Eczema is a rash that starts on the cheeks at 2 to 6 months of age. The rash is red and itchy. If scratched, the rash becomes raw and weepy. The rash in older children is most commonly found in the creases of the elbows, wrists, and knees. Sometimes eczema also occurs on the neck, ankles, and feet.
Eczema is an inherited type of sensitive, dry skin. If your child has asthma or hay fever, or other family members have eczema, it is more likely that your child will have eczema. Flareups occur when there is contact with irritating substances (for example, soap or chlorine). Hot baths or showers also contribute to eczema in children.
In 30% of infants with severe eczema, certain foods cause the eczema to flare up. If you suspect a particular food (for example, cow's milk, eggs, or peanut butter) is causing your child's flareups, avoid the food for 2 weeks and then feed that food to your child one time (a "challenge"). If the food is causing flare-ups, the eczema should become itchy and red or develop hives within 2 hours of eating the food. If this occurs, avoid giving this food to your child and talk to your healthcare provider about food substitutes.
This is a chronic condition and may go away during adolescence. The goal is control, not cure. The early treatment of any itching can help prevent a severe flareup of the rash.
Steroid creams or ointments are the main treatment of the itch of eczema. Most children need 2 types of steroid creams: one preventive cream to treat mild itching and another stronger cream to stop a flare-up once it has started.
Your child should have one bath a day for 10 minutes. Water-soaked skin is less itchy, but it must be covered by a moisturizing cream within 3 minutes of getting out of the bath. Eczema is very sensitive to soaps, especially bubble bath. Young children can usually be cleaned without any soaps. Teenagers need a soap to wash under the arms, the genital area, and the feet. They should use a nondrying hypoallergenic soap such as Dove, Neutrogena, Tone, or Caress for these areas. Keep shampoo off the eczema.
At the first sign of any itching, apply the preventive steroid cream to the area that itches. Keep your child's fingernails cut short. Also, rinse your child's hands with water frequently to avoid infecting the eczema.
An antihistamine medicine is needed at bedtime for itching that is keeping your child from getting to sleep or causes your child to wake up during the night.
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