Dry Skin or Eczema? Here’s what to do.

It is the time of year when the weather starts getting a bit cooler and those with sensitive skin start experiencing dry itchy skin. Whether or not you have been diagnosed with eczema or just seem to be easily itchy, there are things you can do to help your skin.

What is Eczema?

Eczema is a skin condition where the skin gets patches which are dry, red, and irritated. Sometimes the cause is known, but often there is not a definite trigger. Eczema can show up anywhere on the body, but it particularly likes the creases of elbows and backs of knees. It also commonly occurs on the face and neck.

What causes eczema?

Most of the time, we just don’t know. I’m sure you all hate that answer about as much as we like giving it. We do know that in most cases, eczema has a genetic as well as an environmental component. So if you have eczema or lots of others in your family have it, you are much more likely to have a kid with it. There can be many environmental triggers for eczema.  For those with seasonal allergies, outdoor triggers can be an issue. Some kids are sensitive to certain perfumes and other additives to cleaning products. For many, a drop in temperatures outside is all it takes.

Food Allergies

This is a hot topic right now as parents are desperately looking for a cause for their kids’ itchy skin. There is a definite association between eczema and other allergic disorders (like asthma, seasonal allergies, food allergies). But just because your child has sensitive skin, does not mean they have food allergies. If you notice that your child’s skin seems to worsen after eating certain foods, it is worth a discussion with your doctor. But if you go thru the testing process and nothing comes up, don’t despair.

Skin Irritants

One of the most common irritants for kids with eczema is laundry detergent, soaps, shampoos, and lotions. For many kids, that lovely smelling laundry detergent may actually make things worse. So if anyone in your family has a tendency towards itchy skin, try washing all the laundry in one of the “free” detergents. There is a lot of competition between brands, so most of the major brands now have their own “free” versions.

Soaps and shampoos are also common irritants for kids. If your kiddo tends to suffer with itchy or sensitive skin, make sure to stay with the hypoallergenic or sensitive skin soaps and shampoos. Same goes with lotions. Keep it simple.

Outdoor irritants

Many eczema kids find that their skin flares up after playing outside. This certainly doesn’t mean that they shouldn’t play outside. But it does mean we should take some extra precautions. Consider lightweight long pants for outside play so that your youngster minimizes the amount of direct contact with grasses and weeds. Once they are inside, a quick wash-down will remove any remaining irritants from the skin.

How do I fix it?

Unfortunately, there is not a cure for eczema. However, many will find that their skin does improve with time. And many who had significant issues as a toddler will even seem to have outgrown it by the teen years. There are luckily a lot of things we can do at home to minimize the symptoms from eczema.

Keep Clean

We used to recommend that kids with eczema bathe only once or twice per week to minimize the drying effects of a bath. However, current thought is that more frequent bathing may actually be preferred, especially when there is a lot of outdoor play. So bathe when needed. But make sure that the bath water is not super hot and keep the baths short and sweet. Stick to hypoallergenic soaps and shampoos.

Moisture, moisture, moisture

Once your kiddo’s bath is done, pat them dry and be extra generous with moisture. Again, stick with the hypoallergenic lotions. Applying lotion while the skin is still moist from the bath will actually lock in the moisture. There is not one lotion or cream that is better than the others although we all have our favorites. Don’t be afraid to try several different things and see what works best for your kids. If you don’t know where to start, ask your pediatrician. They very likely have a bunch of favorites as well. Moisturize skin at least 2 times daily, and even a 3rd if needed. You are not going to overdo the moisturizing.

What if this isn’t enough?

If you’ve already made changes to hypoallergenic products and have been laying on the lotion all to no avail, it may be time to talk to your pediatrician. There are several medications that can be used to help out for particularly troublesome areas. Your doctor may consider a topical low potency steroid cream or an antihistamine. In very resistant cases, a referral to an allergist or dermatologist may be needed as well.

Feeling Better When You Have A Cold

No one likes getting a cold. As parents, we’ve learned to deal with it.  But watching your kids cough and sneeze and act miserable can push even the most stoic parents to the brink. But although there is unfortunately nothing we can do to make it go away immediately, there are many things we can do to help our kiddos feel better.

