Eczema… What You Need to Know

Disclaimer – This post is geared toward parents of children with eczema but the content applies to anyone with eczema.

When my husband and I were trying to get pregnant, we talked about our family history of illness and chronic disease. On my side of the family, we are absolutely riddled with cancer and also have high blood pressure and high cholesterol. On my husband’s side of the family, they also have high blood pressure, high cholesterol, psoriasis, and eczema.

Eczema, eczema, and eczema.

My father-in-law has had eczema and psoriasis his entire life and it is mainly on his scalp and his knee. My husband also has had eczema his entire life and it is also mainly on his scalp as well as psoriasis on his fingernails. My brother-in-law also has had eczema and psoriasis on his fingernails. My husband was very confident that our child would have eczema from birth, and he was right. Our son, now 2-years-old, has had eczema his entire life and it is mainly on his legs and his upper back.

Before having our son, I didn’t really pay much attention to eczema, even for my husband. He has said that he knew how to manage it and his skin has been pretty healthy ever since I have known him. When our son was born with eczema, we both were unprepared on how to manage it. We asked ourselves many questions to try and root out the causes. Is it his diet? What about the soaps, lotions, laundry detergent, and softness of the clothes he wears? Is there something I am wearing (my lotion or soap) that is irritating his skin? Does sunlight help? We both had so many questions and went through a lot of trial and error to support our son’s immune system for this chronic skin condition. Yes, eczema is classified as a chronic skin condition and according to the National Eczema Association (NEA) is further defined as “a group of inflammatory skin conditions that causes itchiness, dry skin, rashes, scaly patches, blisters, and skin infections.”

Types of Eczema

The NEA identifies seven different types of eczema:

• Atopic dermatitis – common, causes inflammation, dryness, and itchy skin. Typical in small children.

• Contact (allergic) dermatitis – caused by environmental triggers.

• Dyshidrotic eczema – causes a burning sensation, rashes, and blisters which dries out the skin.

• Neurodermatitis eczema – affects small patches of skin, making them itchy and scaly.

• Nummular (discoid) eczema – coin-shaped spots on the skin that can be painful and difficult to treat.

• Seborrheic dermatitis (dandruff) – causes skin to fall off in flakes.

• Stasis dermatitis – skin changes that are caused by poor circulation and resulting in pooling of blood in the lower legs.

For each type of eczema, it can be further classified into stages of severity including: acute, subacute, and chronic.

With our son, we thought he had a mix of atopic dermatitis and nummular eczema. When he had a skin flare up and irritation, his skin it would be red, dry, and itchy for him. They also always appeared to be circular, coin-like, and did take time to treat before they were resolved. The types of eczema my son has are different than my husband and his family, who mainly have neurodermatitis eczema and seborrheic dermatitis (dandruff) so figuring out how to help our son was difficult.

I actually felt lucky that my son’s irritated skin is mostly on his upper back because that is a difficult spot for him to reach and scratch. Since eczema’s main symptom causes itchiness, if my son were able to reach the itchy spots and scratch them, then that would worsen his condition and make it more difficult to resolve. I know that many children have eczema on their arms and legs which is a very easy place to scratch. My heart goes out to those children and parents who are trying to manage this condition.

According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases, the most common locations for eczema by age are:

What Causes Eczema?

As you can imagine with any type of chronic condition, health professionals and national institutes say “there are many factors” to developing eczema. Which, as a parent is just white noise because you want to know what is causing the eczema issue and how you can help fix it.

According to National Eczema Association and other National Institutes, here are the factors that can cause eczema:

• Family history of eczema, hay fever, or asthma (genetics)

• Gender (females tend to develop the disease more than males)

• Exposures to certain things in the environment including

  • Tobacco smoke

  • Air pollutants

  • Fragrances and other compounds found in skin products and soaps

  • Excessively dry skin

• Problems with immune system

My personal opinion, I find it highly unusual that there is no mention of lifestyle or diet in the causes of eczema. HIGHLY UNUSUAL. If you are someone who struggles with a chronic disease, then you know that your lifestyle and diet factor into your chronic conditions. Think of some common chronic conditions and diseases – diabetes, hypertension, heart disease, and obesity. Those ALL have causes of lifestyle and diet yet those are not even mentioned in potential causes by national institutes. Interesting… very interesting. Right?

Revised list of causes with MBC’s opinion:

• Genetics

• Gender

• Environmental Factors

• Immune System

• Lifestyle

• Diet

Okay, so there are somethings that are out of our control as parents such as genetics and gender. There definitely are things, we as caretakers, can do to support our child’s eczema around their environment, immune system, lifestyle, and diet.

