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$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.