Eczema

Background

Eczema is very common at any age, especially in infancy. The exact cause is still not understood but it is related to the development of the immune system. Our skin is our body’s largest immune organ. It is the barrier between the inside and outside worlds.

Eczema is a chronic disease so it needs ongoing management. Some children will outgrow their eczema, in some, it will persist, but be milder, and in some, it will persist and stay the same. There is no way to determine who will outgrow it. Until then, your child skin needs ongoing care.

What To Do

• Moisturize: whole body twice daily with a good thick moisturizer such as Eucerin, Glaxal Base, Aquaphor, CeraVe, Cetaphil. Coconut oil is good for darker skin. If you child needs moisturizing more than twice daily, you can seal the moisturizer into their skin with a layer of Vaseline/coconut butter/shea butter (anything greasy).
• Steroid cream: twice daily as needed to red or broken down areas or itchy spots. Put on before moisturizer. We usually recommend starting with hydrocortisone 1% cream (available over the counter without a prescription) but you may be given a prescription for a different steroid cream if your child needs something stronger.
• Do not dry your child after a bath. Carefully take them out of the tub, put them on a towel and apply moisturizer, sealing the water into their skin.
• Bleach baths: add bleach (yes, Javex or Clorox) to bath water. Use just enough that you can smell it easily but not strongly. Usually it is a few drops in a baby bath or up to half of the bottle cap in a big tub. Do not bathe with soap more than 1-2x/week. When you do use soap, use an unscented BAR soap such as Dove or Cetaphil. Cleansing bath oils are another good option.
• Other helpful tips:
  • use unscented/fragrance free laundry detergent
  • consider dryer balls instead of dryer sheets
  • keep nails short (to prevent scratching)
  • wear loose clothing
• Figure out how often to bathe your child in order to improve their skin. Some kids with eczema need to bathe everyday, some only once or twice per week. lf you are not seeing any improvement doing steps 1-4, then adjust the frequency of how often you bathe them. If they do need to be bathed more frequently, use soap no more than 2x/week.
• After 6 weeks of doing all of the above, if you are not seeing an improvement, please book a follow up appointment. We would have told you at the appointment if we would require a referral from your child's regular physician in order to continue to follow them for their eczema.

When To Be Concerned

Please book an earlier follow up if your child is uncontrollably, itchy, and not sleeping or if their skin is very red and not settling with the above treatment.

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