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As babies grow into children, their eczema will tend to settle into the folds of the skin: behind knees, inside elbows, on the neck and around eyes and ears, although dark skins can also be affected on the outer surfaces of knees and elbows. The rash typically becomes drier, with more flaking of the skin, and turns red to brown-grey colour. Skin in affected areas can also become thickened and sensitive, especially if scratched regularly. These symptoms typically worsen and improve over time, with flare-ups occurring periodically.
Eczema can also have a very real psychological effect on children. Research shows that preschool children with moderate to severe eczema are more likely to have emotional and behavioural problems than other children and that they are more likely to be more dependent on their parents. This is thought to be the result of poor self-image due to their skin’s appearance and interrupted sleep affecting both their mood and ability to learn. In some cases this lack of confidence can impact on the development of social skills.
One of the biggest problems with controlling childhood eczema is the intense urge to scratch at itchy skin, which may then bleed or become infected. These infections can further intensify the itching resulting in even more scratching. Scratching at night can also result in disturbed sleep, making children grumpy and irritable, they may also find it hard to concentrate and learn. Continued scratching can also result in skin thickening. This thickened skin loses flexibility and, as eczema tends to be worst around joints, painful cracks can develop as a result of natural movement.
The key to controlling the physical aspects of eczema is firstly a good maintenance routine which keeps the skin moist and supple, this minimises the risk of infection; and secondly identifying and avoiding flare-up triggers such as harsh detergents, pets, food allergies, heat, etc. By keeping the physical symptoms under control, the destructive secondary symptoms of disturbed sleep and low self-esteem can be minimised.
Apart from the immediate damage caused by scratching itchy eczema, scratching can also turn into habit. To minimise the damage and stop this habit forming, you will need to give you child some effective strategies for dealing with the very real eczema itch. From experience, being told to ‘stop scratching’ without being told how is incredibly frustrating; but learning how not to scratch is an important life skill for an eczema sufferer.
The most effective way to stop children scratching their eczema is by minimising the itching with a good skin maintenance routine and avoiding known triggers. Keeping rooms cool, dressing itchy kids in loose cotton clothing and avoiding harsh soaps and detergents will also help. When these measures haven’t worked, a cold compress (or even an ice cube) can often be effective at stopping the itch – we keep a novelty gel filled compress in the fridge for the purpose (which comes in handy for bumps and bruises as well). Another method of avoiding scratching is to lightly tap the itch with your fingers until it fades – the vibration created by the tapping interferes with the nerve signals responsible for the itch. On really itchy days (or nights), children’s Piriton can be helpful, but it will make them drowsy.
If the itch just won’t go away – distraction can be really effective, especially if it involves both hands. Watch your child and work out if there is a time when they more likely to scratch. This will often be when they are tired, slightly bored in the car, or pre-occupied watching the TV. Armed with this knowledge you should be able to come up with a strategy to help them. Fiddly toys like Lego, tangle toys and even a Rubik cube are great for keeping hands busy. We have found that character action figures are great at keeping our son’s hands out of mischief while he watches the TV. We also have some great games on our mobile phones to keep his scratchy fingers occupied when we are out and about.
A lot of kids scratch without being aware of it. In these cases, sticker charts are a great way to help children become aware of when they are scratching. It also gives you a chance to reward your child for the major, but largely hidden, achievement of stopping themselves from scratching. Our free printable reward chart and stickers include some useful guidance and top tips for helping kids to break the scratching habit before it becomes ingrained.
If scratching is inevitable you’ll need to keep fingers nails clean and short to minimise the damage and risk of infection. It may be also be necessary to cover the hands of children who can’t stop themselves from scratching when their hands aren’t occupied or they are asleep. The unique double-layer mitts of ScratchSleeves minimise the damage caused by scratching, while the cool silk outer mitt is calming on the skin. The loose-fitting sleeve design ensures that the mitts not only stay but avoids any irritation of sore areas on hands and wrists that can occur when wearing other eczema gloves. See more on how ScratchSleeves work.
Children with eczema often find sleeping a problem as their skin can get hotter and itchier at night. This can affect their mood and concentration the following day, especially during flare-ups. A bad night’s sleep does not set them up well for dealing with an itchy day. Here are some things that help our scratchy son to sleep well and wake up bouncing:
As you no doubt already know, this overview isn’t the half of it: visit our Parenting+Eczema blog for more information on the day-to-day challenges of living with childhood eczema. If you know what you want to help your child deal with their eczema but can’t find it, drop us a line and we’ll do our best to help.