Getting Your Skin Back On Track After A Setback
At the end of the day, treatments and home remedies are not foolproof. They may not all work for your severe eczema or you may need more than one type of treatment at the same time, according to Chiesa Fuxench.
But when it comes to handling eczema setbacks, Wall says itâs about knowing what you can control and preparing as much as you can. âI would say I can’t control the weather. But I do know if I’m traveling, I’ll have what I call my âeczema emergency kit.ââ
For Wall, when she stays at a hotel or with friends or family, she makes it a point to pack âfragrance-freeâ products and even brings her own sheets to avoid a flare-up. But even though Wall stays away from most activities that may spark her eczema, sometimes she lets herself enjoy them despite knowing the consequences.
âIt’s a moment and it’s worth it, and you just have to go with it,â Wall says.
âYou really do need to clearly establish a basic skin care regimen. Typically, I say basic and simple because we don’t really want to overburden patients with treatments,â Chiesa Fuxench says.
Ultimately, if you live with lifelong eczema, Chiesa Fuxench notes that itâs important to buy into the idea that, as with other chronic diseases like diabetes or hypertension, youâll have to stay on top of your treatments.
Ashley Wall, 33, Livingston, NJ, eczema advocate.
Annals of Allergy, Asthma & Immunology: âPatient burden and quality of life in atopic dermatitis in US adults.â
How To Use Topical Corticosteroids
Do not be afraid to apply the treatment to affected areas to control your eczema.
Unless instructed otherwise by a doctor, follow the directions on the patient information leaflet that comes with your medicine.
This will give details of how much to apply.
Most people only have to apply it once a day as theres no evidence theres any benefit to applying it more often.
When using a topical corticosteroid:
- apply your emollient first and ideally wait around 30 minutes until the emollient has soaked into your skin, or apply the corticosteroid at a different time of day
- apply the recommended amount of the topical corticosteroid to the affected area
- continue to use it until 48 hours after the flare-up has cleared so the inflammation under the skin surface is treated
Occasionally, your doctor may suggest using a topical corticosteroid less frequently, but over a longer period of time. This is designed to help prevent flare-ups.
This is sometimes called weekend treatment, where a person who has already gained control of their eczema uses the topical corticosteroid every weekend on the trouble sites to prevent them becoming active again.
Indications Of Atopic Eczema In Babies
- Itchiness is a strong factor but babies tend to rub more than scratch. Look out for redness in the forehead and the wrists as well as cracking and breaking of the skin.
- A dry skin is very indicative of atopic eczema.
- If the eczema is infected it will be weeping and oozing and there may be yellow/brown crusting.
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When To Talk To Your Doctor About Baby Eczema
Always talk with your pediatrician if you have any questions or concerns about your babys skin. Thanks to telemedicine, a video visit or quick photo is often all thats needed to check for eczema.
Occasionally, infections develop on top of an eczema rash. If you see any yellow-colored crusting and scabbing, oozy skin, blisters or pus bumps, be sure to call your doctor right away. Always call if your baby has a fever. Your baby may need an antibiotic and to be evaluated in person.
Try Wet Wrap Treatments
Wet wraps can increase moisture intake. A caregiver can take the following steps to apply a wet wrap to the toddler after bathing them and before putting them to bed:
Toddlers with eczema may be more prone to infections that require treatment with antibiotics. However, a caregiver can help prevent infections by giving a toddler diluted bleach baths 23 times a week.
The American Academy of Pediatrics gives the following instructions for a diluted bleach bath:
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Relieve Itchy Skin With Anti
AD RescueWear clothing made with Tencel® fabric is revolutionary for eczema sufferers. Soft and gentle on skin with enhanced breathability and exceptional moisture management making a less favorable environment for bacteria to grow. There are no additives woven in to actively reduce bacteria growth. Most eczema fabrics have chemicals such as zinc embedded into their fabric to manage the growth of bacteria. Our eco-friendly fabric soothes eczema without chemical or metal additives such as zinc. Fabric made with Tencel® fibers are some of the softest fabrics in the world and the breathability supports the bodys natural thermo regulating abilities. Our fabric is super smooth and designed to stay close to the skin for effective treatment.
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Tencel/lyocell is an Oeko-Tex Fiber.
Available in white fabric only. Dyes have been shown to irritate eczema.
Managing Eczema In Winter And Year Round: A Parents Guide
Cold, dry outdoor air and indoor heating can rob skin of its natural moisture in the winter. Red, crusty, dry patches can be common on a baby’s skin, particularly in winter, and cause concern for parents. Such symptoms can be treated, however, and many babies and children do outgrow the dry, itchy skin of atopic dermatitis, also known as eczema.
