Doctors’ Notes


Eczema & Skin Care

Atopic Dermatitis, commonly know as Eczema, is a common, chronic, recurring skin disorder.

Eczema results in dry, easily irritated, sensitive, itchy shin that becomes inflamed and rashes. There is no cure for Eczema. The mainstay of treatment is to relieve symptoms and control inflammation and skin rash. This treament is usually done by applying topical steroidal agents. (Ointments, creams, lotions and gels.)

babyfaceJust as important — if not more important — is the proper care of the Atopic skin. It’s been known for some time that infants and children with atopic dermatitis have a skin abnormality: it fails to retain water. Recent research has shown that that this skin is deficient in a protein called Filaggrin, which is associated with the growth, repair, and maintenance of skin cells. It is also deficient in lipids (fats) called Ceramides 1 and 3.

The deficiency of these two factors leads to increased water loss through the skin, which leads to dry and/or damaged skin. This compromises the barrier function, leaving the skin vulnerable to irritants and allergens.

How Do I Take Care of This Dry & Damaged Skin?

The most important treatment for dry skin is to PUT WATER BACK INTO IT. The best way to do this is to briefly soak the skin in a bath or shower. Water should be warm, but NOT HOT. Moisturize immediately afterwards, while the skin is damp. DO NOT use harsh soaps, and avoid rubbing and scrubbing the skin. Use mild, non-soap cleansers that are fragrance free, dye free, and have a ph less than 5.

Examples of Good Moisturizers

  • Aquaphor Healing Ointment
  • Aveeno Advanced Care Moisturizing Cream
  • Cerave Moisturizing Cream
  • Cetaphil Restoraderm Moisturizing Cream
  • Vanicream
  • Vaseline Petroleum Jelly (inexpensive, but very greasy)
  • Epiceram (requires a prescription)

Application of Moisturizers

Take a bath or shower, preferably at night before bed. Gently dab the skin with a soft towel and apply moisturizer within three minutes to help trap the water into the skin. Moisturizer must be applied at least twice daily — and more often if the skin gets dry. This process improves skin hydration and barrier function.

Dispense the moisturizer from the jar with a clean spoon or butter knife to avoid contamination. Take a dollop of moisturizer, soften it by rubbing it between your hands, and apply it using the palm of your hand, stroking in a downward direction. DO NOT rub by stroking up and down or around in circles. Try different products until you find the one that feels comfortable to your child.

To prevent recurrence, continue to use moisturizers even after the affected areas heal.

Other Recommended Treatments

Bleach Baths: 2-3 times a week, for those whose eczema gets infected (usually due to scratching). Use 1/2 cup household bleach for a full bathtub, 1/4 for a half-bath.

Salt Baths: One cup of table salt to bath water for a soothing “ocean at home” effect.

Oatmeal Baths: Add to bath water, to relieve itching

Also: wash all new clothes before wearing them. Add a second rinse cycle to ensure the removal of soap, and use mild detergent that is dye-free and fragrance free.

All this can be a little time-consuming, but it goes a long way in keeping this sensitive, vulnerable skin from drying and result in itching, inflammation, and rash.


Dr. K.G. Pai, one of the founding fathers of our Kids Plus practice family, is an expert in pediatric dermatology.