Eczema (Atopic Dermatitis)

Eczema is an inherited type of sensitive skin.  Flare-ups occur when there is contact with irritating substances.  In 30% of infants with eczema, certain foods cause irritation to occur.  This is a chronic condition and early treatment of any itching is the key to preventing a severe rash.

The following symptoms are common:

  • Red, extremely itchy rash – raw and weepy if scratched
  • Often starts on the cheeks at 2 to 6 months of age
  • Most common on flexor surfaces (creases) like elbows and knees
  • Constant dry skin
  • This diagnosis must be confirmed by a physician

Home Treatment 

Steroid Creams:  Steroid cream is the main treatment for itchy eczema.  There are significant differences in these products and if the over the counter cream is ineffective, please contact your pediatrician to discuss other options.  1% hydrocortisone cream is commonly used 2  times daily when the eczema flares up for up to 2 weeks at a time.  When the rash quiets down, a deeply moisturizing ointment like Aquaphor, Eucerin Cream or vaseline should be used least once daily for an additional two weeks.  After that, use it immediately on any spot that itches.  When you travel, always take the cream with you.
Bathing and Hydrating Skin:  Hydration of the skin followed by lubricating cream is the main way to prevent flare-ups of eczema  Your child should have one bath each day for 10 minutes.  Water-soaked skin is far less itchy.  Eczema is very sensitive to soaps.  Young children can usually be cleaned without any soap.  Teenagers need a soap to wash under the arms, the genital area, and the feet.  They can use a nondrying soap such as Dove for these areas.
Lubricating Cream.   Children with eczema always have dry skin.  After a 10 minute bath, the skin is hydrated and feels good.  Help trap the moisture in the skin by applying an outer layer of lubricating cream to the entire skin surface while it is damp and after the steroid cream has been applied to any itchy areas.  Apply the cream, such as Keri, Lubriderm, Nivea, Aveeno or Nutraderm, once daily.
Itching:  At the first sign of itching, apply the steroid cream to the area.  Keep your child’s fingernails cut short, and wash your child’s hands frequently.   The use of an oral antihistamine such as Benadryl or Zyrtec can be helpful to break the itch-scratch cycle.
Irritants: Wool fibers and clothes made of other scratchy, rough materials make eczema
worse.  Cotton clothes should be worn as much as possible.  Avoid triggers that cause eczema to flare up, such as excessive heat, sweating, cold or dry air, chlorine, harsh chemicals and soaps.  Never use bubble bath.  Also, keep your child off the grass during the pollen season.  Keep your child away from anyone with fever blisters since the herpesvirus can cause a serious skin infection.  Try to breast-feed all high-risk infants.

Call our Office IMMEDIATELY if . . . 

  • The rash looks infected.
  • The rash flares up after contact with someone who has fever blisters.
  • Your child starts acting very sick.

Call our office during regular hours if . . . 

  • The rash becomes raw and open in several places.
  • The rash hasn’t greatly improved after 7 days of using this treatment.
  • You have other questions or concerns.