Can't Get Your Child to Stop Itching?

Stop the itch, with a visit to the doctor

By J. Bergman, MD, FRCPC and D. R. Thomas, MD, FRCPC

Itching is a common experience, however, if it starts to interfere with you or your child's daily activities, it can be challenging to cope. Eczema refers to several different conditions where the skin is red, irritated and may sometimes form small, pus-filled bumps. The most common type of eczema is called atopic dermatitis. Eczema tends to run in families, so if you have family members with eczema this increases your chances of developing it. This skin condition usually begins before 2 years of age and becomes less common in older children and adults.

Signs and symptoms

• Itching or burning
• Dry skin
• Location of the rash
• For infants, the face, arms and legs are often affected
• For children aged 4-10 years, the rash is most likely found at bends of the elbows, behind the knees, backs of the wrists and ankles, sides of the neck and earlobes
• Red, scaly and crusty patches, made worse by repeatedly scratching
• Infection is very common

What can make it worse?

• Soap, bubble bath, detergents, fabric softeners and products containing perfume
• Bathing too often, especially if you don't use a moisturizer after
• Sweating can make you feel itchy
• Any skin infection can worsen eczema
• Allergies to certain foods, such as eggs, milk, nuts, peanuts, fish, shellfish, wheat and soy
• Triggers in the environment, such as house dust mites, seasonal allergens and pet dander

Medical treatments available from your doctor

Itch relief

You can use antihistamines, such as diphenhydramine (Benadryl), at bedtime to help with itching. These medications are commonly used to provide relief from intensive itching, however, there is little evidence to support this effect. Antihistamines work by preventing the release of histamine, a substance produced by the body to initiate inflammatory defenses of the immune system.
Itchy skin can often be calmed and reduced if regular ongoing moisturization is practiced to soothe and hydrate skin.

Anti-inflammatory medicines

Topical corticosteroids (TCS)

• Considered by doctors to be the standard treatment for eczema
• Always start using the lowest potency possible and do not stay on for longer than instructed by your doctor
• Useful for preventing or reducing the severity of flare-ups
• Low potency corticosteroids are best used on delicate areas, such as the skin folds, face and neck
• Moderate potency steroids are needed for areas with thicker skin or locations where flare-ups occur more frequently
• Side-effects can happen if you use the drug too long, too often, or too much

Topical calcineurin inhibitors

• Pimecrolimus (Elidel 1% cream) and tacrolimus (Protopic 0.03% and 0.1%ointment)
• These newer medicines do not contain steroids and are usually used when other treatments are not effective on your skin
• Only recommended for use in patients over 2 years of age
• Use at the first signs of a flare-up to control your symptoms, then use on and off when necessary
• You may experience burning or stinging after applying on your skin

Control of infections

Children and teens with eczema are more likely to get skin infections. If your child has a fever and you notice the infected areas are red and warm and may have bumps filled with pus, call your doctor immediately. Antibiotic medicines are available for treatment.

Although eczema is a common problem, it can cause a great deal of distress, especially for very young children. The bothersome itch, skin irritation and flare-ups can be successfully managed and controlled with the help of your doctor. For more information, please visit Eczema Guide

Moisturizers and mild cleansers

Daily emollient therapy with moisturizers and mild cleansers is essential for successfully managing eczema, both during and between flare-ups. Emollient therapy helps the skin to retain hydration and restore its crucial barrier function, thereby inhibiting the penetration of irritants, allergens and microorganisms. Moisturizers should be used more frequently and in larger amounts than any other topical treatment for eczema. Maintenance therapy with moisturizers can extend the periods in between flares and reduce the need for medications, such as topical steroids and immunosuppressants.

Although eczema is a common problem, it can cause a great deal of distress, especially for very young children. The bothersome itch, skin irritation and flare-ups can be successfully managed and controlled with the help of your doctor. For more information, please visit Eczema Guide

About SkinCareGuide:
The SkinCareGuide Network of dermatology-related websites was founded by a prestigious group of international dermatologists. It provides comprehensive information for patients and physicians about the skin, its care and various skin conditions and treatments. All content is reviewed by an independent Board of Medical Advisors to ensure that the information is accurate, unbiased and up-to-date. This information is not intended to replace a consultation with your own physician.

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