What's That Rash?

Eczema

Eczema is a skin condition affecting 5 to 7 percent of children. And up to 75 percent of kids with eczema have a family history of eczema and allergies. The first signs of the rash usually develop by 3 months of age, and fortunately babies often outgrow eczema by age 3. However, many of these kids do go on to develop other allergies and/or asthma.

Eczema should be diagnosed by your pediatrician or a dermatologist. It looks different in infants than it does in older children. When infants develop the rash, it typically appears on their cheeks, trunk, or scalp; the areas look red, scaly, and sometimes crusty. In toddlers and older children, the rash is confined to the folds of the arms and legs and the diaper area; it looks red, but it isn't crusty or scaly. In severe cases, the skin can even thicken.

The condition is itchy and can cause significant discomfort. Older children may make the rash worse by scratching and infecting it with dirty fingernails. Young babies who can't scratch themselves may just be irritable.

For many years, cortisone creams have been the mainstay of eczema treatment. For mild eruptions and small areas, they are effective. However, for severe or widespread eczema or for long-term use, they are not wise. Using cortisone, especially the high-potency creams that your pediatrician may prescribe, for longer than seven days can cause changes in the skin, such as loss of pigment. For infants and young children with serious cases of eczema, there are now two prescription drugs available -- Elidel (pimecrolimus) and Protopic (tacrolimus) -- that are not cortisone-based and can be used safely for longer periods of time.

Because skin with eczema is sensitive to drying, moisturize your child's skin every day with a bland lubricant such as Vaseline, Aquaphor, or Eucerin; some doctors even suggest using vegetable shortening, such as Crisco. Moisturizer will also keep eczema from worsening. Apply the cream right after bathing your child, when it can be absorbed easily.

Even though water can dry the skin, it is not recommended that you forgo bathing. In fact, children who are bathed regularly are less likely to develop infections from scratching. Just don't let your child soak in water for a long time. Keep your child relatively cool, especially at night, and, if necessary, give her an over-the-counter antihistamine, such as Benadryl, to reduce the itchiness. For severe itching, your pediatrician can prescribe a stronger antihistamine. When to worry: If the eczema gets worse despite treatment, your child may have developed a bacterial infection. Sometimes antibiotics are necessary to clear it up. Eczema that isn't getting better could also be the result of an allergy, especially to foods such as milk or soy. You may need to consult an allergist to find out the specific cause.

When to Worry:

If the eczema gets worse despite treatment, your child may have developed a bacterial infection. Sometimes antibiotics are necessary to clear it up. Eczema that isn't getting better could also be the result of an allergy, especially to foods such as milk or soy. You may need to consult an allergist to find out the specific cause.

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