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Over your lifetime, you probably walked to raise money and raise awareness for cancer, lupus, MS, or epilepsy. But have you tied up your sneakers for eczema? Although the ailment is far from deadly, and I wouldn’t dare compare it to a devastating disease, eczema doesn’t have a cure. And for the first time, a charity walk was held in North Carolina to try to find one.

Like many people, I have dry skin from time to time, but it’s nothing a little lotion can’t combat. Eczema on the other hand needs more attention. I heard of it, but never really educated myself on the matter, until I became a mom. When my daughter was a couple of months old, I noticed dry patches on her skin. I moisturized her often and ran a humidifier. But the problem didn’t go away. Her pediatrician prescribed Nystatin. The ointment cleared up the red rash on my daughter’s face, but it didn’t do anything about the scaly skin on her body. The doctor then bumped up the medicine to Desonide. I was uneasy about using a steroid ointment, because I heard rumors that it caused hyper pigmentation, especially on African American babies. It worked, but left behind light spots. I later learned it was the eczema not the steroid that caused this. Later, a pediatric dermatologist refilled the Desonide prescription. She said once the problematic areas healed, lather on CeraVe Cream or Aquaphor Healing Ointment. As a journalist, I always search for multiple sources and like to spread the news about my findings.

So, I picked the brains of fellow moms, Skincare Expert Dr. Patricia Treadwell and The National Eczema Association to find out the best ways to treat eczema in infants and toddlers.

What is Eczema?

Eczema is a chronic itchy skin condition. It usually starts within the first five years of life, most often in the first six months. It typically lasts into childhood and adolescence. In some cases adulthood. Some children have very mild eczema and others have severe cases, also known as atopic dermatitis. Children with eczema may be more likely to develop allergies or asthma but one does not cause the other.

“The incidents of eczema in African-American infants is no different from infants in other races. About 15-20 percent of babies have some form of eczema,” Dr. Patricia Treadwell tells Diary of a First Time Mom. “It’s a common occurrence, so pediatricians are familiar with the symptoms and treatments. Parents can take their children to their doctor first, before seeking advice from a specialist. Two-thirds of my patients outgrow eczema after the first year.”

What can trigger a flare up of eczema in my baby?

Eczema flares occur when the skin is very dry, it comes in contact with irritating substances or allergic triggers, or when the skin is infected. Eczema tends to be worse in the winter when the air is dry and tends to improve in the summer when it is more humid. In babies, saliva from drooling may cause additional irritation, particularly to the cheeks, chin and neck. In such cases, applying an ointment like Aquaphor or Vaseline can prevent direct contact with saliva and decrease skin irritation. Specific triggers can vary based on the child and can include pets, carpet, dust mites, fabrics (such as wool), cigarette smoke, and scented products (such as perfume, laundry detergent and air freshener).
 When the skin is infected your pediatrician or dermatologist may have to prescribe an oral antibiotic to improve the eczema.

“I recommend dressing your infant in cotton clothing. Use an unscented laundry detergent and add an extra rinse to the cycle when washing. Extreme heat can cause flare-ups, so make sure your child is dressed appropriately,” says Treadwell.

How do I treat infant and toddler eczema?

“It’s very important to moisturize the skin. Most over-the-counter products will work. It’s a trial and error thing. You should match a brand to your child’s skin based on what works best for them,” says Treadwell. “I typically tell my patients’ parents to start with Vasoline. It’s something their mothers and grandmothers turned to moisturize their skin, and it’s something most people are familiar with.”

According to the National Eczema Association website, parents are often attracted to a moisturizer with “natural” ingredients, but many of these contain plant extracts that can be irritating to sensitive skin.

Here’s what Diary of a First Time Moms had to say:

Whitney McIntosh, Altoona, Iowa: I gave my child an oatmeal bath and immediately rubbed on Eucerin.

Diamonte Hamlett, Pittsburgh, Pennsylvania: My daughter suffers with it. I use Cortisone Eczema Lotion and the healing brand of Hydrocortisone Lotion. In the summer, I add CVS brand Sunscreen. She itched very little during the summer last year with the sunscreen. I also used Disney Baby Eczema Cream, but I think they discontinued it in the stores. It may be available online. I bathe her in dial soap only. Nothing else has worked for me.

Carolyn Davis, Nashville, Tennessee: My daughter had it terribly! I actually found relief with putting a small amount of Hydrocortisone cream on her skin a few times a week, as well as an oil from a company called”Bindi, which is an Ayurvedic organic supplier. It’s actually called Bindi Baby Massage Oil.  She still uses the oil daily to this day, it leaves her skin so soft and smells wonderful! I even use it on my skin as well. I usually mix it with either a little jojoba oil or almond oil, and sometimes I add lavender. Neem oil (which Bindi also sells) works great on breakouts and eczema and dry skin as well.”

Monique Holloway, Atlanta, Georgia: My son had a mild case, so I use Calendula Cream by California Baby. It is a skin soothing cream that works really well for him. It is all natural and you can find it at Target and Whole Foods or on the company’s website.

Jasmine Collins, Columbus, Ohio: My daughter is three, and she has had it since she was born. All I’ve ever used was Baby Aveeno Eczema Lotion and Body Wash, and she hasn’t had any outbreaks since she was about one.”

Michelle Spencer, Orlando, Florida: If the outbreaks are serious enough, I use a little Hydrocortisone 1%. Don’t use it excessively as it is addictive. For bathing I use Aveeno Body Wash. As a moisturizer, I Cetaphil cream in the plastic jar or Curel works really well. My kids have had it so bad they have had a script for Protopic. It’s important to make sure their bedding stays cool, especially when there’s an outbreak because the skin sweats even more at that time. That’s my two cents!”

