Prather Pediatric and Allergy Center - Ask Doctor Brent

Printer Friendly Version

Title: Controlling Eczema



1. Controlling The Itch!

This is best done by avoiding overheating of the skin, avoiding hot baths and by wearing cotton clothes. Hismanal is a new prescription antihistamine which is very effective for itch and is safe and non-sedating. This is only approved in older children and adults at this time but has been safely used in young children in other parts of the world for the past ten years. Benadryl, Atarax and Periactin are also anti-itch antihistamines, however, they cause moderate to severe sedation. Aspirin is a very effective anti-itch medicine but it must be used cautiously in children because of the possibility of causing Reye's syndrome in a child who has had flu or chicken pox.


2. Hydrate The Skin!

Children with eczema have abnormally dry skin and loose moisture at an abnormally rapid rate. By minimizing baths, in other words bathing every two days if possible and avoiding alkaline soaps such as Ivory or Johnson's Baby Soap or Dial, the over-drying can be better controlled. The best soaps to use include Dove, Neutrogena, Basis, Aveeno and Eucerin. After a very brief bath with minimal lathering, pat the skin dry with a cotton towel. Do not rub the skin because this increases histamine release into the skin and itching.

Immediately upon patting the skin halfway dry begin to moisturize generously with any well tolerated moisturizing cream. Examples of these include Eucerin (it's cheap and usually effective), Moisturel, Neutrogena Skin Cream, Alpha Keri Lotion, Nivea Oil, Aveeno Cream and many others.

3. Treat The Skin Inflammation! The standard anti-inflammatory treatment for eczema is 1% hydrocortisone cream twice a day. Occasionally stronger creams are needed for spot areas and some good ones to try include Elocon or Triamcinolone, 1%. There are dozens of other good variants. These stronger creams should be used cautiously and monitored by your physician to minimize any potential side effects. Only 1% hydrocortisone should be used on the face, genitalia, hands or feet for any length of time. Weaker creams such as .5% hydrocortisone which are over the counter are usually not much help.

In summary, understanding that eczema is a lifelong condition and that certain regular steps are necessary to control it is important. Discuss an effective workable plan with your doctor and in severe cases consultation with a dermatologist or allergist is warranted. For a very good summary of the disease and the latest recommendations in its treatment, write to:


Eczema Assoc. for Science and Education
1221 SW Yamhill, #303
Portland, OR 97205