Mommy Call: Eczema

Question:

Hi Dr. Tanya,
My daughter just turned a year this July, she has had eczema since 3 months. Her doctor told me to apply lotion 2 times a day, but lately it is getting much worse. She has dry red patches all on her stomach and back, and her legs have white spots on them as well. Help! What do you recommend and what is your take on using Organic creams?
Andrea

Answer:

Andrea,
Thanks for your question.  I feel for you as my boys both had eczema that fortunately improved with age.  Eczema is common in infants and can be quite challenging to control.  It is a chronic, skin condition, more common in families with a history of asthma and allergies.  Just as you describe, patchy areas of skin become dry, itchy and irritated.  In more severe cases the skin may also become red, swollen, cracked, weepy or scaly.  In darker skinned infants, there may be a post-inflammatory hypopigmentation, which means the areas of skin may temporarily loose pigment after a flare-up.  Flare ups may be in particular areas or widespread.

Many factors can trigger eczema including food, soap, laundry detergent, sweating, temperature changes and basically anything that can dry out and irritate the skin.  To prevent flare-ups, stay away from thing that you know causes a rash.  In many cases it isn’t just one thing, but a combination of things that dry out and irritate the skin.  So try decreasing all allergic or drying substances in your daughter’s environment.  Laundry detergent should be free and clear of perfume and dye. Fabric softeners are not recommended for infants with sensitive skin or eczema.

It’s not necessary to bathe her every night.  A few times a week should suffice.  Use a mild, unscented soap or body wash (such as Cetaphil).  When she gets out of the tub, gently pat her skin, but leave a small amount of water on the skin. Then smear a thick, ointment or cream all over.  Applying the ointment or cream within 3 minutes of getting out of the tub will help lock in the moisture and prevent dryness.  Ointments (such as Aquaphor) and creams work best as lotions often aren’t thick enough.  Use them 2 to 4 times a day.  New products are available (such as CeraVe cream) that may help repair irritated skin as well as prevent further flair ups.  If buying organic is important to you, there are many available, just make sure products are unscented. For severe areas, talk to your pediatrician as there are many steroid or nonsteroidal creams that can be used on a regular or as needed basis.  For severe itching, your doctor may also recommend an antihistamine at night time.

I hope this helps.  Good luck!
Dr. Tanya