Latoya Hall-King, Detroit, Michigan: Cortisone cream!  It worked wonders.

How should I bathe my child with eczema?

Daily bathing is recommended for infants and children with eczema. Baths should be warm, not hot, and they should be short in duration, lasting about 10 minutes. The use of soap should be limited. Bubble bath, epsom salts and some other bath additives should be avoided because they can be irritating to the skin and worsen eczema. Also avoid the use of scrubbers, loofahs and rough wash cloths. Immediately after bathing, a moisturizer should be applied to the skin.

What are bleach baths, and why are they recommended for some children with eczema? It sounds harsh.

Bleach baths may be recommended by your dermatologist if your child has moderate to severe eczema and/or a history of infection. Bleach baths help prevent infections and maintain better eczema control. Staphylococcal aureus is a bacteria that lives on the skin of many children with eczema and can occasionally grow to cause infection and eczema flares. Bleach baths can help control the amount of bacteria on the skin and lead to fewer skin infections. Bleach baths are safe and are similar to bathing in a chlorinated swimming pool. Bleach baths are made by pouring ¼ cup of bleach into a half-filled bathtub. For babies with eczema, 1 to 2 teaspoons of bleach per gallon of water may be added to a baby tub. Always be careful to dilute the bleach before contact, avoid getting bleach water in the eyes, and moisturize immediately after the bath. Bleach baths are usually recommended a few times per week.

Will I need to use steroid ointments on my child?

Very mild eczema may be controlled with a good bathing and moisturizing routine alone. Mild eczema may require the occasional use of a low-potency topical steroid. But the majority of children with moderate to severe eczema (or atopic dermatitis) will need to use low- to medium-potency topical steroids on a more regular basis to control eczema.

Heather Hopson, Pittsburgh, PA Diary of a First Time Mom Creator:

I was hesitant by using a steroid ointment on my daughter’s sensitive skin, especially her face.  But after receiving this advice from her pediatrician and then her pediatric dermatologist, I applied Desonide twice a day.  It worked!  Even though the eczema outbreak cleared up, I have to stay on top of it.  CereVe Moisturizing Cream works wonders. Her smooth skin even has a glow.

Are steroid ointments safe?

Steroid ointments are safe when used appropriately. Some tips for safe application include:

  • Apply topical steroids only to rough affected skin and avoid normal unaffected skin.
  • Avoid the application of topical steroids to skin folds (armpits, groin, thighs, under breasts) when possible, especially for prolonged periods of time.
  •  Avoid the use of topical steroids on eyelids.
  • Apply milder steroids, which your dermatologist can prescribe, to treat the face.
  • Use the mildest topical steroid that controls the eczema, which your dermatologist can help you determine.
  • Apply topical steroids no more than two times per day. Consider using calcineurin inhibitors (Protopic© ointment and Elidel© cream.) These nonsteroidal anti-inflammatory medications are approved for children older than two years, but they are sometimes used “off-label,” especially in rotation with topical steroids, for infants.

“Some parents think the steroid ointment bleaches a baby’s skin when in fact it is typically the eczema itself that lightens, or in some cases darkens, the skin tone,” says Treadwell.

When should I use a steroid ointment on my child?

Topical steroids should be applied no more than twice daily. One application should occur immediately after bathing as part of the bathing routine. A moisturizer should always be applied over the topical steroid. Topical steroids should be applied to red itchy skin until the skin is less inflamed and more comfortable. Be aware that the skin may look lighter in color after the redness clears. This is normal and improves with time.

How much steroid ointment should I use on my infant of toddler?

Enough steroid ointment should be applied so that the skin feels tacky immediately after application. Within a few minutes it is will be absorbed by the skin. Topical steroids should be applied only to red itchy areas of skin.

Are there other treatments for infants or toddlers with eczema?

Gentle skin care and the use of moisturizers, and topical steroids are the most important treatments for eczema. But there are other topical medications such as Protopic© and Elidel© that are safe and effective for use on eczema when used as directed by your child’s doctor. Tar preparations can also be helpful.
It is important to prevent bacterial infection of the skin through the use of bleach baths as part of any ongoing skin maintenance routine. When infection is present, it should be treated with topical or oral antibiotics. Oral antihistamines are very helpful for some children with eczema. They may reduce itch, but perhaps more importantly, they cause drowsiness, which helps children sleep.
Some eczema does not respond as expected to the usual treatments. Such children may be candidates for oral or injected treatments that calm inflammation in the body. Your child’s dermatologist will help you decide if this kind of treatment is necessary.

Will changing my infant’s or toddler’s diet help?

While many parents assume that a particular food is the cause of their child’s eczema, the answer is rarely that simple. Most eczema is unrelated to diet. In fact, parents who remove food from their child’s diet in an effort to clear up the skin can be causing more harm than good. If your child’s eczema greatly improves with gentle skin care and topical medications as described above, it is unlikely that there is a “hidden” food allergy in play. Some children with eczema have food allergies, but that does not mean that the food allergies actually cause the eczema. If your child gets hives (red, itchy swollen skin bumps that look different from eczema) within one hour of eating a specific food, this is a sign of a food allergy and this food should be avoided until you talk to your child’s doctor.

What if I am breastfeeding? Bottle feeding?

Most infant eczema is unrelated to diet, whether breast milk or formula. Many babies with eczema are incorrectly labeled as “milk allergic.” Do not stop breastfeeding or giving cow’s milk formula without first talking to your child’s doctor. In most cases the skin will improve by using the gentle skin care techniques and topical medications described above.

When should you test a child for allergies?

Because most eczema is not related to diet, and because current allergy tests do not accurately predict eczema triggers, allergy testing is not routinely recommended. However, if your child’s eczema has not responded to standard treatments or your child gets a rash after eating a specific food, allergy testing might be considered.

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