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Itchy, blotchy skin - what causes it - and how can I help?

When your child has a rash - or a red, dry patch of skin it can be concerning. For many children, itchy, red skin is a sign of atopic dermatitis - otherwise known as eczema. This condition is most common in babies and children - but it can develop at any age.

Here are some of the questions I am asked by parents about this condition:

What does eczema look like?

The skin is very often dry, red and itchy. However sometimes blisters may form and weep clear fluid. Because this is a chronic skin disorder, the symptoms can come and go in severity.

Just how common is eczema?

Many children (some estimate as many as 1 out of 10 kids) suffer from eczema. The condition is most often seen in very young children. Here are some things we know about children who develop eczema:

  • 65% of children develop symptoms before age 1 and 90% before age 5.
  • Dry climates and city life may make your child slightly more likely to develop eczema.
  • Children from families with a history of asthma, hay fever or eczema are more likely to suffer from it.

What causes eczema in children?

There is no single answer to this. The eczema symptoms may be caused by a number of different conditions specific to each child. Dry skin, allergy triggers, irritating substances or skin infections have all been shown to cause eczema symptoms to appear. Babies and infants drooling onto cheeks or face may cause further irritation, particularly to the cheeks, chin and neck areas.

Some of the more common triggers of eczema in children are:

carpets gasoline dust mites fabric, such as wool
perfume detergent air freshener cigarette smoke

What can be done to treat eczema?

For children with eczema, you are often treating both dry skin and irritated skin. Here are some general suggestions and guidelines I give:

Daily baths
Bathe your child in warm, not hot, water. Do not give your child showers. Short duration - 10 minutes or less.

Limit soap
Use a mild, non-perfumed soap. There are excellent choices which are made for sensitive skin and do not contain irritants. No bubble bath or other additives to the water. Any of these may irritate the skin. The National Eczema Association maintains a list of soaps found to be mild on skin prone to irritation.

No scrubbing
Do not use loofahs, rough washcloths or other things to scrub the skin.

Keep skin moisturized
Try to keep your child's skin from becoming too dry. Use a cream or ointment to seal in moisture immediately following a bath. Vaseline or Aquaphor- type ointments may help form a barrier protecting sensitive skin. This may be particularly helpful if drooling is causing outbreaks on baby's face, cheeks or neck.

When the skin is infected your pediatrician or dermatologist may have to prescribe an oral antibiotic to improve the eczema. Topical steriod such as hydrocortisone creams may help lessen the itch.  Sometimes an oral antihistimine can help as well. Be sure to use these as your doctor directs.

Will my child always have the condition?

Not necessarily. When children with atopic dermatitis grow older, this problem can improve or go away. Many children who develop eczema as infants outgrow it by age 4. Some outgrow it by young adulthood. For a few, atopic dermatitis is a problem throughout their lives.

Even if the child outgrows the condition, the skin may stay dry and easy to irritate.

Is this contagious?

You can’t “catch” the disease or give it to other people. Children should be allowed to play with others. Swimming is fine - but be sure to rinse off any chemicals that may have been in the water.

Watch for other problems

Eczema is a skin condition, however, it may have health effects beyond your child's skin. Your child's sleep may be disturbed since itching is more often more prevalent at night.

Red, irritated skin may lower your child's self-esteem as well. Help your child to understand that this is something that you will both work to keep in control - and it does not define the type of child he or she is.

Your child's physician can be a great partner in helping you and your child create a plan to lessen eczema's effects.


Stephanie Neuhaus, MD

Methodist Physicians Clinic Hawthorne Court

Dr. Neuhaus answers your questions about child health and parenting. She enjoys being a pediatrician because it allows her the opportunity to help people every day. Dr. Neuhaus is always open and honest with her patients and she is excited to watch them as they learn and grow. She strives to build lasting relationships with her patients and their families. Dr. Neuhaus, a mother herself, believes in always listening to patients' moms. They know when something is wrong with their child and d ...

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