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National Foundation for Ectodermal Dysplasias
Eczema and ED
Eczema is an inflammation of the skin. When it flares, the skin is very itchy or painful, red and swollen; blisters
may form resulting in oozing and crusting. When eczema is present for a long time, the skin becomes dry,
thickened and scaly and sometimes the pigment is affected, causing darkening or lightening of the involved
skin. Many different skin diseases can be classified as eczema, including allergic dermatitis (for example, poison
ivy rash), irritant dermatitis (for example, diaper rash), reactions to sunlight, localized bacterial or fungal
infections or dry skin (xerotic or winter eczema).
The most common kind of eczema that occurs in childhood is atopic dermatitis (atopic eczema). Up to 10% of
children worldwide are afflicted with this skin problem. These children often have a strong family history of
asthma, hay fever, eczema and hives and may also have one of these disorders themselves in addition to
eczema. Although we know that the tendency towards allergies is familial, the exact mode of inheritance is
unknown.
The exact cause of atopic eczema is also unknown. Persons with atopic eczema seem to have very sensitive,
irritable skin and become extremely itchy from even minor irritants such as changes in temperature and
humidity, woolly or scratchy fabrics, and certain soaps and skin products. Atopic eczema can be mild and last for
only a year or two in infancy or can be severe and persistent.
Infants and children with ED appear to may have eczema more frequently than other children. Their
malfunctioning and poorly developed sweat and oil glands probably play some role in the occurrence of
eczema. Dry skin forms a poor barrier, permitting nonspecific irritants to cause further skin damage. Dry skin is
also itchy and the inevitable scratching causes further damage.
Some children with ED have severe eczema that is difficult to treat, and others seem to have none at all.
Whether there is atopy in the family probably accounts for some of the differences. Eczema cannot be cured,
but it can be controlled with good skin care. Frequent bathing and regular use of a good moisturizer are
effective measures. So is avoidance of stimuli that cause itching such as extremes in temperature, hot bath
water and woolly, scratchy or occlusive fabrics. Your physician can prescribe medications that will suppress the
eczema and control the itching. Many children "outgrow" their eczema although their skin may remain sensitive
and prone to rashes.
Skin Care for Eczema
Atopic dermatitis, a form of eczema, is a chronic skin problem, often frustrating and stressful for the affected
child and family. The most common symptoms are flaking, redness and terrible itching.
The causes of eczema is unclear, and there is no cure. However, the symptoms can be controlled with daily skincare. For many children eczema will improve over time.
SYMPTOMS OF ECZEMA
People with eczema have very dry skin. The dry skin itches and may crack, and the cracked skin can become
infected. When the eczema flares up, the skin may look red and irritated, or even ooze and look “weepy”. During
infancy, eczema is most likely to affect the face, body, and the outside of the arms and legs. Over time, the skin
thickens. In older children, the eczema is most likely to affect skin folds, such as the neck, inside the elbows, and
behind the knees.
ECZEMA AND ALLERGIES
Some children with eczema have hay fever or asthma. A few children have food allergies. Allergies to foods or
house dust mites may cause hives and eczema flare-ups, it can be helpful to identify and eliminate the offending
agent. If your child has eczema but does not have flares related to exposure to foods allergy testing is not
usually helpful.
MANAGING ECZEMA
Most parents find that they can control their child’s eczema by following the daily skin care routine that is
outlined in this information sheet. The most important part of the routine is to keep your child’s skin
moisturized. It may take some trial and error to find what skin moisturizers work best for your child. Petroleum
The content of this document is for informational purposes only. Questions regarding specific patient issues
should be directed to the appropriate professionals for resolution.
National Foundation for Ectodermal Dysplasias
jelly works best, but some children dislike its greasy texture. Plain mineral oil is an alternative. If you have
questions about your child’s skin care plan or about a product, please call your physician.
YOUR CHILD’S SKIN CARE ROUTINE
Keep your child’s baths short. Try to limit the bath to five of ten minutes each day. Use lukewarm water.
Hot water removes the natural oils from your child’s skin. The hotter the water, the more it will dry out your
child’s skin.
Use as little soap as possible. Use soap only on areas of your child’s body that get dirty: face, hands, feet,
and bottom. Use a mild soap. Soaps and shampoos also remove the skin’s natural oils.
Pat your child dry after the bath. Don’t rub. Rubbing will irritate the skin.
Apply a moisturizer immediately to the entire body. Moisturizer keeps the skin from drying out. Use the
moisturizer everywhere, not just on the affected areas. Remember, children with eczema have dry skin all over.
