Rashes can be caused by many factors, but a proper diagnosis and treatment plan will have children feeling good about being in their own skin again.
Three-year-old Sam was rubbing a red patch around his eye until it looked like an angry sore. His worried mother, Emily Larose of Toronto, knew that this wasn’t just dry skin: his eyes were red and the skin beneath the surface had changed texture. When she and her husband checked the rest of his body, they saw affected areas on the inner corners of his elbows and the backs of his knees. A trip to Sam’s pediatrician set them straight. Along with his gait and musical affinity, Sam had inherited eczema from his father’s side of the family. The good news: eczema, like other bothersome skin conditions, is entirely treatable.
Dr. Paul Cohen, a Toronto dermatologist, says it’s not always easy for parents to differentiate between a variety of common skin conditions because they all look alike. Different causes can lead to the same kind of rash. A skin rash can be caused by bacteria or viruses – such as impetigo and chickenpox – or the environment or genes, such as eczema or psoriasis. Whatever the cause, getting a proper diagnosis, along with an effective treatment and prevention plan, are key to relieving your child’s itch. Not only for aesthetic reasons, but because, if left untreated, these mild conditions can morph into something much more serious.
Dealing With Chicken Pox
Chickenpox is highly contagious, but it’s not harmful for most children beyond the general discomfort. However, Toronto dermatologist Dr. Paul Cohen recommends discussing the vaccine with your doctor. Scarring is quite common, and non-immune adults, especially pregnant women, can be at risk. To manage chickenpox, Dr. Cohen suggests the old-fashioned approach of calamine lotion to sooth your child’s skin, combined with an antihistamine to prevent itching and scratching. Monitor your child’s skin for any changes such as bleeding or changes to the texture of the skin to help identify and prevent infection.
What it is
Also referred to as dermatitis, eczema is an inflammation commonly caused by a reaction to something touching, and subsequently irritating, the surface of the skin. Environmental factors, such as textured fabric, perfumed soaps, detergents and fabric softeners, are some of the most common causes. But in some cases, as with little Sam, eczema can be hereditary. Children with asthma, hay fever and peanut allergies are also more likely to develop this condition. Eczema can affect different parts of the body at different ages. For babies and toddlers it tends to flare up as a patchy rash on the face, elbows and knees. Older children typically experience a rash behind the knees, inside the elbows, on the sides of the neck, wrists, ankles and hands.
Dr. Cohen advises parents to establish a daily routine of moisturizing with products that contain nourishing ingredients such as aloe vera. Use a mild, unscented soap and laundry detergent. Keep in mind that eczema’s itching and scratching cycle means your child’s sleep may also be affected. Dr. Cohen says a humidifier in their bedroom may provide some relief, especially during the dry winter months. Over-the-counter cortisone cream may help alleviate the itch, but if that isn’t enough, a prescription may be needed.
What it is
Psoriasis is a chronic condition that can wax and wane in its severity. Though it affects a small percentage of the population – about 2.3 percent – it is the most common autoimmune disorder. It can be painful and debilitating to its sufferers. The most common type begins with little red bumps that gradually grow larger to form scales on the skin’s surface, which flake off easily and often. However, below the skin’s surface, scales form lesions that are tender and likely to bleed. Current research points towards an abnormality in the function of white blood cells that triggers the inflammation, causing the skin to grow and shed every three to four days. Psoriasis can affect the elbows, knees, arms, legs, palms, scalp, groin and genitals and will often appear in the same place on both sides of the body.
Thanks to research over the past decade, Dr. Cohen says that promising new treatments for psoriasis are now available. “We have a much greater understanding of the cause,” says Dr. Cohen. “Fortunately, with the advent of these treatments, as kids grow into young adulthood, they don’t have to suffer as they once did.”
While eczema and psoriasis cannot be cured, a dermatologist can provide a treatment plan to manage and control flareups. “With older kids, I suggest getting them involved with applying their creams,” says Dr. Cohen. “You have to supervise but you want to give your kids a role to play so they have some control.”
What it is
A child doesn’t have to have sensitive skin to develop this bacterial infection, common among pre-school and school-aged children. In fact, even a small cut that isn’t treated properly can be susceptible to infection from bacteria such as Staphylococcus or group A strep. If your child suffers from eczema, it’s important to be a little more diligent about hygiene, says Dr. Cohen. “Bacteria can enter more easily when a child is breaking down the barrier by scratching to relieve their itching skin,” he says. At its worst, impetigo presents as blisters that eventually break, forming small wet patches of red skin that may weep fluid. Gradually, these patches of skin will form a honey-coloured crust over the affected area.
Impetigo can be treated with either a topical antibiotic cream or a prescription oral medication. It may sound simple, but starting your children off with routine hygiene habits is your best form of prevention. Include regular hand washing throughout the day, especially after playing outdoors or playing with other children, since impetigo is transmissible. “Kids have to keep their hands really clean and parents have to make sure cuts are well managed,” says Dr. Cohen.
Winter sun tips
During the colder weather it’s easy to forget about sun safety. But Dr. Cohen says that even with less daylight, parents still need to be diligent about protecting their children’s skin from the sun’s harmful rays. For children who are skiing, snowboarding or simply having fun in the winter sun, Dr. Cohen recommends using a moisturizer that also contains sunscreen. During the winter months, UVA rays, which can cause your skin to age and increase your risk for developing skin cancer, are still beating down. So slather it on!
Anna Lee Boschetto is a freelance writer and editor in Vaughan, Ont. She has a 21-month-old daughter. Published in November 2010.