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The Girlfriends Guide to Pediatric Eczema

GIRLFRIENDS GUIDE TO PEDIATRIC ECZEMA The Girlfriends' Philosophy is this:

Nearly everything you'll ever need to know about being a mother, you'll learn from other Girlfriends who've been there, done that. Don't get me wrong -- we LOVE our pediatricians and rarely make a move without consulting them, but sometimes we're embarrassed to ask questions or to "waste" their precious time with things that don't involve projectile vomiting or stitching a head wound. Plus there's the fact that some kid problems are more than just physical -- they're emotional too, and that's always hard to talk about, sometimes even with your Girlfriends.

This Girlfriends' Guide is devoted to eczema for several reasons: first, because it's so darn common that you can't go to a preschool without finding five or six kids who suffer from it; second, because this skin condition is one of the most misunderstood and frustrating, it often remains undiagnosed and inadequately treated; and third, to beg you, plead with you and generally whine until you promise to consult your child's doctor to see if there's any relief for your little one that you aren't providing simply because you don't fully understand eczema.

Here's the most compelling information I know: up to 17% of all Americans have eczema and of those, 90% had their first and possibly worst cases by the age of five. Think about how many people may have experienced this condition and almost all of them had to deal with it at the same time they were being potty trained, starting preschool and otherwise joining the outside world. Just the thought of how vulnerable we are makes me feel like crying.

In order to get the best Girlfriends' advice on eczema, I've not only talked with other moms, read everything I could find on the Internet (there's a lot there, by the way) and consulted hundreds of my mommy e-mail friends, but I've also consulted with a pediatric dermatologist and expert on eczema (and now my new girlfriend), Dr. Adelaide Hebert, professor and vice chairman of the department of dermatology at the University of Texas Health Sciences Center in Houston. So, while most of my information is anecdotal -- as it always is in the Girlfriends' Guides -- I'm reasonably assured by Dr. Hebert that nothing I'm saying is bad advice or just plain silly.

There is so much confusing and misleading information out there about eczema. One person tells you to rub your child's rash with petroleum jelly, someone else tells you petroleum products are dangerous, someone else tells you to teach your two-year-old to give up baths and take only showers, while others tell you the condition comes from not keeping your little darling clean enough.

I have four kids who all went through stages of eczema and I barely survived some of them. If I'd only known with the first two what I learned by the third and fourth kid, I'd have a lot more tread left on my mothering tires. With the first two, I tried Calamine and Camouflage; in other words, I painted my little sufferers pink at night and dressed them in clothes that hid the condition by day. And if one had a flare-up on his or her face, then I'd just apply a Halloween mask or keep the kid home from school -- anything to avoid the stares of the other perfect mothers.

Well gather ‘round Girlfriends (and Dads too) because people who've been there, done that are here to give you the skinny on what my daughter used to call "The Itchy Scratchy Disease." Here's some help and encouragement to get you and your child through the rough spots (no pun intended).

Things to Make You Sound Smart When Talking to the Doctor

  1. It's pronounced "eggs-seh-mah"; it does not rhyme with Noxzema. (Although Dr. Hebert says some of her patients swear they get great relief by applying Noxzema they've chilled in the fridge to their trouble spots.)
  2. Eczema is absolutely not contagious. Don't let anyone tell you otherwise.
  3. A child with eczema may have or be predisposed to asthma and/or allergies. It is most common in people with a family history of asthma, hay fever or eczema.
  4. An outbreak of eczema symptoms is called a "flare-up" by the hip folks.
  5. Conditions that make an eczema flare-up are called "trigger factors."
  6. Doctors sometimes may refer to your child's eczema as "atopic dermatitis." Don't worry about the exact meaning. Some parents prefer this daintier and more clinical term, but a rash is a rash is a rash, if you ask me.
Who Says Babies Have Perfect Skin?

I will never get over the disappointment of my first baby girl's baptism day. She was wearing a gown that her grandmother had worn and all the family had flown in for the big day and I just knew the photos would be adorable, EXCEPT HER ENTIRE FACE WAS A BIG RED RASH! The poor little thing just kept rubbing her face on her crib sheets and my shoulder. I stopped crying long enough to call my pediatrician and was told that she was too young for cortisone cream and that I should try "expressing some breast milk and applying it to her face." At that point I cancelled the photographer.

Sitting on my desk beside me as I write this is a picture of me holding my second child in the snow so he can taste his first snowflake. His cheeks are really pink, and I just thought he was too fair for such cold weather. Besides, it was kind of cute at first. Then they got cracked and angry looking and seemed to hurt him. I know it hurt me. I didn't bother mentioning it to a doctor because I thought it would just go away on its own, which it eventually did. Duh, now I know he had eczema, too. Believe me, it's been back to those precious fair cheeks several more times in the ensuing years.

Now that my kids are school-aged, the eczema seems to show up on their arms for some reason. All four of them walk around scratching. By this time, I know they have eczema -- I mean I've had my suspicions confirmed by medical doctors. But I learn more and more every day about the options available for treating eczema, preventing flareups, and coping emotionally.

How Do You Know if It's Eczema?

You will only get a real diagnosis of eczema from a physician. The good news is, it involves no blood tests and only rarely may involve a skin scraping or biopsy to rule out other conditions, so no crying kids! Like Sherlock Holmes, your doctor will probably ask you a number of questions to indicate whether you seem like an "eczema family," like whether you or your mate have ever had the condition or any of its charming companions like asthma and hay fever.

Then they will look for telltale signs that this isn't just any old rash:
  • Does the rash itch? (It may be driving you and your child nuts!)
  • Is the rash recurring, meaning it gets better or worse for no apparent reason?
  • Is the rash red, scaly, dry or cracked?
  • In babies and toddlers, does the rash commonly appear on the face and on the trunk, but rarely in the diaper area? (That's a separate thing we moms get to worry about.)
  • In older kids and adults, does the rash usually show up on the neck, inner elbows, backs of knees and ankles?
  • Did you first notice the rash on your child at a very young age?
  • Do eczema, hay fever and/or asthma run in the family?

If these signs sound familiar to you and/or you've answered "yes" to these questions, then chances are your doctor will diagnose eczema. But PLEASE, go see your pediatrician or dermatologist and have them make a diagnosis! Don't diagnose it yourself. Talk to your doctor about treatment options for your child. For example, there are steroid and steroidfree topical options available in cream or ointment formulations. So, it's important to educate yourself about treatment options and ask your doctor which one might be right for your child.

Effective treatment, as well as a lot of advice from doctors and moms, can help you avoid flare-ups and help clear them up when they occur. And best of all, once you're armed with any medications your doctor might prescribe, as well as an understanding of how eczema works and how to control it, you and your child get your power back!


| Continued... |



Copyright © Novartis; By Vicki Iovine. All art used in this booklet was created by actual eczema patients age 4-12 for the Many Faces of Eczema Children's Art Contest, sponsored by Novartis. Reprinted with permission.




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