead to flares. Practice good hygiene and treat infections promptly.

Create an allergen-free environment at home by using dust mite covers, washing bedding weekly in hot water, removing carpets and upholstery, and avoiding pets if allergic.

When triggers can't be fully avoided, take preventive measures. Moisturize before going out in cold weather, have your child wear long sleeves, or give antihistamines before exposure to known allergens. Work closely with your family physician to develop a management plan.

Itch and Scratch Management

Itching and scratching are some of the most challenging aspects of managing eczema in children. The intense itch-scratch cycle can severely disrupt sleep, school, play, and everyday life. While scratching provides temporary relief, it actually makes the eczema worse over time.

There are several strategies to help prevent and control scratching:

Distraction Techniques

Keep your child's hands busy to prevent scratching. Engage them in activities like crafts, drawing, reading, puzzles or playing with fidget toys. Provide regular reminders to stop scratching. Cool the skin by applying cold compresses, wrapped ice packs or cool gel packs.

Avoid Scratching

Have your child sit on their hands or wear mittens to discourage scratching. Keep nails short and smooth to minimize skin damage. Use adhesive bandages to protect especially itchy spots.

Consider over-the-counter anti-itch creams with pramoxine or calamine lotion.

Treat Chronic Itch

For severe itch, prescription medications like oral antihistamines may provide relief. Topical corticosteroids and calcineurin inhibitors can reduce inflammation and itch. Light therapy and medications like gabapentin may also help in difficult cases. Work closely with your child's doctor to find an effective itch relief strategy.

The key is addressing the itch-scratch cycle early on before it becomes a habit.

Clothing Tips

Choosing the right fabrics can make a big difference in your child's comfort and reduce irritation from eczema. The best options are soft, breathable fabrics like cotton that won't chafe or overly irritate your little one's sensitive skin. Do look for items labeled 100% cotton or with a high cotton content.

You should avoid wool, polyester, and other synthetic fabrics which can worsen itching. The fibers in wool and polyester don't breathe as well. They can trap heat and sweat next to your child's skin, creating more irritation.

It's recommended to stick to cotton, especially for clothing layers that touch your child's skin directly.

When doing the laundry, skip fabric softeners and dryer sheets. The added perfumes and chemicals can remain in the fabric and provoke eczema flare-ups. Instead use a fragrance-free, sensitive skin detergent and skip the fabric softener. An extra rinse cycle can help remove traces of detergent that may otherwise linger.

Look for clothes without tags, seams, or embellishments that could rub and irritate the skin. Turn garments inside out to prevent the seams from making direct contact. Remove tags or trim them if possible. Seek clothes with flat seams rather than thick, raised ones. Opt for soft, simple, seam-free fabrics whenever you can.

Diet and Lifestyle Modifications

A child's diet and lifestyle can play an important role in managing eczema. While food allergies are not a direct cause of eczema, certain foods can trigger flare-ups in some children.

It's important to identify any problem foods and remove them from your child's diet. Common trigger foods include dairy, eggs, soy, wheat, nuts, and seafood. Work with your doctor or dietitian to pinpoint your child's eczema triggers.

Adding supplements like vitamin D, probiotics, and omega-3 fatty acids may also help reduce inflammation and strengthen the skin's barrier function. Talk to your pediatrician before starting any supplements.

Stress is another major eczema trigger for kids.

Finding ways to manage your child's stress through relaxation techniques, physical activity, and good sleep hygiene can prevent flare-ups. Teach them calming exercises like deep breathing, visualization, and progressive muscle relaxation. Limit stressful activities and aim for consistent, early bedtimes. A relaxing pre-bed routine with a lukewarm bath and reading time can set the stage for better sleep.

Making targeted lifestyle changes tailored to your child's specific triggers is key. Keep a symptom journal to identify patterns and work closely with your child's doctor to find an eczema management plan that works. With time and consistency, you can get flare-ups under better control.

Topical Treatments

Topical treatments are an important part of managing eczema in children. These medicated ointments and creams can reduce inflammation, fight infection, and hydrate the skin.

Over-the-Counter Options

For mild cases of eczema, over-the-counter hydrocortisone creams may provide relief from itching and inflammation when used sparingly. Look for low-dose hydrocortisone preparations. Other over-the-counter options like petroleum jelly, ceramide creams, and thick ointments can help seal in moisture. Avoid products with fragrance, dyes, or other irritants.

Prescription Topical Steroids

For moderate to severe eczema, your doctor may prescribe topical corticosteroid creams or ointments. These work by reducing swelling and irritation.

Stronger prescription steroids should be reserved for severe flare-ups and used for short periods under medical supervision.

Potential side effects include skin thinning, stretch marks, and surface blood vessels.

Steroid phobia or fear of side effects can lead parents to under-treat eczema. Work closely with your doctor to find the lowest potency steroid that provides relief.

Appropriate Use

Use the "finger tip unit" method, applying a thin layer of topical steroid to cover an area the size of the tip of an adult finger. Only treat active eczema lesions, not unaffected areas.

