It is okay to bathe every day. The water from a bath is good for the skin. The soap used when bathing, however, will make eczema a lot worse.
Do not put soaps, like Johnson & Johnson washes, in the tub water. Let the child play and bathe in plain tub water for the first 10 minutes. Then take a gentle soap, like Dove or Lever 2000, rub it on a face cloth, and use that to bath only the “dirtier” areas of the body (i.e. the underarms, groin, etc). Rinse the soapy areas with clean water and get the child out of the bath immediately.
Areas that are most affected by eczema, like the inside of the elbows and behind the knees, don’t usually get that dirty, and don’t need soap to get clean.
Once out of the bath, pat dry and moisturize the rashy areas immediately with a good greasy moisturizer, like Aquaphor or plain old Vaseline.
In general, the greasier the moisturizer, the better.
Ointments work better than creams, which work better than lotions. Many lotions contain perfumes, dyes, and alcohol which can worsen eczema. Even if they say “alcohol free”, most lotions have other chemicals that can dry out your skin.
Moisturize as often as you can remember and always after bathing.
The more scratching that is done, the worse the eczema rash becomes.
Benadryl, Claritin, or prescription antihistamines may be used to help with itching. These medicines may make the child sleepy so are best used at bedtime.
Cut, then file the child’s nails so scratching does not damage the skin as much. Long pajamas with long sleeves are also useful to prevent scratching during sleep.
MEDICATIONS FOR ECZEMA
Always talk to our staff before deciding to use any topical medicines for eczema.
Topical steroids are one of the types of drugs used for eczema that doesn’t improve with good skin care. The word “steroid” may be scary, but these steroids are safe as long as they are not used over very large areas, and are not used for too long. A steroid should not be used for more than 2 weeks on a single area.
Over-the-counter topical steroids: Hydrocortisone 1% cream is useful for mild eczema. It’s safe to use up to 4 times daily for up to 2 weeks on small areas.
Prescription-strength steroids: Our favorite is Westcort ointment, a stronger version of hydrocortisone. It can be used two to three times daily.
Elidel: A prescription cream that may be used twice daily, as a replacement for or in addition to topical steroids. This medicine should be saved that for those cases that don’t respond to steroids.