Caring for Children with Eczema

This is a recording of “Caring for Children with Eczema,” a Zoom presentation held on June 8, 2023.

Below is an excerpt of a presentation given by Dr. Lisa Shen, who joined Kuchnir Dermatology in 2019 while continuing her academic career at the Boston University School of Medicine. Dr. Shen completed a dermatology residency and pediatric fellowship at Northwestern University. She received her medical degree from the University of Wisconsin. She is board-certified in both dermatology and pediatric dermatology by the American Board of Dermatology.

Welcome everyone. It is my pleasure to spend a little time chatting with you about my approach to caring for children with eczema. I’m a pediatric dermatologist and most of my patients are under the age of 18. Having said that, I trained in general dermatology as well, and a lot of the concepts do apply to adults as well. So, I know there might have been some questions: Is this relevant to adults? For the most part, yes, but there are some topics that will be more relevant towards kids. For example, food allergies.

So to jump right in, our objectives for tonight: First, we’ll start by just talking about what eczema is; it’s also known as atopic dermatitis. And then a common question I get asked in the clinic is: What causes this and what are the triggers? And associated with that, when do we suspect and when should we not suspect food allergies? Because it’s not as simple as we might think because there are so many things that you see online, and there is some truth to a lot of things, but there are a lot of caveats too. So, hopefully, I will demystify a little bit of that for you.

And then finally, I’d like to discuss the components to a comprehensive eczema treatment plan, including an approach to gentle skin care in children. So, I think one of the biggest challenges of treating eczema, especially in the community, is a lot of people feel that maybe, oh, it’s just like a one-medicine or, you know, one cream or ointment that I need to fix this. And unfortunately, it is not that simple for most cases. So hopefully by discussing all the components to a comprehensive eczema treatment plan, that light bulb will go off. And if you have a child with eczema or if you yourself are suffering from eczema, you might get some clues as to what else could be missing, what other parts of the puzzle we can identify to help get you relief from itchy skin which no one likes.

So, to dive right in, we’ll start with just discussing atopic dermatitis, also known as eczema. So, eczema, by definition, is a long-standing skin condition. It commonly comes and goes, and it is especially common in young children. So, a lot of people call it the itch that rashes. You first start feeling it as something itchy, and then the more you scratch, the more that rash appears. The common locations really depend on the age of the patient. For example, in babies, a lot of kids have eczema on the face, whereas in adults, that’s less common, though it’s still possible. Also, in young infants who are crawling, you might find more eczema on the outer aspects of their elbows, their knees, areas where they’re really having a lot of friction due to crawling. As kids get older, the eczema tends to settle more in the creases of the skin. For example, you can see here the creases of the elbows; we call that the antecubital fossa. That is a very classic location for eczema.

Additionally, eczema does tend to run in families, and sometimes, families might not recall a history of eczema, but oftentimes the clues are maybe someone in the family has some seasonal allergies or maybe someone has asthma. So, that tends to go hand in hand with eczema, and so when I hear those conditions in the families, I do have my radar up for eczema because it is just that common, about 20% of the population in the pediatric group.

To continue learning about eczema, watch the full presentation.