Eczema -The Basics

Atopic Dermatitis or Eczema is a common condition addressed in many pediatric visits. Eczema lays under the umbrella of ‘atopic disorders’  which also includes asthma and seasonal allergies. The main stay of therapy for eczema is topical steroids of which there are different potency levels.  The potency level chosen is based on the severity of the skin lesions. However, in many mild cases there are measures parents can take at home to prevent or at least delay the need to start topical steroid therapy that is generally safe but can be related to certain side effects.

Young infants with excessively dry or sensitive skin (almost all infants) should not have very frequent baths. Every time we take a bath, we strip our skin of natural oils. For very young children, natural replacement of these oils does not happen as quickly as it would in adults, leading to worsening dry skin. After a bath, instead of complete drying, the child should be gently pat-dried. Subsequently the emollient of choice should be placed directly on top of damp skin. This helps to lock in moisture. There are many moisturizers to choose from. A few examples include Dove Sensitive Skin, Aveeno with oatmeal, CeraVe and Cetaphil to name a few. There are also more minimalist and cheaper products such as Vaseline and coconut oil that work well for some patients.

Lastly, if a newborn is found to have extensive eczematous lesions that are widespread to the majority of the body, this may be suggestive of a milk protein allergy and the infant’s formula may need to be changed. This change should be made by the child’s pediatrician. In a similar fashion, older children may have eczema flare ups triggered by food allergies. A food diary may be helpful in such instances to identify specific triggers. In the same sense an allergy panel could also be useful.

As always, with kids, less is often more! I hope you enjoyed reading!