What causes a cold?

Colds are caused by a variety of viruses, the most common of which is Rhinovirus.  However, the common cold may also be spread by RSV, human metapneumovirus, adenovirus, parainfluenza, and coronavirus.  These pesky viruses are experts at constantly changing and mutating.  So even if you get one, another can get you again a few short weeks later.  These are not once and done kinds of bugs.

What are the symptoms of a cold?

Most of us are familiar with cold symptoms. Your kiddo may begin with some clear runny nose and sniffles. Expect some cough and sneezing.  Headaches and body aches are common.  Many children also have a sore throat. Sleeping can be a challenge due to cough and congestion. Some children can have a low-grade fever with a cold although not all do.  Most cold symptoms last 7-10 days with the peak symptoms at days 2-3. Some kids will continue to have some cough remaining for a week or so after the rest of the cold symptoms have gone.

How can I keep my child from getting sick?

Even children with the absolute best hygiene practices can expect to get colds.  But the best prevention from getting a cold is washing hands and keeping those hands out of their faces. I am STILL asking my 2nd grade to please quit putting things in her mouth. She can recite my “hands in your mouth put germs in your body and make you sick” spiel but to no avail… the hands make their way up there anyway.. So model good hygiene practices and teach your kiddos to cover their coughs and wash those hands to the best of their abilities.

How many colds per year are normal?

The average adult gets about 2-3 colds per year.  Kids get a LOT more. Many preschoolers and kids in daycare will get 8-10 per year. Kids get more colds when they’re younger, and fewer as they approach highschool. So your youngster could be spending 100 days/year experiencing cold symptoms. No wonder it may feel like they are ALWAYS sick!

When should you worry?

If at any point during your child’s cold, they are acting a lot sicker than you expect, or are having any trouble breathing, they need to be checked out. Your pediatrician can examine them and see if they are having a secondary infection or if there is something else going on. It can be hard to hear that they just have the common cold, especially if you waiting a long time to be seen. We don’t like telling you we can’t make it go away either. But remember that when we say your child has a cold, we are also saying that they DON’T have an ear infection, DON’T have pneumonia, and DON’T have wheezing. These are good things.

Will antibiotics make it go away?

Unfortunately not. Although we’d all love to have a magic pill to make your kid’s (and ours too!!) misery go away more quickly, that’s just not possible. And using antibiotics when you do not have a bacterial infection leads to antibiotic resistance.  And doesn’t fix the problem.

What over the counter cold medicines can I use?

Although there are plenty of over the counter medicines readily available over the counter, none of them are really all that helpful. And often, they can be dangerous for kids.  Tylenol or Motrin can be given to help with discomfort or fever from a cold. But OTC cough and cold medications should be avoided unless you are told to use them by your doctor.

What CAN I do?

Luckily, there are lots of things we can do to help our littles feel better soon. Somestimes having a cold can be a great reminder for us to slow down and take better care of ourselves.

Saline nasal spray

This is the most under-utilized and most effective tool we have at our disposal…  both for our own colds and our children’s colds. A couple squirts in each nostril is safe for babies on up and can really help them to breathe more easily. Saline nasal spray can decrease the swelling inside the nostrils and also helps to break down all that stubborn mucous and make it easier to drain.

Go easy on the bulb suction

Although bulb suction can be a great tool when there are gobs of snot in a tiny tot too young to blow their nose, too much suction can actually make things worse. Using suction more than a couple of times per day can actually increase swelling in the nose. So even though the mucous is sucked out, their tissue is swollen so there is no net gain. Don’t be afraid to use it if needed, just don’t overdo it.

Honey

If your child is under a year old, NEVER use honey. But for older children, some studies suggest that a teaspoon of honey will work just as well, if not better, than OTC cold medications. And it certainly tastes better! As an added bonus, honey has fewer unwelcome side effects such as sleeplessness or restlessness than many over the counter cold medications.