We spoke with pediatric dermatologist Katherine Puttgen to learn more.
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What Can I Do To Help Prevent My Childs Eczema From Flaring Up
Encourage your child not to scratch
- keep your child’s nails trimmed and clean
- keep affected skin covered with light clothing
- in babies and younger children, consider using anti-scratch mittens, available from most baby shops
Avoid eczema triggers
- If your child finds synthetic fabrics unbearably itchy, you could try natural, breathable fabrics such as cotton or bamboo.
- If heat causes a flare-up, try to keep your little one cool when temperatures soar. Using a fan in their bedroom and keeping them in the shade on sunny days will help.
- If soaps and detergents trigger your child’s eczema, there are plenty of skin-friendly substitutes to try
How Do I Treat Eczema
Eczema is very uncomfortable, and the itch can keep a kid up at night. Its important to get a diagnosis, but even then it can be hard to control. Managing it is an art as much as it is a science, says Weinstein.
Eczema might first look like a patch of dry skin, but it can quickly worsen as your kid scratches. Keeping the skin well-moisturized is your first line of defence . Bathe him, pat his skin and then liberally apply moisturizer while its still damp. On days when he doesnt bathe, keep moisturizing. There are dozens of products formulated for eczemawhether its a thin lotion or thick ointment, choose one thats affordable and works for your kid, because youll be applying it often and liberally, says Weinstein.
Focus on moisturizing instead of driving yourself crazy trying to figure out whats triggering flares, Weinstein says. People will turn their lives upside down, searching for that one thing that if they could only eliminate it, the eczema would go away. That tends to send them down an unhelpful path.
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Why Did My Baby Develop Eczema
What exactly causes eczema is unknown. Researchers dont know why babies develop eczema, though they do know its due to a combination of environmental allergens and genetics. Eczema in babies can cause rashes on a babys skin, itchy skin and eczema flare-ups in the affected areas.
A variety of environmental factors can triggereczema in infants, including certain cleansers, soaps and shampoos. Dry air and ointments can also trigger baby eczema.
If your baby suffers from eczema, consult with a pediatricdermatologist or qualified pediatrician. While they might prescribe a steroid, such as a topical corticosteroid, other steroid cream or an antihistamine, theres other morenatural treatments your healthcare provider could recommend. These can include over-the-counter medications, Vaseline petroleum jelly and fragrance-free products made for sensitive skin.
There are also some preventative measures your family can take as well to help prevent eczema flare-ups. Older infants can wear mittens and gloves to protect the affected areas against triggers. Food allergies can also cause flare-ups and you can create aneczema diet for your infant to reduce their effect. Using detergents and baby lotions that are better for this skin condition can also help.
To learn more about what products can prevent or treat eczema,check out these products that have the National Eczema Associations Seal of Approval.
What You Can Do
You can help reduce your child’s discomfort by:
- keeping their fingernails short to reduce the damage to their skin from scratching
- washing them with aqueous cream instead of soap – ask your pharmacist about aqueous creams and always follow the instructions on the product
- using non-biological detergent and a double rinse cycle when washing their clothes or bedding
- avoiding herbal, ‘natural’ or alternative creams – these can make eczema worse, as they may contain bacteria or high doses of steroids
- rinsing and drying them well after swimming
- dressing them in cool, breathable fabrics like cotton
- keeping them away from anyone with a cold sore – as the cold sore virus can cause eczema to become infected
- using extra moisturiser on areas your child scratches a lot
- avoiding anything you know that causes your childs eczema to get worse
Around 6 out of 10 children with eczema will grow out of it by the time they’re teenagers.
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Location Plays A Big Part
Babies from 1 month to 2 years old tend to get eczema on their cheeks and scalp. Older children will generally have it on the folds of their wrists, knees and ankles. If your child has a red, itchy and scaly rash that isnt in a classic location for eczema, it could be allergic contact dermatitis, meaning they might be allergic to something theyre coming into contact with such as soap, shampoo or lotion.
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How Reducing Indoor Allergens Can Ease Your Eczema Symptoms
Eczema usually isnt a persistent condition, but rather one marked by long symptom-free periods followed by flare-ups.
Various environmental factors may cause the immune system to respond as if the body has encountered a harmful substance, resulting in inflammation and worsening eczema symptoms.
These triggers may include a variety of allergens and irritants, such as:
- Pet dander, pollen, mold, and dust mites
- Allergenic foods
Theres no cure for baby eczema, but the condition usually becomes less severe over time.
Treatment focuses on managing skin dryness to prevent flare-ups and on reducing skin inflammation.
