By Robin P. Gehris, MD, FAAD, FAAP, chief, Pediatric Dermatology, Children’s Hospital of Pittsburgh of UPMC
The good news is that we are more than halfway through winter! The bad news is that in Pittsburgh and neighboring areas the cold, dry weather often continues well into the spring. Many of us are feeling the effect of winter weather on our skin, which can be especially dry at this time of year. Some basic advice may help you manage this on your own, but if you don’t see an improvement within 2 to 3 weeks, you may want to consult your doctor.
Are there things I may be doing that make my dry skin worse?
- Having the heat turned up high or having a fire blazing in the fireplace may be drying out the air in your house and may make your skin more dry
- Taking long, hot showers can dehydrate your skin and exacerbate any dryness
- Fragranced products such as soaps, laundry detergents, creams, and perfumes can further irritate dry skin (even if you can usually tolerate these same products at other times of the year)
- Using moist wipes which contain certain preservatives can be associated with skin allergies and dryness or redness after repeated use
- Frequent hand washing and use of hand sanitizers, while often necessary to combat germs, can also dry out the skin.
What can I do at home to help my dry skin?
- Consider turning down the heat by several degrees and adding a cool mist humidifier to add moisture back to the air. We do NOT recommend warm or hot mist humidifiers, as young children can pull these onto themselves and cause burns or scalding injuries.
- Use only UNSCENTED, hypoallergenic products on your skin. Some of my favorites include:
- Soap: Dove® unscented for sensitive skin
- Laundry Detergent: Tide® Free, All® Free & Clear (or other non-branded, clear, unscented detergents)
- Dryer sheets: Bounce® FREE or other non-branded unscented sheets
- Moisturizers: CeraVe® cream, Cetaphil® cream, Eucerin® cream, Aveeno® cream, Vaseline ointment
- Ointments and creams tend to be best products; they are the least irritating, most moisturizing products. Lotions, on the other hand, are thinner, less effective, and can be more irritating to dry skin.
- Steer clear of “natural” or organic products may NOT necessarily be unscented or hypoallergenic and can actually cause reactions when applied to dry skin. An example is lavender, which is natural, but is scented and can be irritating.
- If you must wash your hands frequently, promptly apply a moisturizer cream after washing.
- Moisturizing creams often need to be reapplied multiple times per day during the harsh winter.
- Avoid perfumed washes, perfumed creams or sprays, and scented fabric softener and dryer sheets
- Refrain from scrubbing the skin, as this can make any itching worse.
How can I tell if my child has more than just dry skin – if it’s true eczema?
Eczema, also known as atopic dermatitis, is a medical condition which is characterized not just by dry skin but also by inflammation, which appears rough or red and can cause significant itching. Some children are more genetically predisposed to developing eczema if they also have family members who have eczema, seasonal allergies, asthma, or eosinophilic esophagitis. Babies with eczema may also have cradle cap. Eczema can become so inflamed that there may be secondary crusting or “weeping”. It may improve with moisturizers, but if there is inflammation that doesn’t improve, you may need a prescription medicine and sometimes even an oral medication to help with itching to interrupt this cycle.
Where should I make an appointment to treat my child’s eczema?
Many patients start by contacting their primary care provider for initial advice on eczema. You should expect improvement within 2 to 3 weeks of a new treatment plan, and if this is not happening, you may want to consult a pediatric dermatologist. For a child or young adult, the medical professional most highly trained to diagnose and treat eczema is a pediatric dermatologist, who has formal training and official board certification first in adult dermatology, followed by specialized fellowship training and official board certification in pediatric dermatology. A pediatric dermatologist should pay specific consideration to your child’s skin type, activities, and schedule as well as the safety of the medications. A good pediatric dermatologist also should provide you with reasonable treatment options that are affordable or will be covered by your child’s insurance so that you don’t spend a fortune treating his/her eczema.
What could happen if I don’t treat my child’s eczema?
The most common side effect of NOT treating your child’s eczema is discomfort and sleep disturbance. The itching can interfere not just with the child’s sleep, but with that of the entire family. Poor sleep and uncontrolled itching can also make it more difficult for your child to focus in school and can even mimic attention deficit disorder.
Other concerning side effects when eczema is allowed to flare out of control are secondary infections. Patients with atopic dermatitis are less able at a cellular level to fight off bacteria and viruses on their skin. In addition, without an intact skin barrier during an eczema flare, kids with eczema are literally “open” to many different infectious possibilities entering their skin. These include bacteria and certain viruses. Some of these, such as staphylococcus or herpes simplex virus, if left untreated, can lead to hospitalization. If you are concerned that your child may have an infection and certainly if he/she also has a fever, please contact your doctor right away to be evaluated.
For more information or to schedule an appointment with one of our pediatric dermatologists at Children’s Hospital of Pittsburgh of UPMC, please visit www.chp.edu/dermatology.