Back-to-School Doesn't Have To Mean Eczema Flares

Back-to-school time signifies quite a bit for school-aged children and their parents including brand new school supplies and outfits, new friends, new teachers, homework and importantly for children with eczema, the changing of the seasons.

"One trigger for eczema flares is the change of seasons and since back-to-school time correlates with summer changing into fall, it is a common time for eczema to flare," says Kimberly Morel, MD, a leading New York City pediatric dermatologist.

"The change of seasons is associated with decreased humidity in the air. Winter air tends to be drier than summer air," she says, adding that "dry air saps moisture out of the skin."

About 15 million Americans, many of whom are children, have eczema, a chronic skin condition marked by itchy, red patches of inflamed skin.

"The more you scratch, the more the rash comes out," says Morel, an assistant professor of clinical dermatology and clinical pediatrics at Columbia Presbyterian East Side Medical Center in New York City.

The majority of children with eczema will present before they turn one, but that leaves about 40% of children who may present at any time - including the first days of school! Besides the change of seasons, even emotional stress of going back to school can contribute to an eczema flare.

Eczema-Free Lesson Plan

Whatever the trigger, eczema treatment starts with the basics, states Morel. That's why Morel and DERMAdoctor has developed a lesson plan sure to make your child's skin irritation-free for the school year, starting with:

Lesson #1
Avoid hot showers which dry out the skin; choose luke-warm water instead.

Lesson #2
Choose and use a gentle, moisturizing, fragrance-free soap such as Cetaphil Gentle Skin Cleanser, Vanicream Cleansing Bar or Dove Fragrance Free soap. "These soaps are less drying and less irritating for already itchy and inflamed skin," she says.

Lesson #3
Avoid bubble baths and anti-bacterial soaps, because they can dry out skin even further. Cleanse with CeraVe Hydrating Cleanser.

Lesson #4
Follow the three-minute rule. "Moisturize within three minutes of bathing or showering," Morel says. Use fragrance-free moisturizing creams or ointments because they are thicker than lotions. As such, "they stay on the skin longer and provide a better barrier against eczema-triggering factors." Try CeraVe Moisturizing Cream, Vanicream Moisturizing Skin Cream, 4 oz, Eucerin Original Moisturizing Cream, or PRIORI Advanced AHA Barrier Repair Complex, which are all ideal moisturizers.

Lesson #5
"Avoid extra ingredients in your skin products even if they are 'all-natural'," she says. More is not better when it comes to skin treatments that soothe eczema. Better, says Morel, is plain Aquaphor Original Ointment, which provide a good base. "If those are too greasy, other brands include fragrance-free Aveeno or Eucerin cream."

Lesson #6
Avoid irritating clothing. "Instead of wool, stick with form-fitting 100% cotton clothing," she says.

Extra credit
"If all of these lessons are followed and your child is still flaring, see a doctor about prescribing medication to soothe his or her skin," she says. The good news is that today there are more eczema treatments available then ever before.

Until recently, steroid creams applied to the skin were the only available topical treatment. While still considered the treatment standard for eczema, these creams can have side effects such as thinning of the skin, stretch marks, easy bruising and an increased risk of infection. These side effects are even more common when used in high potency formulations for an extended period of time, such as when treating eczema.

Today, two new non-steroid treatments known as topical immunomodulators, Elidel and Protopic, work by producing anti-inflammatory effects on the skin without interfering with the immune system.

Another potential perk: People using steroids can become resistant to them, and as a result, may require larger doses for the same relief. That does not seem to be the case with the new immunomodulators.

Bear in mind, that eczema often causes such severe itching that children are up all night scratching (making the rash worse!). A good night sleep is never as important as before a day of school, so "if the itching is making your child's sleep difficult, talk with your doctor about ways to help him or her sleep more comfortably," advises Morel.

Denise Mann
DERMAdoctor Staff Writer

(Any topic discussed in this article is not intended as medical advice. If you have a medical concern, please check with your doctor.)

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