The Itch Factor

Children with eczema struggle every day with painfully irritated skin -- but the right drugs can give many kids real relief.

Eczema Epidemic

boy holding his arm and looking hurt

Shannon Greer

Last year, 3-year-old Anthony Quear was covered with a red, scaly rash that kept him scratching all through the night. "I was up with him every two hours -- sometimes he'd scratch so hard that there'd be blood all over his sheets, and we'd both be exhausted and grouchy the next day," recalls his mom, Angela. She had to keep him inside on hot summer days, and he couldn't even go in the pool to cool off because the chlorine burned his irritated skin. "For a few months, I felt like taking care of his skin was a 24-7 job," says Quear.

Anthony has eczema, also known as atopic dermatitis, a disease that causes itchy, inflamed skin and often starts in infancy. It's estimated that 17 percent of children have eczema, and about one-third of them experience severe symptoms like Anthony's. "We're seeing more eczema in kids than ever before -- the incidence has more than doubled since the 1970s," says Parents advisor Amy Paller, MD, chair of dermatology at Northwestern University's Feinberg School of Medicine, in Chicago. And because many parents worry unnecessarily about the safety of the drugs that ease itching, their kids don't always get the relief they desperately need.

Red Alert

Eczema is more than just sensitive skin. "Normally, the skin should act as a barrier to environmental irritants such as dust, pollen, and animal dander, but when a child has eczema, his skin acts like a sieve that lets irritants pass through into his body," explains Adnan Nasir, MD, a dermatologist at The University of North Carolina at Chapel Hill and coauthor of Eczema-Free for Life. "These foreign substances cause his immune system to go into attack mode, triggering an itchy rash." In fact, scientists have pinpointed why some kids are more susceptible: They have a genetic condition that inhibits production of filaggrin, a protein that normally creates a protective layer over the skin's surface.

Although the disease tends to run in families, experts say one reason there's been a rise in eczema is the same reason there's been a rise in allergies: "Kids in Western societies aren't exposed to as many germs as they were 50 years ago," says Julie Schaffer, MD, director of pediatric dermatology at New York University. "If a baby's immune system is not busy building resistance to childhood infections, it may be more likely to overreact when she's exposed to harmless foreign substances." Not surprisingly, up to 80 percent of kids with eczema also have another allergy-related condition, such as asthma or hay fever.

Eczema usually begins on the scalp, forehead, ears, neck, cheeks, or in the crooks behind elbows or knees. However, the first signs of the condition in a baby may be as subtle as fussiness. "Technically, eczema is only the rash that's created by scratching, but infants don't yet know how to use their hands to scratch their itchy skin, so they can get eczema on their face and scalp from rubbing their head against linens or even their parents," says Dr. Nasir. If you notice that your baby is wiggling a lot, see your pediatrician. If he rules out other conditions like colic, consult with a dermatologist, who can examine your baby's skin for subtle signs of eczema. Older babies and children tend to have more classic symptoms: dry, scaly, red skin. Also, they're better able to describe the itchiness. It's important to get a diagnosis early, because your child can fall into a vicious cycle of itching and scratching that leaves her skin raw and painful.

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