Guide to Rashes
Affecting between 10 and 20 percent of kids, eczema (also known as atopic dermatitis) usually surfaces in the first few months of life. Dry red patches with small bumps usually appear first on the face or scalp, and may ooze, crust over, and itch badly. The rash may spread to the arms and legs, often resulting in circular, dry, slightly raised red patches on the elbows, knees, or on the hands and wrists. (Eczema can also sometimes produce a wet, weepy rash.) Symptoms often improve starting around 5 years of age, after which a child might experience only occasional flare-ups.
No one knows the true cause of eczema, but we do know it tends to run in families. Seasonal allergies, heat, and stress can also trigger eczema.
There's no test that definitively diagnoses eczema. A pediatrician or pediatric dermatologist will make the call by examining the rash and asking about a child's medical history, since eczema is often inherited and many children with eczema also develop allergies and/or asthma.
You can't prevent your child from developing eczema, but you can try to control outbreaks by helping your child avoid things that tend to trigger it. Common irritants that bring on or worsen eczema include fragranced soaps and lotions, perfumes (especially those that contain alcohol), mold, pet dander, pollen, rough fabrics, and food sensitivities (egg white is the most common culprit). Dry winter air can be a trigger too, so keeping skin moist in the wintertime with mild, creamy soaps, fragrance-free lotions, and humidifiers can help.
Your doctor will likely prescribe a topical corticosteroid cream to control outbreaks and itching. Oral antihistmamines like Benadryl (diphenhydramine) may also be used to reduce scratching, which can make eczema worse and possibly open the skin up to infection. Chronic and recurrent eczema that requires ongoing therapy may require other treatments since ongoing steroid use can cause thinning of the skin and other side effects. Other second-line prescription treatments for children age 2 or older may include a short-term regimen of topical calcineurin inhibitors, like Elidel (pimecrolimus) cream or Protopic (tacrolimus) ointment. Milder non-steroidal agents such as Atopiclair (a topical anti-inflammatory) cream or EpiCeram (ceramide-containing cream) may be more friendly to a baby's skin.
Since eczema outbreaks can sometimes be triggered by emotional stress, you can ask a doctor or a pediatric psychologist about relaxation exercises that can help your child through challenging times. Encouraging your child to drink more water (give him a cool-looking bottle to carry around during the day) and feeding him a diet rich in healthy fats (with foods like fish, walnuts, some fortified eggs, and flax seeds) may also keep skin more supple and less prone to eczema.
"We've suffered for seven years with eczema. Our daughter had it since birth and we found that although steroid creams were helpful for severe outbreaks, Spectro Kids EczemaCare cream from Canada works like magic. The other product we have used with success is called Oilatum Bath Oil. We also found that switching to preservative-free and dye-free foods helped quite a bit. At 7, our daughter's eczema seems to be going away, but we still use these products." -- Angela Mantie, mom to Ellamay, 7 and Adeline, 2