Winter 2008

Red, Itchy, Scaly Skin? Maybe It’s Eczema

Keeping your child’s skin well hydrated is the first line of defense

An interview with Amelia Kaymen, M.D., dermatologist

Eczema is a term for a family of skin conditions in which the skin becomes dry, red, irritated and itchy. The skin may develop small fluid-filled bumps that become oozy. The most common form of eczema, called “atopic dermatitis,” affects approximately 20 percent of children.

“Eczema is a dermatitis caused by inflammation of the immune system,” says Amelia Kaymen, M.D., a dermatologist at California Pacific Medical Center. “It is not contagious. In children, we often see it in the fold of the elbows and behind the knees, but it also can appear on the face or other body parts.”

Kaymen notes that there is a genetic predisposition for developing eczema. “Children with eczema usually have a family history of the condition,” she explains. “Kids with eczema also often have family members with allergies and may have allergies themselves.” Eczema is not an allergic reaction, but some children with eczema are allergic to things—such as animal dander—that can make the condition worse.”

Proper Skin Care Is Key

“Because the tendency to develop eczema is inherited, it’s not really preventable,” Kaymen says. “It may be possible to prevent flare-ups, though, by maintaining the proper moisture balance of the skin, which is the body’s barrier to the outside world. Treatment for eczema entails keeping the skin well-hydrated—never let the child’s skin dry out.”

Kaymen offers a number of suggestions for preventing and treating eczema flare-ups:

Bathe the child infrequently, no more than twice a week.
Avoid using soaps or bubble bath that can strip the skin’s natural oils.
Wash the child’s hair at the end of the bath, so he or she doesn’t sit long in soapy water.
Pat the child dry, rather than rubbing, to leave some moisture on the skin.
Apply a thick moisturizing cream or an ointment such as petroleum jelly (Vaseline^®) immediately after bathing.
Use creams without perfumes (such as Eucerin^®) during the day and apply frequently.

Treating Bad Flare-Ups

“With a bad flare-up, you may need to use a topical cortisone cream and an oral antihistamine to control the itching,” Kaymen says.

“You also should consult your doctor if you suspect an infection—‘weepy’ patches that have a yellow crust. Your pediatrician may prescribe oral or topical antibiotics to treat such infections.