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Peds Derm Corner- Eczema- November

Each month, Dr Swanson posts information about a common pediatric dermatology issue to educate patients and parents. This month, the topic is eczema.
What is eczema?
Eczema, also known as atopic dermatitis, is a skin condition that causes itchy, red, scaly patches of irritated appearing skin. Eczema typically starts during childhood. 2/3 of children with eczema will outgrow the eczema.
What causes eczema?
There are 2 factors that cause eczema. One factor is that our skin is our barrier to the outside world. In people with eczema, their skin barrier is “broken” to some degree and it makes them more vulnerable to dryness and irritation. The other factor is that eczema is due to an overactive immune system process. We don’t know what “flips the switch”, but in children with eczema it is like the immune system is turned on perpetually. Those immune system cells work their way into the skin and cause the rash.
How are eczema and allergies related?
Children with eczema are more likely to develop allergies and asthma, but the conditions are associated and NOT a cause and effect. Some people wonder if the eczema is being caused by an allergy or a reaction to a food, but 98% of the time the eczema has nothing to do with a food or an allergy. Typically if a food is the trigger, it is relatively obvious- within 30 minutes of eating a particular food, the rash appears. It is not necessary to do allergy testing on all children with eczema. Typically we just recommend allergy testing if other symptoms- runny nose, itchy eyes, etc- appear.
How is eczema treated?
First of all, there is no cure for eczema. 2/3 of children outgrow it, but there is no treatment that makes eczema go away and stay away forever. The treatment of eczema is focused on the 2 factors that cause eczema. To help with the skin barrier, we recommend sensitive skin care. Sensitive skin care means using products that are hypoallergenic and safe for those with sensitive skin. My favorite sensitive skin care products include ALL Free and Clear laundry detergent, avoidance of fabric softeners/dryer sheets, Dove sensitive skin or Cetaphil soap, Vanicream moisturizing cream, Aquaphor or Vaseline, and Robathol bath oil. For mild eczema, sometimes it clears up just by using these products. To help with the overactive immune system process, we will typically use topical medications on the affected areas. The most commonly used topical medication is a topical steroid. Topical steroids work very well to control the eczema and are extremely safe when used the way your doctor instructs you to. Sometimes side effects are seen when people overuse or abuse the medicines.
Why is it important to treat eczema?
It is very important to treat eczema. Eczema is very itchy and uncomfortable for the person who has it. In children, it can cause sleep issues and poor appetite. These things can lead to a failure to thrive and a failure to gain weight. In addition, studies have shown an increased risk of ADHD and injuries (due to distraction) in children with poorly controlled eczema. These things make sense because it is hard to focus on anything when you are itchy all the time.
If you have any other questions regarding eczema and how it is affecting your child, please schedule an appointment with Dr Swanson, our pediatric dermatologist.
What is a pediatric dermatologist?
A pediatric dermatologist is someone that has undergone extensive training to deal with the specific skin conditions and issues that affect children. Pediatric dermatologists have typically completed medical school, a general dermatology residency, and a pediatric dermatology fellowship. While all dermatologists receive some experience dealing with children with skin problems, a pediatric
dermatologist has chosen to subspecialize and receive more extensive education and training with the pediatric population.