Atopic Dermatitis, also called Eczema

If you or your child has ever had a severe eczema (Atopic Dermatitis) flare-up, you are familiar with the inflamed, dry, thickened skin and constant, intense itching and scratching. Fortunately there are ways to ease symptoms.

An estimated 30 percent of the U.S. population experience symptoms of Atopic Dermatitis, according to the National Institutes of Allergy and Infectious Diseases, but this skin disease is more common among children. Symptoms usually start within the first 5 years of life, often the first 6 months. With time and treatment, as children mature, eczema will often go away – but it sometimes continues into adulthood.

Many different factors contribute to eczema including food and environmental allergens, excessive skin dryness, injury from scratching, and inflammation from bacteria in the skin. Addressing each is essential to controlling the condition.

Eczema and Food Allergens

Although eczema is not necessarily an allergic disease, allergens can play a role. Among infants and toddlers with moderate to severe eczema, it’s often a food allergen.

The most common food allergies in the United States are cow’s milk, egg, wheat, soy, peanuts, tree nuts and seafood. If you think your child might have food allergies, see a board-certified allergist for an accurate diagnosis before removing any food from your child’s diet.

Environmental Allergens

Common indoor allergens that affect eczema include dust mites and pet dander. To minimize dust mite exposure, encase pillows and mattresses with dust mite covers, wash linens weekly in hot water, vacuum with a HEPA (high efficiency particulate air) vacuum, and reduce indoor humidity to 40-50 percent, as dust mites need moisture to live.

No measures can effectively reduce pet dander if the animal remains in the home, but it will help to keep pets out of bedrooms and off furniture or rugs where children sleep or play. Pet dander accumulates in house dust, so use HEPA vacuums to keep it down. When all else fails, finding a new home for the pet may be the only option.

Preventing Dry Skin

The skin of children with eczema dries out more rapidly than healthy skin, so it’s important to keep it well hydrated.

Doctors often recommend the “soak and seal” method – sit the child in a tub of lukewarm water for 15 minutes to let the water soak in, then either shake off excess water or gently pat dry with a towel and immediately apply moisturizer in a thick layer. Reapply moisturizer frequently. The National Eczema Association recommends ointment moisturizers, rather than lotions or creams.

Topical Corticosteroid Medications

Many children require topical corticosteroid skin ointments or creams to fully control their eczema. These come in a wide range of strengths, so always ask your physician which medications and treatment options are best suited for your child.

Controlling the Itch

Controlling the itch is crucial: The more the child scratches the skin, the more the eczema worsens and symptoms can spiral out of control. Over-the-counter antihistamines may help take the edge off the itch and allow for a better night’s sleep. Some parents find wrapping wet cloths around affected skin eases the itch and stops scratching.

If your child’s eczema remains poorly controlled, consult with your board-certified allergist for further treatment options.

Adapted from 
Allergy & Asthma Today magazine’s  “Eczema and Allergies” by John Lee, MD, clinical director of the Food Allergy Program at Boston Children’s Hospital.

Other Resources for Atopic Dermatitis: