Most kids get itchy rashes at one time or another. But eczema
can be a nuisance that may prompt scratching that can only make the
The term eczema refers to a number of different skin conditions
in which the skin is red and irritated and occasionally results in
small, fluid-filled bumps that become moist and ooze. The most
common cause of eczema is
, sometimes called
although it occurs in infants and older children.
The word "atopic" describes conditions that occur when
someone is overly sensitive to allergens in their environment such
as pollens, molds, dust, animal dander, and certain foods.
"Dermatitis" means that the skin is inflamed, or red and
Kids who get eczema often have family members with hay fever,
, or other
. Some experts think these kids may be genetically predisposed to
get eczema, which means characteristics have been passed on from
that make a child more likely to get it.
About half of the kids who get eczema will also someday develop
hay fever or asthma themselves. Eczema is
an allergy itself, but allergies can trigger eczema. Some
environmental factors (such as excessive heat or emotional
) can also trigger the condition.
About 1 out of every 10 kids develops eczema. Typically,
symptoms appear within the first few months of life, and almost
always before a child turns 5. But the good news is that more than
half of the kids who have eczema today will be over it by the time
Signs and Symptoms
Signs and symptoms of eczema can vary widely during the early
phases. Between 2 and 6 months of age (and almost always before the
age of 5 years), kids with eczema usually develop itchy, dry, red
skin and small bumps on their cheeks, forehead, or scalp. The rash
may spread to the extremities (the arms and legs) and the trunk,
and red, crusted, or open lesions may appear on any area
They may also experience circular, slightly raised, itchy, and
scaly rashes in the bends of the elbows, behind the knees, or on
the backs of the wrists and ankles.
As kids get older, the rash is usually less oozy and scalier
than it was when the eczema first began, and the skin is extremely
itchy and dry. These symptoms also tend to worsen and improve over
time, with flare-ups occurring periodically.
Children often try to relieve the itching by rubbing the
affected areas with a hand or anything within reach. But scratching
can make the rash worse and can eventually lead to thickened,
brownish areas on the skin. This is why eczema is often called the
"itch that rashes" rather than the "rash that
How Long Does It Last?
In many cases, eczema goes into remission and symptoms may
disappear altogether for months or even years.
For many kids, it begins to improve by the age of 5 or 6; others
may experience flare-ups throughout adolescence and early
In some kids, the condition may improve and then resurface at
the onset of
when hormones, stress, and irritating skin products or cosmetics
are introduced (or due to other factors that scientists don't
yet understand). And some people will experience some degree of
dermatitis into adulthood, experiencing areas of itching and a dry,
contagious, so there's no need to keep a baby or child who has
it away from siblings, other kids, or anyone else.
Scientists believe that eczema is inherited, so there's no
way to prevent it. However, because specific triggers can make it
be prevented or improved by avoiding possible triggers such as:
- animal dander
- dry winter air with little moisture
- allowing the skin to become too dry
- certain harsh soaps and detergents
- certain fabrics (such as wool or coarsely woven
- certain skin care products, perfumes, and colognes
(particularly those that contain alcohol)
- tobacco smoke
- some foods (which depends on the person, but dairy products
and acidic foods like tomatoes seem to be common culprits)
- emotional stress
- excessive heat
Also, curbing the tendency to scratch the rash can prevent the
condition from worsening and progressing to cause more severe skin
damage or secondary infection.
Diagnosing eczema can be challenging because:
- Each child experiences a unique combination of symptoms that
also tend to vary in severity.
- It's sometimes confused with other skin conditions, such
(better known as "cradle cap"),
(a genetic disease that causes the skin to become scaly and
(caused by direct skin contact with an irritating substance, such
as a metal, medicine, or soap).
- There's no test available to diagnose it
If your doctor suspects eczema, a thorough medical history is
likely to be the most valuable diagnostic tool. A personal or
family history of hay fever, other allergies, or asthma is often an
In addition to doing a physical examination, the doctor will
likely ask about any concerns and symptoms your child has, your
child's past health, your family's health, any medications
your child is taking, any allergies your child may have, and other
The doctor will also help you identify things in your
child's environment that may be contributing to the skin
irritation. For example, if your child started using a new soap or
lotion before the symptoms appeared, mention this to the doctor
because a substance in the soap might be irritating the skin.
The doctor may also ask about any stress your child might
be feeling at home, school, or work (for older kids), because
stress can lead to eczema flare-ups.
Your doctor will also probably:
- Examine the distribution and appearance of the rash.
- Ask about how long the rash has been there.
