Eczema, also technically called atopic dermatitis, comes and goes. As the child gets older, the severity gets lesser and sometimes goes away completely. No one knows what is the exact cause of eczema. But what physicians know is that there is no one medication that can make it go away with one or two medications in a week or two. However, eczema can be controlled. Whether you go to a skin specialist or a primary care clinician, the principles of management are the same.

The goals of treatment of eczema are:

1. Keeping the skin moist or hydrated. The clinician will prescribe a cream, ointment, or lotion to keep you child’s skin moist, the key to controlling eczema. The moisturizer generally will have to be applied three or more times a day. Ointments and thicker creams feel greasier than lotions and keep the skin moist. Lotions on the other hand are easier to wipe on.

Your clinician will tell you how often you should bath your child. Frequent bathing is a concern because it can dry out the skin allowing cracks and fissures to pop out. Follow your clinician’s recommendations and always apply a moisturizer immediately after the child’s bath.

2. Reducing redness and inflammation. When your child’s skin is actively inflamed, your clinician will recommend a local or topical anti-inflammatory medicine for you to apply at the rashes. These are usually corticosteroids, however, it should not be confused with anabolic steroids that is abused by athletes. Topical corticosteroids for eczema is safe when used as recommended by your clinician.

3. Reducing itching. Another important key to eczema management is breaking the “itch-scrath” cycle. Itching is usually followed by scratching which inevitably result to damage of the skin creating more cracks and fissure. If uncontrolled, infection of the skin is the ultimate outcome. Corticosteroid creams and ointments with oral antihistamine are effective itch buster. Cotton and loose-fitting clothes help reduce itching.

4. Reducing eczema triggers. Stress, overheated rooms, allergens, and some food can aggravate eczema. Tell your clinician if your child is allergic to food, cosmetics, wool, detergent, etc. Dust and molds can also aggravate eczema. Sweating and some athletic gears can make eczema flare up.

5. Treat skin infection early. If the eczema looks “bad” and not getting better with with the recommended corticosteroids, the best bet is there might be staph infection of the skin. This will require prescription oral antibiotic (cephalexin, Keflex).

6. For severe eczema or if the treatment of your clinician is not improving the condition of your child, request for a pediatric dermatologist (skin specialist) referral.

Since eczema is not a curable condition, a good strategy is to prevent flare-up of “itch-scrath” cycle and staph infection. As your child grows older, with the above plan, eczema will be tolerable and your child will learn how to cope with it. 

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