Putting moisturizer all over can keep the eczema from getting worse. Petroleum jelly works best, but some
children dislike its greasy texture. Plain mineral oil is an alternative. If you have questions about your child’s skin
care plan or about a product, please call your physician.
CHOOSING A SOAP
All soaps irritate. Superfatted soaps or liquid soapless cleansers are less irritating, but easier to overuse. If you
choose a liquid, use a small amount and rinse well. You may need to try several kinds before you find a soap that
your child likes. Gentle soaps include: Dove (unscented), Basis, Purpose. Cetaphil Liquid Cleanser, Aquanil,
Moisturel Cleanser are examples of soapless cleansers.
CHOOSING A MOISTURIZER
There are three kinds of moisturizers: lotions, creams, and ointments. Some brands come in more than one
form. Usually the ointments work best, and they may stay on the skin longer than lotions or creams. However,
they are harder to apply because they are thick. Also, they may be messy because they are greasy. You may find
that it works well to use an ointment at bedtime and a cream or lotion during the day. Avoid products with a
fragrance or lots of additives that may be irritating or cause an allergic reaction.
Examples are: Nutraderm Lotion, Curel (lotion), Etra, Eucerin Cream or Lotion, Moisturel (Cream or Lotion),
Aquaphor (Ointment), Vaseline petroleum jelly.
ITCHING
Most of the time you can control your child’s itching by following the daily skin care plan. There are some
additional steps you can take when your child’s itching gets worse. Apply moisturizer every time your child’s
skin looks or feels dry. This usually helps control itching. For severe itching, try putting a damp, cool washcloth
on the affected skin. Antihistanes, such as Benadryl, can help promote more restful sleep.
FLARE-UPS
There may be times when your child’s eczema will get worse. His or her skin may: become red of irritated, ooze
or look weepy, appear thick and scaly, itch. Flare-ups may happen anytime, and many different things can cause
them. Flare-ups may happen: when the weather changes, when your child is sick, , when your child is under
emotional distress, or for no apparent reason. Your doctor may prescribe medicines to reduce the symptoms of
a flare-up. Some medicines are applied to the skin. Others are taken by mouth. Anytime the doctor prescribes
medicines for your child, make sure you know: how to use or give the medicine, how often and how much to
use, what side effects to watch for.
INFECTIONS
Children with eczema are more likely to get skin infections. Watch for any of these signs of infection: fever,
redness, swelling, drainage or weepy skin, blisters, scabbing. If your child develops any of these symptoms, call
your physician.
IF YOUR CHILD DEVELOPES DIAPER RASH
Use a damp soft wash cloth to clean your child. Avoid baby wipes. They can irritate and dry the skin. Every time
you change your child’s diaper, apply zinc oxide- containing ointment.
The content of this document is for informational purposes only. Questions regarding specific patient issues
should be directed to the appropriate professionals for resolution.
National Foundation for Ectodermal Dysplasias
FOR SCHOOL-AGE CHILDREN
School-age children can learn to care of their skin. However, they will need the cooperation of their teachers. It
helps if teachers understand that eczema is not contagious. Your child should carry moisturizers to apply
anytime he or she starts itching.
OTHER WAYS TO HELP YOUR CHILD
Most children do best in loose fitting, cotton clothing. It can also help to wash new clothes before your child
wears them. Keep the temperature in your house steady and comfortable for your child. Children often do
better if they are somewhat cooler. Frequent changes in the temperature may cause flare-ups. Avoid wet wipes.
They may irritate the skin.
FOR OTHER CARE GIVERS
If your child has a sitter or goes to day care, you will need to give special instructions to these care givers. It is
important to help them understand that your child’s eczema is not contagious. Ask them to : apply moisturizer
or medicine on schedule. If your child wears diapers, make sure that other care givers follow those instructions,
as well.
WHEN TO CALL YOUR DOCTOR
Please call your physician if you notice any of the following: your child’s skin does not improve even though you
are sticking to the skin care routine; your child has any signs of a skin infection; your child has side effects to any
medicines; you have questions about your child’s condition or care.
Contact the National Eczema Association for Science and Education for more information.
Nancy Esterly, MD
Medical College of Wisconsin
Elaine Siegfried, M.D.
Central Dermatology,
St. Louis, MO
Update 04
The content of this document is for informational purposes only. Questions regarding specific patient issues
should be directed to the appropriate professionals for resolution.