Health Topics : Eczema

1. Give a SHORT daily lukewarm bath of 5-10 minutes with a mild “skin cleanser”. Cetaphil or Cerave cleanser are good choices. Don’t rub with a washcloth – this can lead to irritation.

2. Immediately after the bath, pat the child relatively dry, then apply medication to the damp skin using the following guidelines:
Mild Eczema (Skin is dry with little redness or irritation):

  • Facial Eczema
    • Apply Ointment/Cream 4-6x/day all over the face
    • Apply Hydrocortisone 0.5% – 1% 2x/day in addition to the above Ointment/Cream for 2 weeks
  • Body Eczema
    • Apply Ointment/Cream 4-6x/day all over the body
    • Apply Hydrocortisone 0.5% – 1% 2x/day in addition to the above Ointment/Cream for 2 weeks

Moderate Eczema (Skin is beginning to get redder with more irritation):

  • Facial Eczema
    • Apply Ointment/Cream 4-6x/day all over the face
    • To all RED areas apply Hydrocortisone 1% 2x/day for 2 weeks
    • Apply antibiotic ointment (Neosporin) to all infected looking areas 2x/day
  • Body Eczema
    • Apply Ointment/Cream 4-6x/day all over the body
    • To all RED areas apply Triamcinolone 0.1% ointment or cream 2x/day for 2 weeks
    • Apply antibiotic ointment (Neosporin) to all infected looking areas 2x/day

Severe Eczema (Skin is red, irritated, hot, and looks infected):

  • Come to the office as soon as possible. Your child will likely need oral medications in addition to the topical medications you are using.
  • Any of the following are good choices (OINTMENTS/CREAMS are preferable over LOTIONS): VASELINE Petroleum Jelly, Vanicream, Cerave, Mimyx, Atopiclair, Epiceram, and Mineral Oil.
  • Keeping the medications and Ointment/Creams in the refrigerator can make them cool to the touch and soothing.
  • Generally the steroids should be used 2 weeks on, then 2 weeks off, then 2 weeks on, and so forth AS NEEDED.
  • The best clothes for eczema are 100% cotton. Avoid wool.
  • Avoid irritating factors in soaps, detergents, fabric softeners, dryer sheets, dyes, or perfumes. Use a Hypoallergenic Detergent – Dreft or Allergen Free ALL are good choices. For severe eczema a second water-only wash may help.
  • When the child is itchy/scratching take Claritin (OTC) in the morning and take Benadryl (OTC) or Atarax (Prescription) at night.
  • Trim nails on a regular basis to minimize scratch injury. Put gloves on at night for severe scratchers.
  • Keep air conditioner at 76 degrees (if possible) to avoid excessive sweat irritation.
  • With tough eczema cases, a 2x/week diluted bleach bath can help clear the skin of unwanted bacteria and keep the skin clearer and less itchy. [Mix 1 tablespoon of Clorox bleach with 2 quarts of water and pour onto body from neck down, wait 5 minutes then wash off].
  • Remember that eczema is a chronic condition and will come and go for several months/years.
  • Helpful website: www.nationaleczema.org

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Revised 12.17.2013