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My child has red, dry, itchy patches on her skin. Could she have eczema? Eczema is a general term used to describe a number of different skin conditions. It usually appears as reddened skin that becomes moist and oozing, occasionally resulting in small, fluid-filled bumps. When eczema becomes chronic (persists for a long time), the skin tends to thicken, dry out, and become scaly with coarse lines. There are two main types of eczema: atopic dermatitis and contact dermatitis. Atopic dermatitis Atopic dermatitis often occurs in infants and children who have allergies or a family history of allergy or eczema, although the problem is not necessarily caused by an allergy. Atopic dermatitis usually develops in three different phases.
Contact dermatitis Contact dermatitis can occur when the skin comes in contact with an irritating substance. One form of this problem results from repeated contact with irritating substances such as citrus juices, bubble baths, strong soaps, certain foods and medicines, and woolen or rough-weave fabrics. In addition, one of the most common irritants is the child’s own saliva. Contact dermatitis doesn’t itch as much as atopic dermatitis and usually will clear when the irritant is no longer present and improves when babies no longer salivate over their skin. Another form of contact dermatitis develops after skin contact with substances to which the child is allergic. The most common of these are:
This rash usually appears within several hours after contact (one to three days with poison ivy). It is often itchy, and may have small blisters. Treatment If your child has a rash that looks like eczema, your pediatrician will need to examine it to make the correct diagnosis and prescribe the proper treatment. In some cases she may arrange for a pediatric dermatologist to examine it. Although there is no cure for atopic dermatitis, it generally can be controlled and often will go away after several months or years. The most effective treatment is to prevent the skin from becoming dry and itchy and to avoid substances that cause the condition to flare. To do this:
Your pediatrician usually will suggest a medicated cream or ointment to control inflammation and itching. These preparations often contain a form of cortisone, and should be used only under the direction of your doctor. In addition, other lotions or bath oils might be prescribed. It’s important to continue to apply the medications for as long as your pediatrician directs. Stopping too soon will cause the condition to recur. In addition to the skin preparations, your child also may need to take an antihistamine by mouth to control the itching and antibiotics if the skin becomes infected. The treatment of allergic contact dermatitis is similar, although your pediatric dermatologist or allergist also will want to find the cause of the rash by taking a careful history or by conducting a series of patch tests. These tests are done by placing small patches of common irritants (or allergens) against your child’s skin. If the skin reacts with redness and itching, that substance should be avoided. Alert your pediatrician if any of the following occurs:
Published online:
6/07 The information contained in this publication should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
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Eczema
and Dermatitis