3 things you can do when your child’s eczema gets bad

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It’s winter, and in many parts of the country that means cold, windy weather — and dry, chapped skin. For all of us that can be a problem, but for people who have eczema it can be miserable.

As a pediatrician, I have lots of patients with eczema. Each one of them is different, of course, with different triggers for their eczema and different therapies that help. But when eczema gets bad — when parts of the skin get very irritated and scaly — there are three things that help just about everybody.

1. Moisturize, moisturize, moisturize! This may seem obvious, but I can’t overstate its importance — and helpfulness. When it comes to picking a moisturizer, think greasy when eczema gets tough. This kind of moisturizer is called an emollient. Even just petroleum jelly, or hydrated petrolatum, which are both widely available, can really help dry, irritated skin. And while they feel greasy when you put them on, usually the skin soaks them right up. Applying emollients two or three times a day can really help when things get tough — and can also help prevent eczema from flaring.

2. Bleach baths. This doesn’t mean sitting a child in a tub of bleach, which would be a bad idea. What it means is making the water in the tub kind of like the chlorinated water in a swimming pool. The bleach helps to kill bacteria on the skin, and also helps with inflammation. Add half a cup of bleach (regular household bleach, not concentrated) for a full tub of water, or a quarter cup for half a tub. The water should be warm but not hot, as hot water can dry out the skin. Soak for about 10 minutes, rinse off, and pat dry, not rub dry. Two or three times a week is usually plenty. Check with your doctor before you get started, to be sure it’s a good idea for your child and to decide how often you should do it.

Right after the bath you want to put on any steroids or moisturizers. And then, you might want to consider…

3. Wet wraps. You wouldn’t normally think of putting your child to bed with wet pajamas, but sometimes doing just that can help eczema by keeping the skin moist. Use long underwear or other close-fitting pajamas. You want to cover the area that is most affected. If the eczema is just on the arms, using tube socks with the feet cut off can also work — and for babies, a damp onesie can do the trick too. Dampen the pajamas with warm water and wring them out so that they aren’t dripping, and then put them on (after applying creams and moisturizer), with dry pajamas over them. You can put a towel on the bed to keep it from getting damp while the moisture evaporates and the pajamas dry.

As with any chronic medical condition, eczema is best managed when you work together with your doctor and come up with a plan both for treating flares and for preventing them in the first place.

To learn more about eczema and how to care for it, visit the websites of the American Academy of Dermatology and the American Academy of Pediatrics.

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