What I've Learned As A Parent To A Child With Atopic Dermatitis

As someone who doesn’t have atopic dermatitis (aka eczema) but writes a lot about it for my job, I thought I knew it all: the compromised skin barrier, the itch-scratch cycle, the link to allergies. But then I turned into the mom every doctor hates (or possibly loves?) to see coming. I kept bringing my daughter to the dermatologist for various rashes that all looked a little different or appeared in different places, only to learn each and every time that the rash was atopic dermatitis.

In one instance, I was convinced that she actually had a fungal infection under her armpit (just eczema!). With a red patch on the back of her neck, I thought I might have been brushing her hair too roughly (again, just eczema). By the time daycare called me, concerned she had hand, foot, and mouth disease, I knew the drill. Now that she’s three, her atopic dermatitis (AD) still requires daily management, but we’ve controlled it enough to keep her comfortable — and I’ve gotten better at spotting it. Here’s how, after some trial and error, I made that happen.

AD can look like a lot of different things.

My daughter’s eczema first appeared as a flat red rash on her neck and chest, but now it most often surfaces as tiny bumps on her belly. That’s completely normal. Eczema frequently appears as scaly patches, according to Jocelyn Gandelman, M.D., a board-certified dermatologist at Schweiger Dermatology in New York City. “But some patients have a bumpier type of eczema; some eczema becomes thicker, or sometimes eczema is infected and looks different for this reason,” she says.

AD can also look different depending on its location on the body, she says; the scalp, face, hands, and folds of the body can all show AD a little differently. Now that I know this, I’ve been able to manage new flares without having to run to a doctor — although “if your child has a rash that seems different than their usual eczema or if it isn’t responding to their usual eczema treatment as expected, it is a great idea to see their pediatrician or dermatologist for help,” says Gandelman.

It’s not just a seasonal condition.

Maybe you, like me, associate eczema with winter’s dry, cold weather. And there’s some truth in that: One study in kids with AD found that their symptoms tend to be worse in the winter. But just as often, I catch rashes during warmer temperatures, especially after my daughter’s been in the pool. That’s par for the course. “I actually find many patients flare in the humid and moist summer conditions as well,” says Gandelman. That can turn eczema into a 365-day condition, versus one relegated to a single season. When that’s the case, you can begin to recognize your kiddo’s eczema triggers and use that to prevent future flares, she says, whether by moisturizing more or asking your derm for more heavy-duty treatments.

The fewer, shorter, and cooler the baths, the better.

When my dermatologist told me to bathe my daughter less often, I was partly grossed out and partly relieved (mostly because it meant less work for me). But switching from nightly baths to every other night has made a huge difference in alleviating any flares that pop up. How I do it matters, too: “Bathing especially with very hot water or very long baths can disrupt the skin barrier,” says Gandelman. She also warns against using soap from head to toe and instead focuses on the face, neck, armpits, and groin. “It’s totally ok to keep soap off their back, chest, and legs — and this actually leads to a lot less irritation from bathing for eczema-prone babies and children,” she explains.

Moisturizer is non-negotiable.

If you have AD, you know this is obvious — but if you’ve ever tried to coat a squirming, rolling toddler in moisturizer, you might also realize why this can be so hard. I can always tell when my husband and I have been slacking on my daughter’s moisturizing routine, mostly because she starts scratching. “Moisturizer can make a huge difference for children with eczema as it can help restore the skin barrier,” says Dr. Gandelman. She recommends a fragrance-free formula that doesn’t contain natural botanical ingredients, like lavender or plant extracts, because these “can cause even more irritation or even an allergy,” she says.

Go ahead and wing it.

I’ve taken a spaghetti-at-the-wall approach to my daughter’s eczema, trying pretty much everything with varying success. We’ve done a bathtub filter and a cool-mist humidifier in her room, and when she plays outside, she only uses mineral sunscreen. I assume they’re all working together to keep her comfortable — and that haphazard approach is totally fine if it helps manage the AD. “The most helpful thing for eczema is a combination of lifestyle changes with gentle skin care — including a moisturizer — and working with your child’s pediatrician or dermatologist for help using prescription eczema medications as needed to control it,” says Gandelman. There are so many options for atopic dermatitis out there that going to the doctor, albeit over and over, isn’t a bad thing — and might even be the best way to get your little one the relief they need.

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