Proactive Interventions and Support

Now that you have an idea of what type or types of eczema your child has (always consult with your healthcare provider), you can start making a plan to proactively help your child manage this condition. Let’s break down each one of the causes, that are in your control, to make your plan.

Environmental Factors:

• Make a list of all the hygiene products you use for both you and your child. You want to make a list for everyone because contact dermatitis could be the cause of your child’s skin flare ups.

  • Your list needs to include: bath soaps, hand soaps, body wash, shampoos, conditioners, lotions, makeup, hair products, deodorant, perfume, cologne, sunscreen, and ointments.

  • Tip – if you have visitors or relatives over and your child suddenly is itchy, it could be the visitor or relative’s hygiene products.

• Make a list of all household and cleaning products.

  • Your list needs to include: laundry detergent, fabric softeners, and cleaning products. Don’t forget cleaning products which is a common cause of contact flare ups.

  • Tip – Keep this list handy and update it when you change products. It is a common question you will get asked at your healthcare provider’s office visits to help them rule out potential causes of flare ups.

• Consider the cleanliness of commonly used baby gear and locations in your home.

  • Some easy ones to think about are your car seat, stroller or wagon, booster seat, highchair, baby swings, jumpers, and kitchen towers.

  • Tip – Commonly used baby gear can be wiped down with a simple wet dishrag after each use. You don’t always have to use cleaning products on those commonly used items, they can just wipe clean.

• For a list of the hygiene products and household items we use, see below.

 Diet:

• Monitor or make a list of the foods and drinks your child consumes on a daily basis.

  • This is especially key when first introducing solid foods! There are all kinds of food tracker apps to make this easy. Keep a log of each food and any skin flare ups. This is SO helpful to do early on.

  • As you monitor their food intake, if you notice flare ups when you eat a new food, then that could be a root cause of their eczema.

  • Tip – our son’s main food flag is dairy. It is not all types of dairy, it is with certain brands of dairy products. We have transitioned him to certain dairy products that don’t flare up his gut health or eczema. You don’t always have to eliminate a food completely, sometimes you just need to try a different brand.

• Monitor quantity of food intake as well.

  • Some foods may be a low irritant for your child when consumed in small quantities. Yet, when they eat too much of something, that could put their gut health and immune system out of balance and cause a skin flare up.

  • Tip – my son LOVES yogurt. He could eat 2-3 yogurt cups per meal but we don’t allow that because it causes his eczema to flare up. We didn’t know that until we made that error. Oops!

• Maintain hydration!

  • Your skin is the largest organ in your body and when you are dehydrated, your skin reflects that. If your child doesn’t seem to be consuming enough fluids and has other symptoms of being thirsty or dehydrated, then keep an eye on fluid intake to try and balance out their skin needs.

• For our solid food list that we rotate through each week, see below.

Immune System:

• Identify when you child starts feeling ill if their skin changes. When the immune system is compromised and trying to fight off sickness, your child will have a more difficult time maintaining healthy skin. You may grow to expect skin flares when your child is ill.

• Potentially random – when my son’s teeth would start coming in, his skin would become more irritated and he would have more skin flares. With everything else in his environment and diet remaining the same, his teeth through his system out of balance and he would have minor skin flares. Random? Yup but sharing for you in case that happens.

Lifestyle:

• Diet and immune system contribute to lifestyle factors as well.

• Keeping with a consistent skin care routine can be very helpful with minimizing eczema symptoms. A routine such as regular baths and quality lotions can be incredibly helpful.

• Keep track of triggers such as food, extreme heat, lack of sleep, and stress.

• Consider sunlight exposure to help with proactive support or even treatment options for your child. This one can be a little tricky because you don’t want your child to get sunburnt, obviously, and you may put sunscreen on your child. Sunscreen could be a root cause of your child’s eczema but getting out into the sun really helps with eczema. So strike a balance here with getting outside in the sun and being cautious of sunburns.

Additional Treatment Options

Phototherapy

Speaking of getting out into the sun, phototherapy is a highly effective treatment option for eczema. Phototherapy, or light therapy, can relieve symptoms life itching and inflammation and can support the skin in healing. Light therapy uses an ultraviolet light to treat eczema and is typically offered by a dermatologist. Depending on the severity of your child’s eczema, your insurance, and the opinion of your healthcare provider, this may or may not be an option.

Over-the-Counter or Prescription Medications

There may be circumstances when you need some type of additional medical intervention. When my son was 1-year-old, he had a really bad skin flare up on his back. We tried treating it at home for over 2 weeks and did not see any progress. It grew to be almost his entire back and we needed help. Our pediatrician prescribed hydrocortisone cream and that worked wonders for our son. Pediatricians and pediatric dermatologists can also prescribe antihistamines and other medications as needed.

