There are a ton of different skin conditions we may be faced with when it comes to our kids. Some ailments come up that we just don’t recognize, or worse, we mistake them for something we can treat at home by ourselves when a dermatologist is truly needed.
A common skin condition that is often mistaken for something else in children is eczema.
To answer some of our questions about eczema in children and to help us understand how to treat it is Mary Hylton, CNP in our Hudson office.
What is eczema?
Eczema is the term given for a group of skin conditions characterized by inflammation and itching of the skin, ranging in severity from mild to severe.
“In children, the most common type of eczema is atopic dermatitis,” Mary says. “Although symptoms can vary, depending on the type of eczema experienced, the skin usually appears red and flaky and patients experience itching and sometimes burning.”
If your child is suffering from dry, red skin, or complains of itchiness, don’t hesitate to bring them in for a quick visit. Catching and treating eczema quickly can aid in the recovery process and prevent other conditions from developing.
How common is it in children?
Eczema is actually a very common skin condition!
In America, millions of children have some form of eczema. Children with eczema are also at higher risk for developing asthma and allergies. Therefore, it is important that the condition be properly diagnosed by a dermatologist quickly, so that we can work with allergists and pediatricians to develop the best treatment plan for each patient.
What causes eczema?
The cause of eczema is complex and, while we have learned a great deal about the condition, research is intense and ongoing.
“Identified causal factors of eczema include genes, environmental interactions, and the body’s immune system not responding the way it should to an internal or external stimulus,” Mary shares. “Essentially, eczema can occur because someone is genetically predisposed to the condition, or because of a reaction to something in one’s environment, or because the immune system responds oddly to a threat.”
At what age can eczema begin?
Eczema can begin in infancy, and usually appears within the first 6 months to 5 years of age.
Is eczema a chronic, lifelong condition?
Short answer: it can be.
“Although a good percentage of patients see some improvement by puberty, eczema can stick around and patients can experience flare-ups well into adulthood. But with the partnership of a dermatologist and the implementation of a tailored treatment plan, symptoms can become less severe and more manageable with time.”
What parts of the body can eczema appear on?
Eczema can occur anywhere but is more common in certain areas depending on age and the specific type of eczema.
In infants, eczema usually begins on the cheeks, forehead, and scalp. As children age, the condition appears more often in areas around joints (elbows and knees), the neck, and even around the eyes.
Are there any other skin conditions in children that look similar to eczema?
Absolutely! Parents are referred to dermatology clinics because eczema is often mistaken for other conditions such as ringworm, psoriasis, and even scabies.
“Within the category of eczema there are also numerous variations of the condition that must be differentiated to treat correctly,” May explains. “When eczema is misdiagnosed or treated incorrectly there can be serious consequences.
One of the most common is infection, as frequent scratching can open the skin and introduce bacteria, which needs to be treated properly in addition to the eczema flare.
Is eczema contagious?
No, your little one cannot “pass” eczema to someone else. This is an important discussion that we have with children and parents, as the stigma of eczema can have a significant and negative impact on children.
It is essential for children to understand that they are not “diseased” or “dirty”, nor should they fear engaging with other children. Again, eczema is one of the most common skin conditions impacting youth today and is nothing for children to be ashamed of.
With that said, this is another reason to let a specialist, who understands the condition well, be the person to help frame the communication with your child.
How are children treated for eczema?
We use a multitude of treatments for children with eczema and every patient’s treatment plan is unique to the individual, as well as the type and severity of the condition. There are prescription topical medications, with both steroid and non-steroid base options, that prove very effective at controlling flares.
We also educate patients and their parents to take proactive steps to help reduce the length and severity of flares, as well as to avoid triggers that contribute to flare ups. Some common suggestions include a bathing schedule with gentle cleansers, and identifying products that can be used daily, such as emollients (softens the skin) or moisturizers.
I encourage parents to avoid trying any over-the-counter remedies, wet wraps, or bleach baths without first consulting with a dermatologist.
Sometimes oral antihistamines or light-based treatments may need to be incorporated into the treatment plan. There have even been injectable medications that have been very effective at controlling symptoms in our patients with moderate to severe atopic dermatitis.
Again, research is constantly underway for this condition with new treatment options becoming available for patients. This is yet one more reason why a dermatology specialist needs to tailor the plan to each individual patient.
Are there products you recommend most often for children with eczema?
“There are a lot of great products that can be used for patients with eczema and I advise parents to use what works best for your child. Brands like CeraVe, Baby Aquaphor, Vanicream, and Aveeno are typically a good place to start.”
All of these are great, unscented, non-irritating options. The National Eczema Association also has wonderful resources for parents and I encourage parents to visit the website for information.
Is there a way to prevent eczema?
There are some things that parents can do to help lessen the chance that a child could have a flare or lessen the severity of already present eczema.
“Winter months bring low humidity, and lots of dry, warm air moving through the home. These factors work together to make everyone’s skin extra dry, which is amplified in those with eczema,” Mary says.
Some simple steps you can take to help combat these factors include:
- avoiding overdressing children while indoors
- wearing cotton clothing instead of wool
- using humidifiers.
Using emollients and moisturizers when coming out of the warm, not hot, bath or shower is essential. Ensuring use of free and clear detergents and avoiding bubble baths are also important. Once identified, environmental factors that can bring on a flare and cause increased irritation should be avoided.
Common irritants include:
- chemicals in cleaning products and detergents
- fabrics of clothing such as wool
- Stress
- allergies to certain foods
Because it will vary for each patient, this becomes a key part of every patient/parent discussion with your dermatologist.
Again, each child will present with eczema differently and that is why it is pivotal that they are evaluated by the best possible providers for treatment and management of our favorite tiny humans! Book your appointment in order to get the right eyes on this skin condition and work on a treatment plan that’s right for you.
Resources:
Paller, A and Mancini, A. (2016). Hurwitz Clinical pediatric dermatology: a textbook of skin disorders of childhood and adolescence. Elsevier.
National Eczema Association. http://nationaleczema.org.
About Mary Hylton, MSN, RN, FNP-BC
Mary Hylton graduated from Denison University with a Bachelor of Science in Biology and minor in Music. She graduated with honors from the Frances Payne Bolton School of Nursing at Case Western Reserve University where she earned two Masters degrees in Nursing, becoming a board certified Family Nurse Practitioner and a member of the honors nursing society Sigma Theta Tau.
Mary specializes in both general and pediatric dermatologic conditions, especially acne, eczema, warts, and psoriasis. She is also experienced in cosmetic dermatology, with specific expertise in laser-based procedures and Botox.
Mary has lived in the Cleveland area for almost ten years with her wonderful husband and two beautiful children.
