What is eczema (atopic dermatitis)?
Eczema (atopic dermatitis) is a chronic (long-lasting) skin condition that comes in many forms.
With eczema, the skin becomes dry, very itchy, and a rash usually appears. There are times when the condition is worse, and times when the condition is better. When the condition worsens, this is called a flare-up.
For information about the impact of eczema and ways to help your family cope, please see Eczema: Coping with eczema.
Eczema at day care and school
If your child goes to day care, talk to the daycare staff and to parents of other children that attend the daycare centre about eczema. Explain that your child has this condition and that it will not spread to other children.
School can cause a great deal of stress in children with eczema. By the time children attend grade school, they are old enough to realize that their skin is different from other children. Parents, family members and teachers should understand the stress that these children experience and that they may need more emotional support and understanding.
Talk to your child about diversity, bullying and acceptance
Talk to your children about eczema and address topics such as diversity, bullying at school and acceptance. Children with eczema often have to endure hurtful comments from other children, even when they are young.
They may feel:
- uncomfortable in social situations
- self-conscious about their skin
Their itching and rashes may also affect their school and social situations and may lead to sleep loss, which can make concentrating in school difficult.
Remind your child that:
- They are not to blame for their eczema.
- It is not due to bad hygiene.
- They cannot spread eczema to other children.
Talk to your child's teacher
Speak to your child's teachers about eczema and try to work together to help make school easier for your child. Help the teacher understand which situations can cause your child to feel itchier (e.g., learning challenging concepts; disagreements with friends). All children are exposed to such situations, but children without eczema do not feel itchy as part of their body's response to these stressors. The teacher should understand why a child may be scratching, fidgeting or not paying attention.
Constant itching and physical discomfort may keep your child up at night, causing a lack of sleep. Your child may feel tired, drowsy or have a hard time getting up in the morning. Eczema may also interfere with your child's concentration and learning because of the constant itching or lack of sleep. When eczema is disturbing your child's sleep or school performance or attendance, these are signs that the eczema is out of control and requires better management. Discuss what strategies can be used to manage your child's eczema with their health-care provider.
Steps to take to decrease flare-ups at school
Certain steps can be taken to help decrease the chance of eczema flare-ups at school:
- If heat is a trigger for your child's eczema, you may want to ask the teacher to seat your child away from sources of heat such as sunny windows, radiators and air vents.
- You may want to ask if a cotton alternative would be OK for school uniforms.
- Certain activities in the classroom may make the symptoms of eczema worse, such as using glue, paint, clay, foods, wood and metal. You may want to speak to the teacher about using different materials if these particular activities worsen your child's eczema. To avoid any flare-up because of these materials, make sure your child is allowed to wash their hands after any activity.
- Talk to the physical education teacher to see if certain activities need to be adapted to your child's needs.
- Make sure the school is aware of all food allergies that your child has. Make sure your child is aware of what to avoid.
- If your child needs daytime moisturizing, have a doctor's note allowing your child or a nurse to apply it at school.
Physical activities and playing
It is important that your child participates in their regular activities as much as they can. Your child's eczema may interfere with some of these activities. Excessive sweating can be a problem and can lead to irritation and itching of the skin. When playing or doing any type of physical activity, it is important to stay cool. If your child has a flare-up, it might be a good idea to lessen activities that would lead to a lot of sweating or ensure there are breaks in such activities to cool off.
Timing may be a factor in the activities that your child chooses to participate in if heat is a trigger. For example, playing outdoor sports later in the day, closer to the evening, may be helpful. At that time of day, the temperature has decreased, and the sun is not as strong, making it easier to stay cool.
Swimming
Swimming is a good sport for children with eczema because they sweat less. Many parents are concerned that the chlorine in the water can be very drying and irritating to the skin. Bromine and salt water pools can also be irritating. However, by following these steps, you can help reduce the irritation caused by swimming pools:
- Apply a layer of petroleum jelly to your child's body before they go swimming indoors. Once your child has a layer of petroleum jelly applied, they can play and swim in the water. If heading outdoors after swimming, sunscreen should be applied to exposed skin. If the pool is outdoors, sunscreen in a cream-base can provide both sun protection and act as a protective layer on your child's skin. To reduce the risk of slipping around a pool, do not use these products on the bottom of the feet.
- After swimming, rinse your child's skin well to remove chlorine and salt. After rinsing, apply your child's regular medicine if needed, followed by moisturizer if indoors or moisturizer then sunscreen if going outdoors. If the water in the pool is warm, your child's skin will always look redder because the warm water brings more blood flow to the skin. It may look as though your child's eczema is getting worse, but the prominent redness will resolve as your child's skin temperature returns to baseline.