$Unique_ID{PAR00067} $Font{NP} $Pretitle{} $Title{Medical Advice: Eczema} $Subtitle{} $Author{ Editors of Consumer Guide Chasnoff, Ira J} $Subject{Eczema Dry scaly pink rash Itching skin food foods beverage beverages diet dietary allergies medication medications humidifier Bathe Bathing soap soaps coal-tar ointment ointments hay fever asthma eye allergies allergic reaction vitamin vitamins itching scaliness impetigo herpes simplex virus vaccinia viruses cheeks knees elbows folds cheek knee elbow fold nummular eczema ringworm pityriasis rosea seborrhea cradle cap} $Log{} Your Child: A Medical Guide Eczema Quick Reference SYMPTOMS - Dry, scaly, pink rash - Itching skin HOME CARE - Stop giving the child any new foods and beverages that were added to the diet in the month before the rash broke out. - If discontinuing new foods and beverages does not improve the rash within four to seven days, ask your doctor if you should stop giving the child those foods and beverages that are most likely to cause eczema (see the tables in this article). - Look for and remove irritating substances that may be coming in contact with the child's skin (see the table in this article). - Ask your physician if any medication your child has recently received could be causing the problem. (Do not discontinue any medication without your doctor's permission.) - To avoid further drying of the skin, use a humidifier to moisten dry air. - Bathe the child sparingly, using a mild soap. - If eczema clears up, try gradually returning discontinued foods to the child's diet. Reintroducing only one food per week may help you to detect foods that cause a reaction. Avoid those foods. PRECAUTIONS - If the rash is severe or infected, see your doctor. - If the rash does not improve after one week of home treatment, see your doctor. - As you add new foods to your infant's diet, watch for signs of rash. - If your infant is allergic to both cow's milk and soy formula, your doctor can recommend a nonsoy, nonmilk formula. - Keep a child using coal-tar ointments out of the sun as much as possible. Coal-tar ointments increase sensitivity to sunburn. FOODS LIKELY TO CAUSE ECZEMA IN INFANTS UNDER ONE YEAR OF AGE Cow's milk Peanut butter Milk products Fish Wheat flour Shellfish Eggs Tomatoes and tomato juice Citrus fruits and juices Tropical fruit drinks and Chocolate desserts Nuts FOODS LIKELY TO CAUSE ECZEMA IN CHILDREN ONE YEAR OF AGE AND OLDER Citrus fruits and juices Tropical fruit drinks and Chocolate desserts Nuts Candies Peanut butter Ice cream Fish Spices (except salt) Shellfish Corn Tomatoes and tomato juice Berries SUBSTANCES LIKELY TO CAUSE ECZEMA Soaps Fabric dyes (particularly Detergents red and blue) Fabric softeners (especially Water softeners sheets for the dryer) Cosmetics Wool Metals Synthetic fabrics Plastics Stretch-cotton fabrics Eczema is a common, noncontagious rash in children. Generally, it starts between one month and two years of age, but sometimes it begins later. Eczema may disappear after two years of age, or it may appear off and on throughout childhood. The cause of eczema is questionable, but the condition is usually inherited. Eczema may be a form of atopic dermatitis (any inflammation of the skin due to allergy). Children who have eczema often later develop other allergies, such as hay fever, asthma, and eye allergies. Eczema sometimes is an allergic reaction to foods, beverages, and medications (including vitamin supplements). It also may be an allergic reaction to substances that come in contact with the skin. In some children, environmental conditions (such as heat and cold) or emotions (such as anger) may cause itching and scaliness of the skin all over the body. Skin affected by eczema can easily become infected, especially if the skin is scratched. Common complications of eczema include impetigo and infections with herpes simplex virus and vaccinia virus. SIGNS AND SYMPTOMS The eczema rash is dry, slightly scaly, pink, and itchy. The rash becomes red from rubbing and scratching. There is no fever or other symptoms, except when scratching causes an infection. Eczema often begins on the cheeks ("clown" eczema) and around the mouth. It may also crop up on the buttocks or elsewhere. The most common location is behind the knees and in the folds of the elbows. Eczema rarely covers the entire body. It sometimes takes the form of round, coin-like patches scattered on the body (nummular eczema). When it appears in this round patchy form, eczema may be confused with ringworm and pityriasis rosea. Often eczema occurs in combination with seborrhea (cradle cap). HOME CARE Home treatment of eczema is often successful, except in severe or infected cases. The first step is to stop any new foods and beverages that have been added to the child's diet within a month of the appearance of the rash. (It is important to consult your doctor before making any dietary changes, however, because of the risk of creating nutritional deficiencies.) Also, ask your physician if any medication your child has recently received could be causing the problem. (Do not discontinue any medication without your doctor's permission.) In addition, look for and remove irritating substances that may be coming in contact with the child's skin. (See the tables in this article for lists of foods and substances likely to cause eczema.) If stopping these new items does not improve the rash in four to seven days in a child under one year of age, ask your doctor if you should stop giving all foods and beverages that are likely to cause eczema. Ointments that contain coal-tar derivatives are safe to use, but their use can obscure the physician's initial evaluation of the condition. Bathe the child sparingly, using a mild soap. To further avoid drying of the skin, use a humidifier to moisten dry air. (Be sure to keep it meticulously clean, however. Otherwise, it can become a source of infection if microorganisms are allowed to grow in it.) If following this procedure clears up the eczema, try gradually returning the discontinued foods to the child's diet, one at a time. Reintroducing only one food each week should help detect the foods that cause a reaction. Those foods should then be avoided. PRECAUTIONS - As new foods are added to your infant's diet, watch carefully for any sign of a rash. - If your infant is allergic to soy formula as well as cow's milk, your doctor will recommend a nonsoy, nonmilk formula. - Coal-tar ointments increase sensitivity to sunburn. When using these ointments, keep the child out of the sun as much as possible. MEDICAL TREATMENT Help your doctor find the cause of eczema by trying home treatment first and noting what doesn't work and what seems to help. Inform your doctor, too, of any similar cases that have occurred in your older children. Your doctor may prescribe steroid creams, ointments, or lotions to relieve the rash. Oral steroids will not be prescribed unless eczema is severe, and then they will be given for only a brief period. Oral antibiotics may be prescribed if eczema is infected.