Itching, Scratching – Scratching, Itching

Just throw in eczema and you have the complete annoying package.

The itch is often the worst and most irritating part of eczema and scratching is usually the most damaging.

Eczema is an inflammatory skin condition that has a typical red rash, dry skin and is always itchy.  The itch can be so bad that it is difficult not to scratch but unfortunately the more you scratch to worse the itch will become.

Scratching usually accompanies the itch and is very damaging as it:
•    breaks the skin leaving it prone to infection
•    worsens the itch
•    causes the skin to thicken
•    leads to scaring

It is very important not to scratch

We all know not to scratch but when the scratch is relentless like that of eczema it is almost impossible not to scratch.  And that is for an adult who knows not to.  The problem is compounded when you have a baby or toddler who doesn’t know not to scratch or understand why they are so itchy and uncomfortable.

Although the itch is always a part of eczema there are ways that it can be controlled or at least lessened.

Use emollient creams to reduce the itch

There are many emollient creams available designed to treat the symptoms of eczema, none the least the itch.  It is a matter of finding a cream that suits your child’s skin, one that doesn’t irritate their skin further and that actually lessens the symptoms.

This can be a matter of trial and error but when you find a cream that  is helping use it consistently whilst the eczema and itch are present.  And remember if the itch returns it means that the cream is wearing off and needs reapplying, not that the cream isn’t working.

Keep the skin moisturised

Dry skin is always more itchy and irritated than moist skin.  Use topical moisturisers to moisturise the skin. The easiest and most effective way to moisturise a baby or child’s skin is to add a bath oil to their bath water and allow them to soak in the water for 10 – 15 minutes each day.

Ensure your child is drinking adequate fluids.  Weepy or broken skin loses fluid making the skin become even dryer and therefore even itchier.

In the winter the air becomes dryer as the temperature drops and in the summer we tend to use air conditioners that will strip the air of its natural moisture.  It is therefore important to be aware of the humidity in the air year round and moisturise the skin all year round.  Well moisturised skin will help to reduce flareups.

Keep the skin cool

Eczema skin is extra sensitive to heat and cold.  Hot, sweaty skin becomes irritated and will itch more than cool skin.  Avoid anything that will overheat the skin.  Ensure bath water is not too hot.  A warm bath is all that is necessary.

Exposure to sun and sunburn will also irritate the skin making it itchy.  Try to avoid the midday sun and never let the skin become burnt.  Use a good sunscreen and keep the skin covered.  Remember to slip, slop, slap.  Any exposure to direct sunlight is too much for a baby’s skin and may cause burning and damage to the skin.

Keep children busy

Keeping your child distracted is one of the biggest things you can do to stop them from scratching.  If their hands and mind are busy they are less likely to think about the itch and less likely to scratch.  Young minds do not stay focused for long so keeping a child distracted is a difficult task.

Older children can be given activities like painting or water play however it is more difficult to distract a baby.  Colourful things to look at and objects to hold will help for a short period.

Extra tips for babies or when children are sleeping

A well distracted child will often only scratch in their sleep when their mind is relaxed and they are unaware of what they are doing.  It is therefore important to take measures to minimise the risk of damage to the skin due to scratching in the sleep.

  • Cut nails short to minimise damage from scratching.
  • Cover hands with cotton mits so nails do not scratch directly on the skin.
  • Dress your child in lightweight cotton bed clothes that have long arms and legs.  The less skin exposed the less that can be damaged by scratching.
  • Do not allow the room to overheat and ensure the air is moist.  A humidifier may be needed in the dryer months.
  • Turn clothes inside out so the seams do not irritate and cause itching.
  • Avoid synthetic or woolen bedding.
  • In more severe cases arms may need to be splinted to stop intractable scratching.
  • Moisturise and apply emollients immediately before bed so the skin is as comfortable as possible as the baby goes off to sleep.
  • Reduce dust mite as much as possible.

If night itching persists discuss the problem with your doctor.  He may prescribe an antihistamine to minimise night itching and aid in sleep.

The simplest trick

Applying a cold compress to itchy skin will sooth the skin and reduce the itch.  A small child can help by holding the compress in place thereby feeling like they have some control over the itch.  Remember the skin is itchy and inflamed not burnt.  Use a cold compress not a frozen one which may damage the skin and worsen the itch.

NB. It is interesting to note that babies will rarely scratch before the age of four months.

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