Dr. Wang's Thoughts

Eczema in toddlers

posted January 19th, 2015 by admin in Eczema

Coping with Eczema in toddlers

Toddlers with eczema can be a challenge to manage. They are often resistant to application of creams, and cannot keep still for mommies to apply the creams for them. This is also a time when they start to become more physically active, engaging in lots of indoor and outdoor play. Often, contact with sand, excessive dust, heat and  sweat can aggravate their eczema. Once the eczema starts to flare up, it is invariable that the child will start to scratch, and this often leads to worsening of the eczema and damage to the skin. It is not uncommon for the itchy skin to disrupt their sleep at night. Many mommies with toddlers afflicted with eczema can attest to frustrating nights trying to placate and soothe their toddlers waking up at night because of itch.

So, how can eczema be treated and prevented?

The 2 key steps are : 1) Controlling the inflammation of the skin  2) Repairing the skin barrier


1) Controlling the inflammation of the skin

Controlling the inflammation of the skin requires the use of anti-inflammatory creams. The most widely used anti-inflammatory creams are steroid creams. Steroid creams are very effective in calming down eczema, and if used appropriately and judiciously, will not lead to side effects. The important message here is that there are different strengths of steroid creams available, and using the most appropriate steroid cream will often bring about rapid relief of eczema. Mild steroid creams are usually prescribed for mild cases of eczema, whereas stronger steroid creams are needed for severe eczema. A doctor will be able to advise regarding what is the most suitable steroid cream for your child’s eczema.  Once the eczema has settled, the steroid creams can be discontinued. In general, it is not advisable to use strong steroid creams on the skin continuously for more than 2 weeks.

2) Repairing the skin barrier

The skin functions as a barrier, protecting us from environmental irritants and allergens. Normal healthy skin also contains natural moisturizing factors. However, children with eczema are often born with an impaired skin barrier. Their skin is more ” permeable” and hence more easily disturbed by environmental irritants and allergens. Their skin is also inherently lacking in natural moisturizing factors.  Hence, children with eczema need moisturisers ! It will be advisable to apply moisturisers at least 3-4 times a day on the affected area. Use moisturisers that are fragrance- free, and with minimal preservatives as they have a lower risk of irritating the skin.  Also, use a mild-soap free skin cleanser, as normal soaps tend to be too drying for the skin.

By applying the above 2 principles of 1) Controlling the inflammation and 2) Repairing the skin barrier, majority of toddlers with eczema can have satisfactory control of their skin condition.