Eczema: A Parent’s Guide (Pedcast)


Transcript:

Welcome to this edition of DocSmo.com. Hope you are having a great day. Thanks for joining me today. I am your host, Dr Paul Smolen, a general pediatrician with 30 years of experience caring for both sick and well children. I’ve learned a few things during that time and I want to share that knowledge with you.  As I like to say, from the crib to the country club, from the bassinette to the board room and everything in between… that’s what we talk about on DocSmo.com. Today’s cast very important because we are going to learn about a common skin condition, in fact, the most common skin condition in children-eczema. In today’s pedcast, I hope to give you a fundamental understanding of what is going on in the skin of a child with eczema. We have all heard that word, eczema, but do you understand what exactly it is?  I hope after listening today, that you will.  Before we get started today, let me remind my listeners, that I am probably not your child’s doctor and what you hear on this podcast is intended to supplement your child’s regular healthcare.  For specific advise about your child’s health, visit the wonderful person you call your pediatrician.

 

 

You remember from biology class that your skin is made of two layers, the deep part called dermis and surface called epidermis. You may recall that the surface epidermal layer is made mostly of dead cells, which serve to protect the deeper part of our skin, the dermis.   The dermis is where we find the working part of our skin, the sweat and oil glands, the hair follicles, as well as the nerves in our skin.  Babies have two layers as well but their epidermis is thinner and more fragile when they are young. That’s probably why their skin is soooo soft! Soft is great but your babies skin is supposed to be a barrier to the outside world and when it is broken, there are bound to be problems. Thin epidermis can mean easily damaged and cracked.  Bad. Think of your child’s epidermal skin as the shingles on your roof.  If the shingles are cracked or loose, the roof is going to leak. The same is true with your child’s skin; if the epidermal barrier isn’t intact it is not going to work well.  Without an intact barrier (shingles so to speak) your child’s skin will let in irritants that it was not meant to touch and the deeper parts of your child’s skin doesn’t like touching the outside world and will react by turning red and angry…. Itchy red angry skin means the dermis isn’t happy.  In  a  nutshell,  that  is  what  we  call  eczema.

 

 

 

Now that you know what is happening in the skin in a child with eczema, let’s talk about the essential dos and don’ts in skin care for a child with this condition. First the don’ts

Try not to remove oil from their skin by:

Don’t over bathe: Limit bathing.  I suggest twice weekly for young babies.

Don’t use hot water: Try not using hot water when bathing as this may remove oils your baby’s skin really needs.

Don’t use much soap-Try using very little soap for the same reason.  When you do use soap, don’t put the soap in the bath water. Just use a little on the washcloth and only use it on the areas that need it.

If your child is infection prone, many dermatologists recommend using “Clorox” in the bath to kill some of the nasty skin bacteria that can infect the broken skin of eczema. Many experts recommend ½ cup per full bathtub no more than twice weekly. Check out the references in the Smo notes if you don’t believe me or ask your child’s pediatrician but…. take care to follow the directions carefully.

 

I also want you to limit your child’s exposure to irritants:

Limit Laundry products- I do not recommend you use dryer sheets or softeners. Now, I don’t do much laundry but I hear that baking soda in the wash cycle is a good softener.

Make sure the detergent you choose is perfume and dye free.

Avoid irritating fabrics like wool from touching your child’s skin.

Remember that if you wear perfume or wool clothing, your baby is probably going to get a good dose of it when you carry them around so be careful to keep a cloth on your shoulder when this is going on.

Avoid vigorous rubbing during bathing.  Only use a soft cloth.

Avoid alloy metals- snaps, earrings, jewelry

Avoid skin products with chemicals, especially perfumes

Avoid touching grass or other things that  you find trigger trouble

If you find a food that starts the whole inflamed skin process, avoid it!

 

 

If you do have a child with sensitive skin, here are some of the things that you want to do to help keep their skin in good condition. Hydrate the skin. Moisturize quickly after bath as well as at other times.  Use the thickest moisturizer you can that has no perfumes.  Petroleum jelly may work for your child.

Try reminding yourself to moisturize by associating the moisturizing with other activities such as diapering and bathing.  The more the better.  We are talking at least 4 times a day.  Remember, those shingles are cracked and need repair. Suppress eczema that is inflamed. Watch for signs of infection

Pustules, blisters, oozing mean it’s time to seek help from your child’s doctor.

 

6.

-Let me sum up today’s podcast with one of those DocSmo pearls that I love: “Modern children’s skin probably needs less exposure to modern life.”  Let me repeat that;  “Modern children’s skin probably needs less exposure to modern life.”

Less bathing!

Less soap!

Less hot water bathing!

Less exposure to chemicals and perfumes of all sorts!

7.

 

That wraps up another edition of DocSmo.com

I told you were going to be smarter after this podcast.

If you enjoyed today’s talk, go ahead and check out the extensive DocSmo library of pediatric topics

Share any thoughts you have with us by sending a comment to our blog at www.DocSmo.com.  We would love to hear from you.

This is your resident pediatrician, Dr. Paul Smolen, broadcasting from studio 1E in Charlotte, NC hoping you have all the facts about your child’s skin cracks

 

Until next time

 

Smo Notes:

 

  1. Doc Smo podcast with Dr Primmer on Eczema: https://www.docsmo.com/wp-admin/post.php?post=1018&action=edit

 

  1. Clorox formula for bathing :

 

http://aapgrandrounds.aappublications.org/content/21/1/3.full.pdf

http://www.mayoclinic.com/health/eczema-bleach-bath/AN02003

 

 

Subscribe on iTunes!

 

Subscribe on iTunes or follow us on Facebook and Twitter!

 

*By listening to this pedcast, you are agreeing to Doc Smo’s terms and conditions.

 

All Rights Reserved.

4 Comments

  1. Michelle Vincent says:

    1/2 cup of white vinegar in the bath will raise the acidity level of the skin, where germs will not grow. It is definitely a preferred method over chlorox. Also, tea tree oil will help greatly with the itch…Olive oil baths harbor staph…so, do not use those. Remember, eczema is your body’s way of saying something is wrong on the inside…

    • DocSmo says:

      Michelle, Thanks for your input. I have read that many people find diluted vinegar, either taken orally or applied topically as you describe, provides some relief to their eczema with this therapy. As you pointed out in your comment, surface staph infections may play a large part in the eczema cycle of crack and itch. Changing the environmental conditions of the skin may reduce staph colonization which may trigger eczema. Studies are currently underway to see if diluted Clorox is better than placebo for eczema care. I am not aware of scientific studies looking at vinegar’s role in therapy, but I wouldn’t be surprised if it is effective. My best to your family!

  2. Dao says:

    Hi DocSmo,

    Are water softeners beneficial to children with eczema? I am thinking about purchasing one. My son has chronic eczema since he was an infant. I have read mixed reviews though about water softeners. What is your take on it?

    • DocSmo says:

      Dear Dao, I have looked at the latest guidelines from the AAP about best practices for children with eczema. They don’t mention water softening as good or bad in their recommendations. They don’t mention it at all. I think if you want a water softener for other reasons, then I would purchase one. If not, I would not get it expecting that your children’s skin will improve with it’s use. I am sorry but I don’t have any other information that might be helpful. Thanks for your question.

Leave a Reply

Your email address will not be published. Required fields are marked *