Topical steroids should not be abruptly stopped, but rather tapered off to avoid rebound flares. Follow your doctor's instructions carefully.

Complementary Therapies

Complementary therapies are often used alongside conventional treatment to provide additional symptom relief for eczema in children. Some of the most common and beneficial complementary options include:

Phototherapy

Phototherapy involves exposing the skin to ultraviolet light under medical supervision.

For children, narrow band UVB phototherapy is most commonly used. It can help reduce inflammation, scale, redness and itching.

Phototherapy
Photo by Mufid Majnun

Phototherapy treatments are done 2-3 times per week in a doctor's office.

Wet Wrap Therapy

Wet wrap therapy involves applying topical medications and moisturizers to the skin, followed by wet cloth bandages. These wet wraps are then covered with a dry bandage outer layer.

The wet wraps boost the absorption of medicated creams and provide a protective barrier to prevent scratching. This can rapidly heal severe flare-ups.

Evening Primrose Oil

Evening primrose oil is an oral supplement derived from the seeds of the evening primrose plant. It contains gamma-linoleic acid (GLA), an omega-6 fatty acid that helps reduce inflammation.

For children over 1 year old, evening primrose oil can help strengthen the skin barrier when taken daily.

Mind-body Approaches

Mind-body approaches like meditation, guided imagery and hypnosis leverage the mind-body connection to influence physical symptoms. Teaching children relaxation techniques has been shown to help reduce feelings of stress/anxiety and lower inflammation. Apps, videos, and audio recordings make guided practices accessible.

Other complementary options include salt baths to reduce bacteria on the skin, silk clothing to avoid irritation, and acupuncture to balance energy and boost immunity. Always consult your child’s doctor before beginning any new therapies. With an integrative approach, eczema can be managed effectively.

Promoting Emotional Resilience

Eczema can take an emotional toll on children, so it's important to provide support and build resilience. It's important to encourage open communication with your child about their feelings and experiences.

Let them know it's okay to feel frustrated, sad, or upset sometimes. When doing so, validate their emotions and don't minimize their struggles.

Look for opportunities to praise your child and build their self-esteem. Compliment them on how they're handling their eczema so well. Celebrate small wins and milestones in their treatment journey. Focus on their positive qualities and strengths.

Consider joining an eczema peer support group, either locally or online such as Eczema Exchange. Connecting with other children who understand their experiences can provide comfort and boost confidence. Share tips and encouragement with each other. Just knowing they're not alone makes a big difference.

Work on problem-solving skills together. When facing eczema challenges like itching or teasing, brainstorm ways to handle the situation. Over time, they will build resilience and be able to self-soothe more effectively. With your support, they can thrive while managing eczema.

When to Seek Medical Care

It's important to keep a close eye on your child's eczema and know when to seek medical attention. Contact your child's doctor right away if you notice any of the following:

Signs of infection

Eczema can leave skin vulnerable to bacterial, viral, and fungal infections. Watch for symptoms like honey-colored crusting, pus-filled bumps, swelling and redness beyond the typical rash, fever, and chills. Skin infections require prescription antibiotic or antifungal treatment.

Uncontrolled itching and loss of sleep

Intense itching that disrupts sleep is a sign that the current treatment plan isn't working. Lack of sleep can affect your child's growth, mood, and ability to focus at school. Tell your doctor so they can adjust medications or treatment approaches.

No improvement with over-the-counter treatment

If gentle moisturizers, bathing techniques, and environmental changes don't relieve your child's eczema after 2-4 weeks, it's time to make an appointment. The doctor can assess severity and determine whether prescription anti-inflammatory creams or oral medications may help get the rash under control. Don't hesitate to seek medical advice.

While mild-to-moderate childhood eczema can be managed at home, it's crucial to involve your child's doctor if you have any concerns about worsening symptoms, infections, or lack of improvement with basic care techniques. Ongoing communication with your healthcare provider is key to finding an effective treatment plan for your little one.

Conclusion

Managing childhood eczema can feel like navigating a maze, but with the right strategies and routines, you can significantly ease your child's discomfort and improve their quality of life. By following our comprehensive guide, you’ve learned the importance of soothing bath times, selecting suitable clothing, and creating a supportive school environment. You’ve also discovered how to address emotional challenges, prevent scratching, and identify eczema triggers.

Remember, you’re not alone in this journey. Involving your child in their care empowers them and fosters a team approach, making the treatment routine more manageable and less stressful. Support siblings and other family members to build an understanding and empathetic household.

By planning ahead for flare-ups and seeking professional help when necessary, you ensure that you’re always prepared to manage your child’s eczema effectively. Keep these tips handy and continue to adapt and refine your approach as you see what works best for your little one.

With these practical, holistic approaches, you’re well on your way to soothing and nurturing your child’s eczema-prone skin, helping them feel more comfortable and confident every day. Here's to healthier skin and happier days ahead!

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