- Look for evidence of thickening of the skin from itching or
The doctor will also want to rule out other diseases and
conditions that can cause skin inflammation, which means that your
child may have to be seen more than once before a diagnosis is
made. The doctor may also recommend sending your child to a
dermatologist or an allergist.
Sometimes, the doctor may refer your child to an allergist for
testing to find out if the rash is an allergic reaction to a
Allergy testing can involve one or more of the following:
- a blood test
- a patch test (placing a patch of suspected allergen, such as
dyes or fragrances, on the skin)
- scratch/prick tests (placing suspected allergens on the skin
or injecting them into the skin)
Your doctor may also ask you to eliminate certain foods (such as
eggs, milk, soy, or nuts) from your child's diet, switch
detergents or soaps, or make other changes for a time to find out
whether your child has a reaction to something.
, also called cortisone or steroid creams or ointments, are
commonly used to treat eczema and are
the same as the
steroids used by some athletes
. These medicines are usually applied directly to the affected
areas twice a day.
Continue to apply the corticosteroids for as long as the doctor
suggests. It's also important not to use a topical steroid
prescribed for someone else. These creams and ointments vary in
strength, and using the wrong strength in sensitive areas can
damage the skin, especially in infants.
Nonsteroid medications are also available now in creams or
ointments that can be used instead of - or in conjunction with -
Other prescription treatments your doctor may recommend
- antihistamines (to help to control itching)
- oral or topical antibiotics (to prevent or treat secondary
infections, which are common in kids with eczema)
Some older kids with severe eczema may also be treated with
ultraviolet light under the supervision of a dermatologist to help
clear it up and make them more comfortable. In some cases, newer
medications that change the way the skin's immune system reacts
are also prescribed.
Helping Your Child
You can help prevent or treat eczema by keeping your child's
skin from becoming dry or itchy and avoiding known triggers that
cause flare-ups. Try to follow these suggestions:
giving your child frequent hot baths, which tend to dry the
- Use warm water with mild soaps or nonsoap cleansers when
bathing your child.
using scented soaps.
- Ask your doctor if it's OK to use oatmeal soaking
products in the bath to help control the itching.
excessive scrubbing and toweling after bathing your child.
Instead, gently pat your child's skin dry.
dressing your child in harsh or irritating clothing, such as wool
or coarsely woven materials. Dress your child in soft clothes
that "breathe," such as those made from cotton.
- Apply moisturizing ointments (such as petroleum jelly),
lotions, or creams to your child's skin regularly and always
within a few minutes of bathing, after a very light towel dry.
Even if your child is using a corticosteroid cream prescribed by
the doctor, apply moisturizers or lotions frequently (ideally,
two to three times a day). But avoid alcohol-containing lotions
and moisturizers, which can make skin drier. Some baby products
can also contribute to dry skin.
- Apply cool compresses (such as a wet, cool washcloth) on the
irritated areas of skin to ease itching.
- Keep your child's fingernails short to minimize any skin
damage caused by scratching.
- Try having your child wear comfortable, light gloves to bed
if scratching at night is a problem.
- Help your child avoid becoming overheated, which can lead to
- Eliminate any known allergens such as certain foods, dust, or
pet dander from your household. (This has been shown to help some
- Have your child drink plenty of water, which adds moisture to
Although eczema can be annoying and uncomfortable for kids, its
emotional impact can become the most significant problem later -
especially during the preteen and teen years, when your child will
need to take responsibility for following the prevention and
You can help by teaching your preteen or teen to:
- Establish a skin-care routine. Brief, lukewarm showers or
baths and moisturizing regularly will help to avoid or alleviate
- Use only "unscented" makeup and sunscreens and
facial moisturizers labeled noncomedogenic and oil free.
- Recognize stressful situations (such as taking tests at
school or sports competitions) and how to manage them (such as by
breathing, focusing on an enjoyable activity, or taking a
- Be aware of scratching and minimize it as much as
When to Call the Doctor
Children and teens with eczema are prone to skin infections,
and herpesvirus. Call your doctor immediately if you notice any of
the early signs of skin infection, which may include:
- redness and warmth on or around affected areas
- pus-filled bumps on or around affected areas
- areas on the skin that look like cold sores or fever
Also, call your doctor if you notice a sudden change or
worsening of the eczema or if it isn't responding to the
Even though eczema can certainly be bothersome for kids and
parents alike, taking some preventative precautions and following
the doctor's orders can help to keep it eczema under
Patrice Hyde, MD
Date reviewed: October 2008
Note: All information is for educational purposes only. For specific medical advice,
diagnoses, and treatment, consult your doctor.
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