Hot tea

A nice warm cup of tea with lemon and honey can be very soothing to a sore throat and helps ease some of the mucous down. Steam from hot peppermint tea can help open up nasal passages. Not able to convince your little to try some tea? Try some hot apple cider or hot cocoa instead. The warm liquids may not make the cold go away sooner, but they will certainly ease a sore throat.

Extra snuggles

Take the opportunity to give your little one lots of extra snuggles. Tuck them in and read a book. Acknowledge that they feel like poop and reassure them that they’ll be back to their perky selves soon.

Extra sleep

Don’t forget that children with colds need lots of sleep.  Make sure that they’re getting to bed at a decent hour. Cut back on non-essential extracurriculars.

Please remember, if your child is acting sicker than usual, has a high fever, or any difficulty breathing, contact your pediatrician ASAP.

Molluscum Contagiosum: What you need to know

Has your child or another child you know been diagnosed with molluscum contagiosum?  If so, you are definitely not alone.  Molluscum is a skin condition caused by a poxvirus known as molluscum.  It most commonly affects kids under 10 and it is very contagious.  In fact, some reports suggest that 20% of kids will be affected at some point during their childhood.  If your child has been diagnosed with molluscum, there are some things to look for.  But worry not, this disorder is usually self-limited and will resolve on its own without intervention.

What does it look like?

Parents often describe molluscum as “skin tags.”  They are small, usually several millimeters, and often show up in clusters.  Molluscum lesions are round and raised.  They tend to be pink or flesh-colored and almost pearl-like and shiny.  If you look closely, the center has a tiny indentation.  The gunk inside is white and firm, not pus.  Molluscum bumps can live anywhere on the body, but particularly like insides of elbows, armpits, and behind knees.

Incidence

Because up to 20% of kids are affected at some point in their childhood, you can be assured that your child will be exposed at some point.  (Joy!!) Children with eczema and sensitive skin are often more likely to get it and have more bumps than those who do not.  Molluscum happens more in gyms where kids share mats and equipment.  Young wrestlers spread the virus easily.

Diagnosis

In most cases, no special tests are needed to diagnose molluscum contagiosum.  And although you may never have heard of it, the chances are good that your pediatrician has already seen several today and will recognize it near immediately on sight.  For cases that are not clear, we will consult dermatology.

Treatment

Most of the time, time and patience are all that we recommend for treatment.  And although this is frustrating for parents (believe me, I know, our kids get molluscum too!!), it is often the safest method and the least harmful.  Many treatments for molluscum have downsides.

Do Nothing

This is the most recommended treatment for molluscum contagiosum.  Most cases of molluscum resolve on their own (without intervention) within 6-18 months.  They disappear nearly as quickly as they come, and generally leave no scarring or other indication that they’ve even existed.

Pros: Cheap, easy, painless

Cons: Does not stop spread, patience is a virtue most of us (myself included) don’t have in spades.

Freezing

If there are many lesions, or the lesions are causing a lot of distress due to location, freezing can be an option.  Think of freezing, or cryotherapy, like localized frostbite.  Your doctor will use liquid nitrogen for 30-50 seconds on each little bump.  As many children have upwards of 20-30 bumps, this can be quite an undertaking and will often need to be split over several sessions.

Pros: Decreases spread of the molluscum and encourages the body to resolve the infection sooner than it would have on its own.

Cons: It HURTS!  Even after the initial procedure, it will continue to hurt.  Afterwards the skin blisters.  Cryotherapy increases the risk of infection and scarring.

Topical creams

Several creams can treat molluscum contagiosum.  Most pediatricians who start creams use acne creams such as tretinoin to treat molluscum.  When using tretinoin cream, apply only to the very tops of the molluscum avoiding the skin at the base.  Over the counter wart medicines are safe to use.  Dermatologists may also apply a medicine such as cantharidin in the office which kills the top few layers of skin.

Pros: Can decrease spread of the molluscum and encourage the body to resolve the infection sooner than it would have on its own.

Cons: Often causes blistering and pain to the surrounding skin.  In children with eczema, it can cause a flare-up of the chronic skin issues.  As with any disruption in the skin barrier, can increase risk of infection and scarring.

Curettage (cutting off)

This is something usually done by the dermatologist.  The dermatologist uses a special curved instrument to scrape off the affected bumps.

