As winter approaches, the skin irritations and rashes associated with eczema tend to start showing up with increased frequency. As a pediatric dermatologist I see this trend in my patients every year. Eczema in children first shows up in infancy and gets better as kids get older. But in the meantime, many sufferers of childhood eczema find this time of year uncomfortable. In this post I explain some of the common triggers of eczema-related rashes and offer some suggestions for parents to deal with these symptoms.
Many people equate eczema with dry skin. What they may not realize is that eczema is a skin condition where skin does not have the ability to retain moisture properly. It’s normal for water to evaporate from everyone’s skin, but if someone has eczema it means their skin is losing more moisture. This above-normal level of moisture loss in the skin makes the skin more susceptible to irritations and rashes.
These rashes and irritations are triggered by different things this time of year. Below I list five of the more common triggers of eczema flare-ups.
- One of the most common flare-ups is caused by dry air and low ambient humidity. Outside, cold air holds less humidity. Inside, indoor heating with forced dry air pulls moisture out of the skin. I’ve witnessed patients with bad outbreaks this time of year and then they go on vacation to a warm, humid environment and return with their skin remarkably better.
- Being in school, surrounded by germs is a recipe for increased sickness. When kids are sick with a virus, cough, or cold their resistance is down. When this happens to children with eczema, their already compromised skin is even more susceptible to irritations and rashes caused by lack of moisture in their skin.
- Stress is another trigger that causes flare-ups. Schoolwork, sports, the holidays – these are all activities that can generate stress that contributes to eczema-related flare-ups.
- Certain products or textures can also trigger flare-ups. As the weather gets colder children are wearing more clothes. Remember, children with eczema have skin that dries out easily so their skin doesn’t function as a normal barrier against the elements. In other words, their skin doesn’t have the same protective abilities. This leaves the skin more vulnerable to coming into contact with something that causes irritability. Where normal skin can tolerate a certain texture or product, eczema skin will react and become inflamed. The trigger can be a type of clothing, texture, certain soaps, or even dust.
- Eczema flare-ups are also associated with environmental allergies and asthma. In dermatology, these three conditions are called an atopic triad. Typically, if a child has environmental allergies or asthma, a flare-up in one condition causes the child to be sensitive to a flare-up in the other.
Now you know a little more about common triggers for eczema-related irritations and rashes. But as a parent, what can you do? I recommend two approaches to my patients’ parents. The first is for them to treat the symptoms of the inflammation, which usually requires medication. Your child’s doctor can determine the best treatment depending on your child’s age and the severity of the symptoms. This leads to the second approach. What I see after a parent treats their child’s symptoms effectively with medications is that they forget about the eczema when things are good. The best preventative is to not forget to treat their child’s eczema when their skin is good. Between flare-ups parents still have to be vigilant and provide high maintenance to compensate for the skin’s lack of barrier function.
With three children of my own I realize this preventative approach is easier said than done. However, it really is easier to be proactive and preventative than it is to treat the symptoms. Here’s a suggestion that might make your life a little easier. In my experience, a lot of non-dermatologist physicians tend to tell patients to avoid bathing. This is unfortunate because bathing is actually very good for the skin. Not only do kids like to bathe but it’s relaxing. Stress is an inflammation trigger. So not only do these kids miss the relaxing benefits of a nice bath or shower but kids with eczema are bothered by the idea that their bathing habits have to be different than everyone else. This is an additional source of stress. Bathing also hydrates skin. You really want your kids to soak up as much water as they can and a warm, steamy bath or shower is excellent for their skin. The challenge is what you do when they get out of the bath. If you don’t seal in the moisture with a good moisturizing cream then it all evaporates. Try and make it a habit to moisturize your child as soon as they hop out of the tub. Some products I recommend are Cetaphil® cream and CeraVe® cream. Heavier creams are more effective than lighter lotions.
Hopefully, an increased awareness of eczema-related triggers will give you the ability to be more proactive for your child. This way your children can spend autumn and winter focusing more on fun and less on the typical seasonal irritations and rashes.
Contributor: Dr. Robin Schaffran