Emily,

My seven-year-old son has very bad eczema on his feet. He scratches at night and it disrupts his sleep. There are cracks in his skin from the dryness. Is there something you can recommend that we can use at bedtime to help the situation?–Mark, via email

Dear Mark,

You and your son have my sympathy. Eczema is a horribly uncomfortable skin condition and I know frustrating it is to find the perfect remedy to combat dry, cracked skin.

Eczema, also called atopic dermatitis or atopic eczema, affects nearly ten percent of all infants and children. Generally, the condition is attributed to family heredity and stressors (including chemical irritants, heat and sweating, allergies, emotional stress, or infection.)

Eczema is difficult to treat partly because it is difficult to figure out just which stressors are triggering the dry, scaly skin that signals atopic dermatitis. To add insult to injury, because the condition consists not just of dry skin, but of itchy dry skin, scratching and rubbing often seem like the only remedy. Of course, this can irritate and even break the surface of the skin, making it more prone to soreness and infection.

Antibiotics, topical steroids, and antihistamines are often prescribed by doctors to treat the symptoms of eczema. However, as with many medications, these do not actually solve the problem. While whole-body treatment is beyond the scope of this column, I would make the following suggestions:

Moisturize, moisturize, moisturize. Keeping the skin as hydrated as possible will help to alleviate some of the itching and cracking that can lead to scratching and skin breakage. (See moisturizing tips below.)

Stay cool. Helping the body to stay in as cool a state as possible (this includes wearing clothing that “breathes”) can ease the itching that often occurs with sweating. Frequent cool showers or baths immediately followed by moisturizing can help relieve particularly bad bouts of itchiness. Don’t be fooled by the initial soothing feeling that comes with hot showers or baths, hot tubs or saunas, as they can be particularly drying in the hours after.

Watch what you eat. There is some debate about whether diet plays a role in the severity of eczema, but keeping a detailed food journal can help to rule out food as a trigger. A food journal need not be complicated. Simply remove a potential food trigger (dairy, eggs, wheat, soy, peanuts and seafood are commonly reported ones) for a week. Keep a log of how the eczema is affected. By removing one food from the diet at a time, you will avoid malnourishing the body but will be able to identify if any food allergies are responsible for the condition. Obviously, discontinue eating any offending foods.

Calm down. Stress can manifest itself in a variety of ways. For me, the muscles in my neck and shoulders bear the brunt of my more stressful days. It’s possible that stress could contribute to the itching and cracking associated with eczema. Relaxation techniques may be helpful.

Don’t be so irritated. For people with sensitive skin, many seemingly harmless everyday items can lead to very unpleasant symptoms. Exposure to scented laundry detergents or powders, cosmetics, body care products (especially those containing skin-stripping sodium lauryl/laureth sulfates), perfumes, wool and animal dander should be monitored closely, and the use of any offending product should be discontinued.

Moisturizing Tips

Keeping the skin well moisturized was at the top of the list above for a reason. It is the most effective way to alleviate itching. There are a whole slew of creams, lotions, ointments, and oils out there. Sorting your way though can be a nightmare, especially with a child who obviously has very sensitive skin.

A good rule of thumb is to only use those store-bought products that contain as few ingredients as possible. Fillers, fragrances and chemical stabilizers are a recipe for disaster when treating eczema. The longer the ingredient list, the longer the list of potential skin irritants.

Mark, your son may be most helped by taking a lukewarm colloidal oatmeal bath right before bed. Immediately following the bath (while the skin is still moist) use the following mixture on his feet.

Mix: One-half cup extra-virgin olive oil with 1/2 cup sweet almond oil. Add the contents of three Vitamin E gel capsules and stir.

Cover his feet with cotton socks while he sleeps. (The socks help to facilitate absorption and will keep his sheets from getting oily, They may also act as some kind of deterrent, or at least an added layer of protection from his mid-night scratching.)

While eczema (especially that of the infant and child) usually clears up by the early teens, teaching proper skincare early is best. As usual, awareness of what goes in and on your body is the best treatment advice I can give you. There is no one-size-fits-all solution for eczema, but as you rule out various triggers, you should find significant improvement occurs. I wish you and your son (and any other eczema sufferers out there) the best of luck.

Dr.Sarah Tyler is a dermatology specialist in UK. Let her show you how you can help your child lead a normal, enjoyable life with the Minimum Disruption From Eczema.

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