Pros: Instant gratification

Cons: Painful, may lead to scarring

Oral medicines

For children with widespread molluscum lesions, your pediatrician may recommend treatment with an oral medicine such at cimetidine.  Cimetidine is a medicine generally used for acid reflux. But in some children, it can encourage the body to take care of the viral warts.

Pros: easy and painless

Cons: requires taking medicine twice daily for 3 months

Prevention of Spread

You can minimize the spread.  Follow a few simple rules.

Wash Hands

Do not share towels

keep sores covered if possible

Try not to scratch

Restrictions

Molluscum is a NORMAL childhood ailment.  DO NOT restrict their activity.  They MAY attend school.  They MAY attend sports.  If you are getting pushback from anyone questioning this, let your pediatrician know so they can help.

Outcome

Luckily for all of us, this is just a little blip in your child’s health and wellness.  Molluscum contagiosum WILL resolve.  With or without our help.  So hang in there.  This too shall pass!!

Other Resources for Molluscum Contagiosum

American Academy of Dermatology Overview of Molluscum

Mayo Clinic symptoms and causes of molluscum contagiosum

CDC on Molluscum Contagiosum

Suicide Prevention

Each year, September 10th is recognized as World Suicide Prevention Day. The suicide rate among young people has tripled since the 1940s.  And according to this article in the National Institute of Mental Health, there were over twice as many deaths due to suicide than homicide in 2016. But together, we can all do our part in suicide prevention.

Statistics

  • Suicide is the 3rd leading cause of death between 10-24 years old.
  • Suicide claims about 4,600 youth lives  each year.
  • There are 157,000 youth between the ages of 10-24 treated in the ER for self-inflicted injury each year.
  • Girls are more likely to attempt suicide, but boys are more likely to be successful.
  • 16% of high school students will consider suicide, 13% will make a plan, and 8% will make an actual attempt.

What this means

What this means is that over time, we are nearly guaranteed to either know someone or know of someone who has at least considered suicide. Suicide can touch any family and can happen in families who don’t know there is a problem. Many kids can paint a perfect exterior and successfully hide their pain from even close friends and families.

What Can You Do

Know the Signs

If you hear someone talking about wishing they were dead or talking about wanting to kill themselves, you need to take action right away. But often, the signs are more subtle.  Is your child becoming more withdrawn? Avoiding friends and not seeming to enjoy things they normally enjoy?  Are the mood swings significantly more dramatic than usual? If you are worried something may not be right, ask questions.  Let them know you love them.  Go do something together and ask directly if they’ve thought about hurting themselves.  These are hard questions, but they need to be asked.

Do Your Part

One of the most powerful things you can do as a parent is to let your child know that you’re there for them.  And not just when things are good.  But also when they are at their worst.  So take a deep breath and plunge right on in.  Let them know that you’ve noticed that they seem to be struggling.  Tell them you’re there if they need to talk.  Remember that many children who are contemplating suicide feel deeply and utterly alone and that their voice and presence doesn’t matter.  Be there.  Acknowledge the struggle.  And if you are worried about them, get help.  Talk to your pediatrician.  Get them in with a counselor.  It truly does take a village.  Do not hesitate to expand yours.

Self-Care

Are you taking care of your emotional health?  Is your teen taking care of their’s?  If not, there is no time like the present. Kids face enormous pressure at school trying to balance their education, friends, family, and social media.  Talk about stress management and listen to what they think would help them to decompress.  You can read more about self-care in Self Care for the School Year.

Reach Out

If your teen or someone you know is struggling, don’t be afraid to reach out and ask for help. Find a counselor or talk to your doctor. You (and they) are not alone. Know where to call for help. If you don’t know where to turn, you can also call the suicide hotline at any time for help.

suicide prevention hotline

Spread the Word

Make sure you let others know what to look for.  Teach your kids to recognize signs of distress in their friends.  Empower your friends to help as well. There may be only 1 suicide awareness day, but the time to be aware is every day.  We have to look out for each other and help keep all of our kids safe.  To learn more about suicide prevention, check out the Take 5 site to learn the steps.