
Ask Dr. Bob

Many Children Outgrow their Eczema 

This column originally ran in the St. Louis Post-Dispatch on Feb. 11, 2008

             Chris Schneider would wake two to three times a night to find her infant daughter Andrea screaming and scratching herself to the point of bleeding.  Her skin was red and swollen, and her eyes were crusty and difficult to open.  Chris would do her best to comfort her daughter, but nothing seemed to work.  For Chris, this nightly ritual played out for more than two years.  Andrea’s intellectual development lagged behind other children her age.  At age two-and-a-half, she finally began speaking. 

The young mother’s stress level was matched only by rising medical expenses and mounting frustration.  Doctors were unable to find a cause for Andrea’s condition. At one point, the baby was taking more than 12 medicines a day.

            “Andrea was tested for so many conditions, it began to look like we’d never find what was causing her to suffer,” Schneider said.  “We had almost given up hope.”

It was then that Schneider took Andrea to see Elaine Siegfried, M.D., director of pediatric dermatology at SSM Cardinal Glennon Children’s Medical Center.  Dr. Siegfried diagnosed Andrea with eczema, a condition that appears as red, irritated skin and sends the immune system into overdrive to protect the body.  In its attempt to protect, the immune system causes the skin to itch severely like poison ivy. An extreme case of eczema like Andrea’s affects only a minority of the population, but less severe cases can also be painful for children and stressful for parents.  Eczema affects 10-20% of children in the United States, so a great number of children are affected by this condition.  The good news is that many of them will “outgrow” eczema in their teen-age years.

            Parents concerned about eczema should look for these signs:

    • Red, scaly, irritated skin
    • Frequent scratching, sometimes to the point of breaking the skin

“Eczema causes itchiness because it reduces the skin’s ability to trap moisture,” Dr. Siegfried said.  “To prevent itching, you must make sure that the skin is hydrated at all times.  I recommend moisturizing often during the day and especially before going to bed.”

            Prevention is key, and Dr. Siegfried urges parents to avoid perfumed diapers and fabric softeners, as they contain chemicals that can become irritating.  When purchasing clothes, avoid garments with blue dye, which can aggravate the skin.  Because new clothing contains formaldehyde, which prevents wrinkling, it should be washed before it’s worn.  Siegfried also recommends bathing children instead of having them take showers, because it introduces more moisture to the skin. 

“Moisturizing is often the best way to combat eczema,” Dr. Siegfried said. “Apply a petroleum jelly and mineral oil moisturizer right after your child’s bath and throughout the day to keep the skin hydrated. After a bath, a good rule of thumb is to moisturize while the mirrors are still covered with steam.”

            Irritated skin was bothersome, but hardly the worst symptom Andrea endured.  The eczema had blocked her sinuses so much that her sleep was affected.  This lack of sleep delayed her intellectual development.  To alleviate her suffering, doctors had to perform reconstructive surgery on Andrea’s nose and sinuses. 

             “Andrea’s eczema had an effect on our entire family,” Schneider said.  “For the first two-and-a-half years of her life, her anxiety was high and she would scream for hours on end.  Sure, it was difficult for me.  But as a mother, all I wanted to do was end my daughter’s suffering.”

            While Andrea’s case was extreme, even mild cases of eczema can be uncomfortable for children.  Dr. Siegfried advises parents to keep a close eye on their children and see their pediatrician if they become concerned.
