Eczema and Kids: Coping Strategies for Parents to Help
The constant itching and scratching can take a toll. Here are 10 tips on how to support your child, from distractions and 'spa days' to relaxation techniques and simply listening
Eczema is a chronic skin condition that affects 20 percent of kids in the U.S., according to the National Eczema Association. For millions of children, that means dealing with incessantly itchy, dry and scaly skin. Beyond impacting concentration, sleep, self-esteem and even what they can wear, the process of managing eczema also takes a toll on their patience – from the relentless urge to scratch to the time-consuming, goopy process of bathing and moisturizing.
That's where parents can play a strong positive role. In a presentation at the 2012 NEA Patient Conference, Jennifer LeBovidge, PhD, a psychologist at Boston Children's Hospital Atopic Dermatitis Center, and a clinical instructor in psychology at Harvard Medical School specializing in pediatric psychology, offered these tips to make the journey a little easier – and sometimes even fun.
1. Team approach to itching
Take a non-blaming, "we're-in-this-together" stance. Even language can make a difference. Instead of saying, "Don't scratch," which makes it about the person with eczema, try, "Your eczema's bothering you; what can we do?" Subtle shifts can help. Focusing on what kids can do boosts their sense of control and self-esteem.
2. Trigger awareness
Help your child be a scratching "detective" or "scientist," looking for data and clues. Beyond environment and foods, stressful situations can be a trigger, as can mindless activities or sedentary activities when hands are free (watching TV, talking on phones – even bedtime). What about exposed skin? For babies, it might be diaper changes. For older kids, it could be when they're in the bath or right after the bath.
3. Block scratching
There are simple ways to cover and protect the skin, like wearing longer clothing or tights. Some kids wear cotton wristbands (without latex elastic). At night, try sleep suits, gloves or arm sleeves designed for eczema. Wet wrap treatments can help, too; in addition to moisturizing the skin, they can provide a barrier.
4. Get distracted
It works! Being engaged in an activity lessens scratching. Try special toys at diaper changes for babies. Ditto bath toys: Some parents rotate them, or play tic-tac-toe with bath crayons on the side of the tub. Think "hands-on," too. Handheld video games are great for long car rides or doctor's office waits. Or get creative with drawing, painting, collage, blocks, pop-up books or singing songs with hand gestures. Sometimes a change of scenery helps, as well.
Another way to distract is to engage in a game. Some families play a game when the child gets out of the bath, using a timer to beat their best time. How fast can they apply creams and get their clothes on?
Try "competing responses," too – i.e., engaging those hands with something else. During sedentary activities like watching TV, when the urge to scratch pops up, keep a "coping bucket" nearby with, say, a stress ball or a smooth stone to rub. Making friendship bracelets or knitting are other great options.
5. Bathing, moisturizing and wet wraps
All this is often a source of anxiety for kids. Chatting about the "whys" can help: "Our skin is thirsty and it's taking a drink, and our moisturizer is sealing it in." Having children help rub their moisturizer in, or drawing pictures with it on their skin can help them feel more in control. Novelties may work, too. Some kids bathe with their clothes on; it reduces stinging, and the sheer goofiness makes it fun. Or try a bathing suit or washing in a kiddy pool.
With teens, transform bath time into spa time, where they also listen to some favorite music. If teens find their facial moisturizer too thick, work with their doctor to try to find a lighter one. Some kids hate that goopy, sticky feeling when they're putting on pj's or clothes after moisturizing. Get them a special robe that they wear just while things are soaking in.
For wet wraps and pj's, why not turn those into mermaid or fishy pajamas? If kids are putting bandages on, choose a special color or use super hero tights or princess gloves to make it fun.
6. Soothing the senses
For many, a cool shower can help reduce the itch. A cool washcloth or an ice pack works, too. Do what’s soothing for your child. The idea is to try to “block the itchy messages going to the brain” with other messages, like the cool sensation of an ice pack.
7. Relaxation techniques
There's a stress link with eczema, so if we can reduce stress, that's good. Try deep breathing: even, relaxed breaths, in through the nose and out through the mouth. Or, progressively tense and then relax different muscle groups throughout the body. For example, pretend to squeeze an orange in your hand, as hard as you can, and then let your hand go limp. It helps kids feel the difference between tense and relaxed. Many relaxation CDs and apps can help with these techniques.
8. Using imagery
Guided imagery is another relaxation technique that can also help with the itch. Picturing being somewhere else or a change in your body it can actually produce real changes. Using all of your senses can help. Try a classic beach scene: There's a cool breeze, you hear a seagull in the distance, waves are crashing on the shore, in and out, in and out, and you can taste that residue of the salt from the sea on your lips. The concept is that you start to feel as if you were there. For kids, fun scenes work best—like being on a spaceship. Imagine having a feeling of weightlessness, viewing the Earth below, and looking at the cool control panel.
Or, picture relief. If the eczema feels really hot and burning, you might imagine the look and feel of cool water washing down your skin and melting away those red patches. It doesn't matter if what you're imagining is "correct." It still can work. It's whatever image is soothing for you.
9. Answering peers' questions
Kids don't have to tell everyone what eczema is, but it will come up. When kids have some factual language, they do better. Give it a name. Keep it simple. "It's eczema and it is dry, itchy skin." Some say, "It's like an allergy – you can't catch it." You're setting the tone it's no big deal. Peers pick up on this. Parents can role-play responses with kids so they feel more prepared.
10. Supportive parenting
When kids say "I hate this" or "Why me?" as parents, we want to rush in with answers. Sometimes what's most helpful is to really listen first – to let your child know you understand. Help her realize that there's more to kids than eczema. Get kids involved in activities that improve their self-esteem.
Think about how you talk about your kids. Is it often about eczema, or are you spending as much time talking about the fact that she's a great T-ball player or learning to read? Be mindful of the coping styles that you're modeling, too.