What is Eczema? It’s More Than Skin Deep


Children's Hospital Los Angeles RN Remedies Gloria Verret

Did you know our skin is an organ? In fact it is the largest organ in the human body and it holds us together! Our skin has a big job to do too. It is our first line of defense and it also defines who we are. It’s no wonder why problems of the skin can be so emotional and so hard for children. Itchy, dry and broken skin can be very painful. Every mother knows this, from diaper rash, sunburns and itchy rashes; skin problems are something most of us have to deal with. For example, my daughter has fair skin that burns and is sensitive to many things such as metal; her pierced ears lasted less than a month before causing pain and swelling. She is also prone to dry and itchy skin which she inherited from me.

One of the most common skin problems is eczema. If your child has eczema, they are not alone because it affects five to 20 percent of children with 60 percent of cases beginning in infancy. Eczema is a growing problem with cases increasing over recent years. This chronic condition is a difficult one, and can negatively impact on quality of life. In my research, I was surprised to see how devastating this condition can be for those who suffer from it, which is why I was inspired to write about it and partner with Terry Renteria, RN, wound ostomy care nurse (WOCN) specialist to tell you about eczema and how you can help manage your child’s condition.

What is Eczema?

There are two types of eczema.

  1. Extrinsic, which is 70 to 80 percent of eczema cases and is similar to allergies
  2. Inherited (also known as intrinsic)

Both types of eczema are from a combination of genetic and environmental causes. Some of the environmental causes include a reaction to certain foods like eggs, milk, peanuts wheat or fish, nylon clothing, pets, dust and sweating. More than half of people with eczema suffer from it mostly during the winter months. Unfortunately, it may not completely go away during the summer because grass pollens can cause the eczema to trigger and show up on the skin. The reason why your child’s skin becomes so dry from eczema is because they have less ceramides than those not affected with eczema. Ceramides prevent water loss from the skin, and with less of it, the skin gets drier. Because your child has eczema, their skin is also more prone to infection (such as staph aureus which I talk about more in my blog post about MRSA infection).

baby on back_shutterstock_2500x1667

What Does Eczema Look Like?

As I mentioned above, eczema makes your child’s skin very dry. Here are other ways to recognize when your child’s skin is showing an eczema breakout.

  • Babies will have dry patches of scaly red skin with scratch marks.
  • Older children may get rough scaly skin from constant scratching.
  • You may see redness and fluid filled bumps or blisters that can burst and leak fluid.
  • The open areas from the burst blisters are prone to infection
  • In serious eczema flare ups, the skin will be dry, scaly and discolored. Eczema flare-ups are considered “serious” when they occur more than eleven times per year and last over two weeks.
  • Less serious flare-ups occur about eight times per year and last for less than two weeks.

In most cases, kids will outgrow eczema in their late teens and early 20s but the skin may stay sensitive and at risk for further eczema outbreaks.

How is Eczema Treated?

There are first line and second line treatments. First line treatments involve over-the-counter emollients and lotions, while second line treatments are prescribed by your child’s physician. Keep reading to learn more about both types of treatment.

First Line Treatments

First line involves emollients, lotions and topical steroids. These types of treatments help with the itching and irritation of eczema and keep it from getting drier. Emollients and lotions re hydrate the skin and protect it and may reduce the need for using topical steroids. When using lotions, it is important to pat (not rub) your child’s skin dry, gently, and use these lotions with other prescribed eczema treatments unless your child’s physicians say otherwise.

Topical steroid creams may be needed for eczema outbreaks that do not heal with lotions. These steroid creams are proven effective but can also cause your child’s skin to thin out or your child’s skin may become immune to the topical steroid and it will not be effective at treating anymore. If you are using these creams to help your child’s eczema, using them for two days a week has been shown to reduce outbreaks rather than just lotions and emollients alone. Topical steroids are safe if used promptly and as directed by the doctor or nurse practitioner.

Second Line Treatments

If second line treatment is needed for your child it will be prescribed by their physician. Some are medicines called inhibitors applied as a cream. This might also be prescribed as a preventive measure to stop flare ups.

  • Some cases of eczema may not respond to other treatment and may require phototherapy or drug therapy.
  • Antibiotics may be needed if the broken skin becomes infected.
  • Antihistamines may be needed to control itching and, in order for the skin to heal, your child must learn to not scratch their skin when it itches.

Managing Your Child’s Eczema

  • Avoid dressing your child in wool or placing wool directly on the skin because this will trigger a flare up.
  • Avoid using too much soap on your child’s skin. A little will go a long way. Using emollient soap substitutes helps too.
  • Try to keep your child from scratching their dry skin.
  • Dress your child in cotton clothing and underpants.
  • Apply lotions and emollients after your child bathes. Apply thick lotions, liberally, at night such as petroleum jelly.
  • Make sure your child’s nails are short.
  • Keep an eye out for foods that cause flare-ups. Avoid the foods I mentioned above (eggs, milk, peanuts wheat and fish), while also making sure your child gets proper nutrition. You can read more about proper nutrition.

Kids with eczema go through a hard time dealing with the physical appearance of the condition and the discomfort. I hope this blog post helps you care for your child and always remember to keep their nails short, so their impulse to scratch won’t cause more harm on their skin, which is one of our most important organs!