Will Your Child Always Have Eczema?

As of 2024, there is no current cure for eczema. There are only proactive steps and treatment options to minimize flare ups and protect from infection.

According to NEA and Healthy Children, they claim that most children will outgrow certain types of eczema (such as atopic dermatitis) by the time they are 4-years-old. I don’t know how true that is based on my husband’s family genetics and experience. Each child is different, of course, so that may be the case for your child. I am planning for my son to always have eczema and to support him as proactively as I can.

The current statistics around prevalence of eczema in the U.S. states that 1 in 10 children have eczema. I, personally, think that statistic is low or maybe in my social circles I see more children with eczema than 1 in 10. A research study conducted by The Global Asthma Network in 2023, identified that 6% of all children and adolescents have symptoms of eczema and that it slightly rising year over year for the past 10 years. In 2023, there were about 1.3 billion children and adolescents in the world. 6% of 1.3 billion is 78 million children and adolescents.

Looking at the financial aspect and the healthcare industry, the average person spent about $600 annually on eczema treatment in 2023. If we focus in just on the 78 million children and adolescents suffering from eczema, not adults, then the average annual healthcare spend for 2023 was $46.8 billion dollars. That is big, big business that is rising and there appears to be no cure.

Like I shared above, I’m planning for my child to always have eczema and need some type of proactive or treatment support throughout his life.

Summary Steps for You to Take to Manage Eczema:

1. Identify the type or types of eczema your child has.

2. Make a list of all hygiene, household, and cleaning products you use on yourself and on your child.

3. Keep track of the location, size, frequency, and length of skin flare ups. We keep a skin log for our son including the day the symptoms started with photos of the flare up to monitor progress or regression.

4. Monitor the type and quantity of food and drinks your child consumes.

5. Maintain a routine skin care regime and stay hydrated.

6. Get outdoors as often as you can to get sunshine on the skin.

7. Validate your health insurance coverage and budget for potential out-of-pocket expenses for treatment of eczema each year.

Be prepared for skin flare ups, they do happen even when you think you have it under control. Here are our Hygiene and Household Products as well as our Food List for your review.

Hygiene Products – Baby Jason:

• CeraVe Lotion: https://amzn.to/3QImRjE

• Aveeno Lotion: https://amzn.to/3V0aPoI

• Eucerin Mineral Sunscreen with 50SPF - https://amzn.to/3UyObn1

• Aveeno Bath Soap - https://amzn.to/3QGRfLu

• Aveeno Colloidal Bath Soak - https://amzn.to/3V0aPoI

• Diaper Rash Cream

  • Aquaphor Healing Ointment - https://amzn.to/3WRkeQt

  • A+D Ointment - https://amzn.to/3Va1B9d

Tip! If you have a Health Savings Account (HSA), you can use that to pay for some of these hygiene items. Checkout my blog on HSA benefits here: https://www.mamasbookcellar.com/blog/hsa

Household Products:

• All Liquid Laundry Detergent for Sensitive Skin - https://amzn.to/3V6LIAm

• Downy Ultra Liquid Fabric Softener - https://amzn.to/3V9kl8J

• Shout Free Liquid Stain Remover - https://amzn.to/3wVu0Xc

• Dawn Dish Soap - https://amzn.to/3QTdWfz

• Softsoap Antibacterial Hand Soap - https://amzn.to/4bEVejW

• The Pink Stuff Cleaning Products - https://amzn.to/4av6zle

Food List: https://www.mamasbookcellar.com/resources - Solid Food List

I hope this blog post was insightful and helpful for you to understand eczema and how you can proactively avoid flare ups and treat them if need be. Please share with people you know so we can raise awareness about this chronic skin condition!

References:

National Eczema Association: https://nationaleczema.org/eczema/

National Institute of Arthritis and Musculoskeletal and Skin Diseases: https://www.niams.nih.gov/health-topics/atopic-dermatitis

Healthy Children: https://www.healthychildren.org/English/health-issues/conditions/skin/Pages/Eczema.aspx#:~:text=Both%20a%20person's%20genes%20and,themselves%20do%20not%20cause%20eczema.

The Global Asthma Network 2023 Study: https://onlinelibrary.wiley.com/doi/full/10.1111/cea.14276

UNICEF population statistics: https://data.unicef.org/topic/adolescents/overview/

WebMD average eczema spend in 2023: https://www.webmd.com/skin-problems-and-treatments/eczema/cost-eczema