Caring for Children with Atopic Dermatitis: A Comprehensive Guide

Atopic dermatitis, also known as atopic eczema or simply eczema, is the most prevalent skin condition in children, causing significant discomfort. Proper skincare is not only vital for alleviating a child's discomfort but also for preventing complications associated with the condition.

1. Complications of Atopic Dermatitis in Children

Atopic dermatitis in children is primarily influenced by familial (genetic) and allergic factors. Children from families with a history of other allergic diseases, such as bronchial asthma or allergic rhinitis, are at higher risk of developing this condition. While approximately 50% of patients may see an improvement in their teens, many cases persist into adulthood.
Atopic dermatitis in children is characterized by dry skin and red rashes, commonly found on the face, scalp, arms, legs, or behind the ears. In toddlers and older children, these rashes often appear in the skin creases around the knees, wrists, elbows, and ankles. In some cases, the rash can extend to cover a child's entire body, and it typically induces intense itching, often leading to sleep disturbances.

Several factors can exacerbate atopic dermatitis, including:

• Heat: Such as wearing heavy clothing, exposure to hot fabrics, hot baths, or proximity to fireplaces.
• Dryness: Caused by soap usage, air conditioning, arid weather, and other factors.
• Itching: Triggered by irritants like clothing tags, animal fur, grass, sand, and dust.
• Infections: Including viral or bacterial infections.
• Other factors: Such as exposure to chemicals, environmental triggers, and allergens.

2. Caring for Children with Atopic Dermatitis

2.1. The Objectives of Proper Skincare

Proper skincare serves several critical purposes, which include:

• Improving disease symptoms by reducing itching and inflammation.
• Moisturizing the skin to maintain adequate hydration.
• Protecting the skin from external irritants.
• Preventing and treating infections.

2.2. Managing Itching in Children

Itching is a major concern in children with atopic dermatitis as it can exacerbate the condition and potentially lead to infections. To alleviate itching in children, consider the following strategies:

• Moisturize the affected skin or apply damp bandages.
• Keep your child's hands clean and their nails short to prevent scratching.
• Divert your child's attention when they are itching excessively, engaging them in activities like games or watching TV.
• Administer medications as prescribed by the doctor.

Wet bandaging, or moist compresses, may be necessary if the child's condition doesn't improve within 24 to 48 hours after starting cortisone treatment. These wet dressings usually yield positive results within three to five days. The procedure involves:

• Wetting a towel or bandage with warm water mixed with a skin moisturizing solution.
• Applying cortisone or other prescribed medications to dry, red skin areas.
• Applying moisturizer to the entire body.

The application of wet bandages or moisturizing depends on the extent of the condition and the location of skin damage, including the face, head, hands, feet, and the torso.

2.3. Hydrating the Skin

Consistent use of a non-irritating moisturizer is recommended when symptoms of atopic dermatitis are present or even after the condition has improved. Apply the lotion to the entire body, not just the affected areas. If medications are prescribed, apply them before the moisturizer. The frequency of moisturizer application should be adjusted based on the severity of the condition. Encourage children to participate in the application process and ensure that clean tools are used to prevent contamination.

2.4. Bathing Your Child

Avoid using excessively hot water for your child's bath, as it can exacerbate dry and itchy skin. Opt for warm water, no warmer than 30 degrees Celsius, depending on the ambient temperature. Bathing your child should be a daily routine, preferably two hours before bedtime to promote better sleep.

Use shower gel instead of soap during bath time, as soap can further dry out the skin. Soak your child in a basin or bathtub mixed with shower gel for 15 to 30 minutes to increase skin moisture.
Comply with any specific instructions provided by a specialist if your child has unique needs.

2.5. Additional Considerations

• If your child is affected by perioral dermatitis related to food or saliva, clean the skin around their mouth with a soft, wet towel and apply a layer of moisturizer.
• Ensure that your child's clothing is made of soft cotton, and remove any scratchy labels to prevent skin irritation.
• When selecting a blanket for your child, opt for cotton or cotton-blend options to avoid overheating.
• Avoid substances that may irritate the skin, such as detergents and harsh soaps.
• Maintain a comfortable environment for your child, ensuring that it is neither too hot nor too cold.

Seek immediate medical attention if your child's condition doesn't improve after two days of treatment or shows signs of infection, such as broken skin or oozing areas.