Have you ever dealt with the itchiness and discomfort of eczema? It’s tough, right? Now, imagine dealing with that as a kid during winter. The cold, dry air makes it worse, making the skin even drier and itchier. Trying to convince a little one not to scratch? Nearly impossible. Plus, our home heating systems aren’t doing us any favors, as they zap moisture from the air, making that already dry skin more likely to crack and bleed. It’s a real winter struggle for kids with eczema.
What is Atopic Dermatitis?
Atopic dermatitis, also known as eczema, is a condition where the skin becomes dry, inflamed, and itchy. It is estimated that one in 10 people suffer from atopic dermatitis, with the highest prevalence in early childhood. It is a chronic condition, but tends to worsen, especially in children, during winter months.
Symptoms of Eczema
Eczema can appear anywhere on the body and can vary from person to person. In babies, it tends to be seen on the face, neck, scalp, arms, and legs. In children, the disease settles where the skin tends to fold, such as the back of the knees, inside the elbows, back and sides of the neck, and around the mouth, wrists, and ankles.
Why Does Eczema Get Worse in Winter?
There are multiple reasons that atopic dermatitis tends to flare in cold weather:
Lack of Skin Protecting Protein
The dry, cold air causes kids’ skin to become depleted of moisture and disrupts the natural skin barrier, leading to an exacerbation of eczema. We now know that more than 50% of kids with eczema have a genetically defective skin barrier, caused by smaller amounts of a protein on the skin called filaggrin. Filaggrin helps provide a skin barrier and protect the skin from potential allergens, pollutants, bacteria, and external triggers that may lead to worsening eczema.
Reduced Humidity & Increased Dust
“Indoor heating strips the air of natural humidity and dries out the air. We also tend not to open windows in winter, and dust mites accumulate at higher numbers in the winter due to poorer air ventilation. Dust mites are a known trigger for itchy, eczema-prone skin, and the dry air contributes to worsening kids’ dry, itchy skin.”
Bundling Up
While we always want our kids to be wearing the appropriate layers to keep them warm in winter, the friction and heat generated by layers of clothing can trigger even more itching and inflammation in dry skin, especially if any of those layers are made of wool.
How to Treat and Prevent Atopic Dermatitis
Atopic dermatitis treatment includes both systemic and topical medications, as well as lifestyle and diet changes.
Skin Care & Bathing
“Parents should use gentle cleansers without added dyes or perfumes and avoid hot baths and showers. Applying a thick, cream-based moisturizer or emollient to the skin within three minutes of bathing or showering helps lock in moisture and prevents the skin from drying out”
“I recommend Vaseline or Aquaphor for kids prone to dry skin. These emollients are unperfumed and help lock in moisture and create a barrier to protect the skin and prevent water loss. I tell parents to use thick creams and not lotions during the cold, winter months, as lotions contain more water and tend to contain additives.”
“Bleach baths can be helpful to prevent superficial skin infections in kids prone to eczema. Adding a quarter capful of bleach to a bath once a week is enough to rid the skin of potentially harmful bacteria and prevent skin infections like impetigo.”
Clothing
“Parents should dress kids in breathable cotton and avoid wool as this can trigger eczema. I also encourage parents to dress kids immediately after applying emollients for an occlusive effect.”
Medication
The most used medications to treat eczema are corticosteroids. The latest corticosteroids are not only more effective than the previous generation, but also safer. Oral medications to treat atopic dermatitis include immunosuppressants.
Diet
Increasing your child’s vitamin D intake may improve symptoms of atopic dermatitis. Similarly, several probiotics can play a significant role in reducing the rate of eczema.
“Dietary interventions for improving eczema have been studied extensively, but results vary and there continues to be a lack consensus among medical providers and researchers. Some studies point to a lack of vitamin D as a contributing factor for eczema. Additionally, probiotics have been lauded as a potential dietary intervention to improve eczema-prone skin.”
Daily Watchouts
“Parents should consult a dermatology provider if their child’s eczema does not improve with these suggestions and daily use of over-the-counter emollients. Additionally, if a child is losing sleep due to itchy skin, or if a child’s skin bleeds or becomes yellow and crusted, parents should seek medical attention and consult a dermatology provider.”
Takeaway
In conclusion, managing your child’s eczema during the winter months can be challenging, but with the right care and precautions, you can help alleviate their symptoms and improve their comfort. By understanding the causes of eczema flare-ups in winter and implementing the recommended skincare routines, clothing choices, and dietary adjustments, you can make a significant difference in your child’s skin health.
Megan Sevilla is Physician Assistant certified by the National Commission on Certification of Physician Assistants. She was raised in Concord, Ohio, and graduated from Hawken School in Gates Mills, Ohio. Megan holds a bachelor’s degree in Spanish from Vanderbilt University, where she was inducted into Phi Beta Kappa Honor Society and graduated magna cum laude.
Following her undergraduate education, Megan moved to Washington, D.C., to pursue a master’s degree in international politics from American University. After working many years in government in Washington, D.C. and Madrid, Spain — at organizations including the U.S. House of Representatives, the U.S. Department of Defense, and the U.S. Embassy in Madrid, Spain — Megan returned to school and earned a Master of Medical Science degree from Baldwin Wallace University’s Physician Assistant Program in 2021.
