Three Steps to Treat Winter Eczema in Children
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The coldest months of the year are here, and I still can’t believe we’re in the middle of a pandemic. Despite the cooler weather, we’re still trying to find fun outdoor activities to keep everyone safe and happy, however with various members of my family with atopic eczema that’s always tricky.
If you or someone in your family suffers from atopic dermatitis, you may know very well how cold weather may worsen it. That’s why today I’m sharing with all of you new and effective treatment options that I'm sure will help you as much as they’ve helped my family treat moderate-to-severe eczema.
Thanks to Med-IQ, a couple of months ago I shared an article about how to detect atopic eczema in kids, today I share with you three steps to help you treat it by thinking about your treatment journey as a therapeutic ladder that you can “climb up” based on the severity of your kids’ atopic dermatitis.
As you may have read before, I love partnering with Med-IQ as they are an accredited medical education company that provides an exceptional educational experience for doctors, nurses, pharmacists, and other healthcare professionals.
Did you know that 10% to 25% of children have atopic dermatitis; of which, approximately one third have a moderate-to-severe disease? The interesting thing is that 87% of parents of these children say their child’s healthcare provider did not discuss systemic therapies or are unsure whether their child’s healthcare provider did.
That’s why it’s very important to learn about these treatment options so you can advocate for your kids and find the doctor that best serves that purpose.
So here are the three steps on how to climb the treatment ladder according to Dr. Peter A. Lio, MD, Founding Director of the Chicago Integrative Eczema Center.
Step 1: Gentle Skincare
The first step on the ladder is gentle skincare treatments, using soaps and cleansers that are oil-based, do not contain preservatives, and moisturize the skin. Identifying and avoiding possible irritants and allergens that can trigger or aggravate disease flare is important but also challenging.
For example, in my household; mattresses, pillows, and duvet’s materials have to be hypoallergenic, otherwise, they provoke allergies and rashes. Also, during the winter season, wool sweaters are almost intolerable for one of my daughters. So, avoiding these irritants is much better than trying to treat them later.
Step 2: Corticosteroids
The second step in the ladder is often corticosteroids, although the long-term use of topical steroids is often not recommended. Corticosteroid-sparing therapies are also available if basic management strategies do not provide relief.
These options are best for mild or moderate atopic dermatitis or in combination with systemic therapies for more severe disease.
Moving up the ladder may be necessary for moderate-to-severe atopic dermatitis patients.
Step 3: Systemic Therapies
One treatment option for these patients is nonspecific immunosuppressants, such as systemic corticosteroids. However, these can cause rebound flares and multiple adverse effects with long-term use.
Newer systemic agents are now available and approved by the FDA that target the underlying causes of atopic dermatitis, including the factors that cause itch and inflammation.
Additionally, dupilumab is approved for use in patients aged 6 years and older for moderate-to-severe atopic dermatitis that is not controlled with topical therapies. Systemic therapies may also be augmented by topical medications.
So, in conclusion, because atopic dermatitis is a chronic condition, a formal written plan or “Eczema Action Plan” can help you follow your recommended management plan. It is important to follow treatment instructions carefully so that if your kids' symptoms don’t improve or they experience any side effects, your doctor can determine whether another treatment is right for them.
It is also essential to seek care from your skin care provider if treatments are not working despite following the treatment plan as a treatment change may be needed.
Many parents wonder whether they should see their child’s pediatrician or a dermatologist if their child is experiencing eczema. This decision depends on your child’s treatment results. Some pediatricians are comfortable treating up the ladder, but others are not. Therefore, you may need help from a dermatologist or pediatric dermatologist.
It’s important to look for a healthcare provider that works as your partner on your kids’ treatment journey. Look for clinicians who ask for your preferences, discuss your prior experiences, and partner with you to develop an eczema action plan.
If you have kids with atopic eczema as I do, I hope this information helps you tackle these winter months so we can have one less thing to worry about during these difficult times.
Also, please help Med-IQ continue with their valuable research by filling out this quick and anonymous survey:
Med-IQ is conducting an anonymous survey and would appreciate your input. The survey will take less than 10 minutes to complete. Survey responses are shared only in aggregate. Your responses to these survey questions will provide Med-IQ with important information about your experiences with atopic dermatitis, which will help us develop future educational initiatives. Once you've completed the survey, you will have the option of providing your email address to be entered into a drawing administered by SOMA Strategies to win 1 of 10 $100 VISA gift cards. If you choose to enter, your email address will be used only to randomly draw the winners and notify them of their prize.
Doctor that lead the discussion:
Peter A. Lio, MD
Clinical Assistant Professor of Dermatology and Pediatrics
Northwestern University Feinberg School of Medicine Founding Director, Chicago Integrative Eczema Center Chicago, IL
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