Mar 17, 2015 — Do you feel like you’ve tried everything to get your kid to stop scratching at his eczema but nothing’s worked? A short bath might help. Dr. Tom Miller discusses childhood eczema with dermatologist Dr. Mark Eliason, who gives some helpful information on the condition and the best ways to treat it at home.

Interview

Dr. Miller: Your child has eczema. How do you stop that scratching and itching that's driving them crazy? We're going to talk about that next on Scope Radio. I'm Dr. Tom Miller.

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Dr. Miller: I'm here with Dr. Mark Eliason. He's an assistant professor in dermatology. Mark, how do you help kids get through eczema?

Dr. Eliason: I'd love to talk about that. Eczema also called atopic dermatitis in children. It's a condition that occurs . . .

Dr. Miller: Atopic, what does that mean?

Dr. Eliason: Oh, atopic means that someone develops eczema with kind of a family disposition. It's not that they ran into something that caused the eczema, it's not that they're doing something wrong, their skin just tends to do this easily on its own.

Dr. Miller: So they tend to come from a family of scratchers and itchers?

Dr. Eliason: A lot of people in their family probably have it. So, when we help and we counsel parents who have children who have atopic dermatitis, we talk to them about some strategies they can use at home. In addition to some of the medications they can get from their pediatrician or dermatologist, there are some simple things that they can do to make it better. One of them is to try to make sure the skin stays moist. Kids with atopic dermatitis dry out a lot faster than the average person, and their skin doesn't always look dry. It doesn't always look flaky or look like it's peeling off, but it is dryer than the average person's skin.

Dr. Miller: So would that be more common in dry climates?

Dr. Eliason: It's exacerbated and worsens in dry climates such as Nevada and Utah.

Dr. Miller: Perfect.

Dr. Eliason: Yeah. So what we often talk to people about are ways to avoid making the skin dryer. And this sounds pretty counter-intuitive, but bathing can actually be a problem. Our skin stays moist, not because of water, but because of oils that we produce naturally, and children with atopic dermatitis make less of this oil and they can't keep it in there like a normal person can.

Dr. Miller: So too frequent bathing could definitely be a cause . . .

Dr. Eliason: Right.

Dr. Miller: . . . or an exacerbant.

Dr. Eliason: Precisely. In our culture, we encourage people to bathe every day, but in actuality, our skin doesn't actually need it, and it can actually be harmful. It's okay to take a bath that's warm, that's comfortable. But a bath that's blazing hot is not good. Or a bath that's too long, longer than 10 minutes or so can actually start to pull more oils out than they have and it will make things worse when they get out of the bath.

Dr. Miller: Now what would be the typical age range for children with eczema? What would be the peak ages, if there is such a thing for eczema?

Dr. Eliason: Well so it happens at any time. For most kids, it happens before puberty, and then it will sometimes happen though in adulthood.

Dr. Miller: It tends to get better after puberty?

Dr. Eliason: So it's a rough estimate, but about a quarter of kids grow out of it as they go through adolescence. When we talk to parents also, we talk to them about simple things they can also try to help their kids with, which includes things like when kids are bathing, you want to use milder cleansers, not the harsh bar soaps but maybe mild soaps, the kinds that don't bubble up or form a lot of lather.

Dr. Miller: Such as?

Dr. Eliason: Cetaphil cleansers is one example. Eucerin cleansers, a lot of these soaps that are kind of targeted towards dry skin or hypoallergenic can be helpful. Soaps that have fragrances in them can also be irritants. When your kid get out of the bath tub, it's also a useful thing to do is to moisturize them right away using creams instead of lotions, as lotions don't really moisturize as well as the cream does.
Kids that still are having problems beyond that sometimes benefit from the use of antihistamines, things like Benadryl in the evening. Again, you want to make sure they're safe to take those, but those can take away some of the itching, and by helping kids get a little bit sedated will actually help them fall asleep sometimes when the flares are really bad.

Dr. Miller: So frequent bathing, not a great idea, use mild soaps, and use creams to keep the skin moist.

Dr. Eliason: Exactly. And we even have children sometimes be on creams into ointments or things that have names like Aquaphor or even Vaseline is a simple, very effective thing that can keep the skin very moist and lubricated, and it helps to avoid overuse of some of the prescription medicines that doctors use.

Dr. Miller: And so if those things aren't working, maybe see the dermatologist?

Dr. Eliason: Definitely.

Dr. Miller: Thanks very much, Mark.

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