Eczema in Children, Special Concerns During Winter Months

Posted by admin on December 22, 2008 under eczema | Be the First to Comment

New Infections Make Eczema Care More Critical

Winter is a tough time for parents and children with eczema. The weather is colder, the heater in on, and people like to warm up with a hot bath or shower. These are all ingredients for dry skin and the worsening of eczema.

The skin acts as a barrier to the outside to prevent things like infections and to keep the skin moisturized. With eczema and atopic dermatitis (childhood eczema), the skin is broken down. This broken barrier allows more transepidermal water loss and leads to more irritation from the environment.

Patients with eczema and atopic dermatitis are more susceptible to skin infections – infections with Staphylococcus aureus, herpes simplex virus, and molluscum contagiosum. With the recent emergence of infections caused by methicillin resistant Staphylococcus aureus (MRSA), patients with atopic dermatitis need to work especially hard at prevention by reducing the colonization of the bacteria (MRSA) on the skin. An individual can be a carrier of the bacteria, through their nose or anus.

Since colonization of the skin leads to re-infection and the worsening of eczema, sufferers need to reduce the amount of MRSA bacteria on the skin.

Diluted bleach baths have been recommended to reduce Staphylococcus aureus colonization in patients with atopic dermatitis. Such a bath is made with ½ C of 0.005% sodium hypochlorite added to a full tub of water, twice a week. In addition, mupirocin (Bactroban) can be applied with a Q-tip to the nose twice a day for five to 10 days. If you think your child has a staph infection, talk to your doctor about treating the infection as well as seeing if your child is a carrier of the bacteria through their nose.

Those with atopic dermatitis are easily irritated by allergens such as detergents and perfumes. They are also at risk for developing allergic rashes from things that they come in contact with (allergic contact dermatitis). This can happen when an individual becomes sensitized to a product that they have used for a long time. For example, someone has atopic dermatitis and has developed an allergic rash to the moisturizer that they have used for a long time. The most common contact allergens (products that produce a rash) are emollients, chlorhexidene, hexamidine, tixocortol pivalate, and bufexamac. If someone suffering from atopic dermatitis develops a rash, the cause might be something they have been using for a long time.

The treatment for eczema is aimed at eliminating the irritation (redness, scaling and inflammation), as well as repairing the barrier function of the skin. Topical over the counter hydrocortisone or prescription corticosteroids work to treat the inflammation of the skin. The barrier of the skin is repaired with moisturizers or emollients. An emollient gives a smoothing effect on the skin and a moisturizer affects the hydration. Moisturizers work in three vehicles; ointments, creams, or lotions.

Petrolatum is an ointment that is also very effective in repairing the barrier of the skin. It is available as Vaseline, Eucerin ointment, Aquaphor, and others. Cera-Ve is a relatively new product that is available as a cleanser, lotion or cream. It is product that helps to repair the ceramide deficiency found in atopic dermatitis.

There are many products in the market designed to help the skin. Ointments are better than creams. Creams are better than lotions. Make sure that the moisturizers don’t have fragrances. If the moisturizer irritates you or your child’s skin, DON’T USE IT. Limit the bathing, use a mild soap and moisturize.