Eczema Strategies to Stop the Itching

Strategies to Stop the Itching

This is one ailment that can really make a parent feel helpless. Your child is itching and scratching, and it's impossible to convince her to stop. Yet there seems to be no reason for this itchy ailment that can cause children to scratch themselves raw.

Eczema, also called atopic dermatitis, is usually associated with dry skin. It starts with a pink or red area that becomes itchy. After your child scratches, the skin gets rough and scaly or--in infants--may ooze and form a crust.

Eczema is common in babies between the ages of 2 months and 18 months, but it can occur at any age. In fact, about 10 percent of us have an outbreak of eczema at some point in our lives, according to Hugh Sampson, M.D., a pediatric allergy/immunology specialist, professor of pediatrics and director of the Pediatric Clinical Research Unit at the Johns Hopkins University School of Medicine in Baltimore.

There's definitely a link between dermatitis and allergies. Many children with eczema come from families whose members suffer from hay fever, asthma and seasonal runny noses--and your child is more likely to have eczema if you or your spouse has had it. Also, everyday exposures to soaps, perfumes, dry air, heat or stress can trigger outbreaks of eczema. Generally, it waxes and wanes, though it often disappears completely as children grow up.

If your doctor has diagnosed your child as having eczema, he'll help you look for the factors that are triggering outbreaks so you can reduce your child's exposure. Because causes can differ, you may need to experiment to find what works best for your child. But here are what some of the experts recommend.

Limit bathing. Daily bathing isn't necessary, and it tends to make already dry skin even drier, says William Epstein, M.D., professor of dermatology at the University of California, San Francisco, School of Medicine. ''Instead, you can sponge bathe the parts of the body that really need it--the hands, face, neck, armpits and (for babies) the diaper area.'' When you do bathe your child in the tub, make it quick--don't allow time for splashing or playing. ''Get your child in and out quickly,'' says Bill Halmi, M.D., clinical assistant professor of dermatology at the Thomas Jefferson University Hospital in Philadelphia.

Try a soap substitute. If you use a soap substitute such as Neutrogena Rainbath shower and bath gel, your child can bathe daily, says Robert Rietschel, M.D., chairman of the Department of Dermatology at the Ochsner Clinic and clinical associate professor of dermatology at Louisiana State University and Tulane University School of Medicine, all in New Orleans. ''It does an excellent job of keeping the skin relatively free of bacteria,'' he explains, ''which in turn helps cut down on secondary infections.''

Another good soap-free cleanser is Cetaphil, says Karen Houpt, M.D., assistant professor of dermatology at the University of Texas Southwestern Medical Center in Dallas. Don't expect it to lather up like regular soap, however.

Choose unscented products. A moisturizer or soap can contain fragrances that will trigger a flare-up of eczema. ''Look for products that state that they're fragrance-free, such as the soaps Neutrogena and unscented Dove, and moisturizers like Neutrogena Norwegian Formula and Eucerin,'' says Dr. Houpt.

Keep it warm. Water should be warm enough to keep your child comfortable, but no warmer. ''Hot water is more drying than warm water and tends to remove the oils from the skin,'' says Dr. Halmi.

Wash gently. Try to wash affected areas with water only or water and soap substitute. ''But if you need to use a washcloth, be very gentle,'' says Dr. Houpt. ''The tendency is to take soap and washcloth and really scrub the rash down, but nothing could be worse.'' Scrubbing and soap irritate the skin and dry it further.

Apply moisturizer liberally. Right after bathtime, while your child's skin is still wet from the bath, is the perfect time to apply moisturizers. ''Mixing the oil with the water on the body will help hold some of the moisture in,'' says Dr. Epstein.

Dr. Rietschel recommends a cream such as Eucerin Creme rather than a lotion: ''Creams are heavy enough to seal the skin and keep the moisture in,'' he says. Plain petroleum jelly will work, too (although it produces a rather slippery child). ''Be sure to apply any moisturizer all over the body, not just to the affected areas,'' says Dr. Halmi.

Add cool compresses. ''After applying oils or moisturizers, top with a cool compress for particularly itchy areas,'' says Dr. Epstein. ''It helps soothe the skin.'' A washcloth soaked in cold water makes a good compress.

Keep nails short. To help limit the damage a baby or child can inflict on an itchy outbreak, keep fingernails clipped short and keep the edges of nails rounded, says Dr. Epstein. Another way to decrease nighttime scratching fits is to put mittens or socks on your child's hands at bedtime.

Keep 'em cool. Avoid overdressing or bundling up your child unnecessarily at night, because getting too hot can make the rash worse, says Dr. Halmi.

Choose snug PJs. ''Loose-fitting pajamas can actually cause more rubbing and irritation to the skin than close-fitting ones,'' says Dr. Halmi. So choose knit nightwear over floppy, button-down PJs.

Opt for cotton. Cotton clothing is the best choice for your child to wear against sensitive skin, says Dr. Halmi. Avoid wool, which can especially irritate eczema.

Double-rinse clothes. Because detergents can irritate skin, run your child's laundry through a double rinse cycle to help remove detergent residue, says Stephen M. Purcell, D.O., chairman of the Department of Dermatology at Philadelphia College of Osteopathic Medicine and assistant clinical professor at Hahnemann University School of Health Sciences. Also, avoid fabric-softening dryer sheets, because they put chemicals in the clothing that can irritate the skin.

Humidify the surroundings. Dry air can contribute to itchiness, and most homes with central heating are too dry in winter. When the heat goes on, run a cold-air humidifier or place pans of water on or near heat outlets, suggests Nelson Lee Novick, M.D., a dermatologist and associate clinical professor of dermatology at Mount Sinai School of Medicine in New York City and author of Super Skin.

Reach for the hydrocortisone. ''Hydrocortisone applied to the affected areas can help relieve the incessant itching of eczema,'' says Dr. Rietschel. Many hydrocortisone-containing over-the-counter products are available at pharmacies. Choose products in a 1 percent concentration and preferably ones that are ointment-based, rather than cream-based.

''The ointment-based form tends to boost the potency of the cortisone because it seals it in and then drives it through the skin in slightly greater concentrations,'' says Dr. Rietschel. If you only have cream cortisone on hand, add a coating of petroleum jelly over the cream to produce the same effect.

Try an antihistamine. An over-the-counter antihistamine such as Benadryl may help quell the itch, says Dr. Houpt, but only give it before bedtime because it's likely to make your child sleepy. Be sure to read package directions to make certain the product is recommended for your child's age. For the correct dosage, follow package directions or consult your physician. Dr. Houpt advises against using an antihistamine product such as Benadryl Spray directly on the skin: The direct application may cause an allergic reaction.

Take stock of your child's diet. ''There's a 20 to 30 percent chance that a food allergy may be causing your child's eczema,'' says Dr. Sampson. Children with eczema are most often allergic to eggs, milk, peanuts, wheat, soy, fish and tree nuts, although a child is usually allergic to only one or two of those foods. ''If you notice a clear-cut pattern where a food consistently creates problems for your child, then it should be eliminated from his diet,'' he says.

Reduce stress levels. Stress can trigger eczema or make it worse, says Dr. Rietschel. Encourage your child to talk about problems, offer help with homework and cut down on your child's activities if the two of you decide there's just too much in the schedule. And try to keep calm about the rashes themselves, Dr. Rietschel says, so your own worries don't add to the child's stress.