Doctors recommend the following strategies to parents whose babies have eczema:
Your doctor may also recommend other eczema treatments for your child, including:
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How Does Baby Eczema Differ From Dry Skin
Dry skin is a symptom of eczema. Your pediatrician can diagnose eczema by examining your babys skin. He or she may send you to a pediatric dermatologist for confirmation and treatment if the condition is severe.
In general, dry skin can be handled at home with some moisturizer and isnt as bothersome as eczema. However, babies with darker skin tend to have drier skin than those with lighter skin making moisturization even more crucial.
What To Do At Home
To help prevent hand eczema:
- Wear rubber or latex gloves to protect hands from harsh soaps and detergents when washing the dishes or cleaning.
- Use lukewarm water and a small amount of mild soap when washing your hands.
- Apply prescribed medicated creams and ointments after washing. Then apply a moisturizer.
- Use a fragrance-free, gentle moisturizer during the day. Some examples are: Dove®, Aveeno®, CeraVe®, Cetaphil®, Eucerin® and Aquaphor®.
- Wear warm cotton gloves outside in cold weather to prevent dry, chapped skin.
HH-I-380 6/15 Copyright 2015, Nationwide Childrens Hospital
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Will Babies And Children Outgrow The Need For Treatment
One open question is how long younger children might need to stay on Dupixent. Adults with moderate to severe atopic dermatitis may need to remain on this drug for years, if not for their entire lives, in order to sustain symptom relief, Fuxench notes.
For young children, this may be a whole different ball game for many reasons, Fuxench says. Some younger patients might outgrow their disease, ending the need for this medication. Its also possible that taking Dupixent early in life might prevent eczema from worsening in the future, limiting the need for lifelong treatment.
Despite the uncertainty around long-term usage, it makes sense for parents of young children with eczema to ask their doctor about Dupixent if kids symptoms are poorly controlled by other interventions, Fuxench advises.
I do not think that for the majority of patients dupilumab will be the first-line option, as most pediatric patients have mild disease that can be managed with a gentle skin care regimen and occasional use of prescription topical therapies, Fuxench says. But it is a treatment option that can bring relief to those whose disease is poorly controlled.
Baby Eczema Risk Factors And The Environment
While baby eczema is the result of immune-system dysfunction, likely from a genetic predisposition, studies have found a number of risk factors.
For example, a study published in February 2018 in the International Journal of Environmental Research and Public Health suggested that children have a higher risk of developing eczema if their mothers experienced high-stress situations during pregnancy.
In a study published in May 2018 in the Journal of Allergy and Clinical Immunology, researchers in the United Kingdom analyzed the sociodemographic characteristics of about 675,000 children in a primary-care database. They found that the children were more likely to be diagnosed with eczema if they fit one of the following descriptions:
- Black Caribbean
- Of high socioeconomic status
Another study, published in May 2018 in the Journal of the European Academy of Dermatology and Venereology, looked at how the outdoor environment specifically air pollutants and meteorological conditions affected eczema risk in children of both sexes. The researchers concluded that high levels of carbon monoxide, ammonia, formaldehyde, lead, particulate matter, and ozone levels may all influence the development of infantile eczema.
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Key Points About Atopic Dermatitis In Children
Atopic dermatitis is a long-term skin condition. Its common in babies and children.
A child with allergies or family members with atopic dermatitis has a higher chance of having atopic dermatitis.
Itching, dryness, and redness are common symptoms.
The goals of treatment are to ease itching and inflammation of the skin, increase moisture, and prevent infection.
Staying away from triggers is important to manage the condition.
It usually gets better or goes away as a child gets older.
More Than Half The Kids In Trials Experienced A 75 Percent Reduction In Disease Severity
In a clinical trial reviewed by the FDA as part of the approval process for patients under 5 years old, patients used topical corticosteroids alone or combined with Dupixent every four weeks for 16 weeks. More than half the kids treated with both topical corticosteroids and Dupixent achieved at least a 75 percent reduction in disease severity by the end of the trial, according to data shared by the companies selling the drug.
With topical corticosteroids plus Dupixent, 28 percent of children achieved completely or nearly clear skin by the end of the trial, compared with just 4 percent of the kids who only used topical corticosteroids, according to data from the companies. And, 48 percent of patients on topical corticosteroids and Dupixent experienced a clinically meaningful reduction in itching, compared with 9 percent of those who only used topical corticosteroids.
It is the itch that severely adversely affects childrens sleep and thus adversely affects their activities or daily living, says Saxon Smith, PhD, a dermatologist and a clinical professor at the Australian National University Medical School in Canberra.
Rectifying this with effective disease control can be transformational in the lives of these young patients, Dr. Smith says.
These side effects didnt cause young patients to stop treatment with Dupixent in the trial, according to the companies.
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