Every morning when Jennifer Jacome’s 8-year-old daughter, Aelin, heads off to school, she grabs a special backpack. “It contains a skin kit that has all the essentials she needs to manage her atopic dermatitis: moisturizer, a gentle cleanser to wash her hands with at school, wipes for her face to remove pollen when she goes outdoors for recess, and her EpiPen, since she has food allergies,” says Jacome, a public relations executive in Houston, Texas. “We let her pick out all the skin care products in there to give her a sense of control.”
School or day care can be tricky for any kid, but it can be particularly challenging for children or teens with atopic dermatitis, often known as eczema. More than a million school-age children in the U.S. have severe atopic dermatitis, according to the National Eczema Association. If they have a flare-up, other kids and even teachers may think the rash is contagious. They may get teased or bullied. If they were up the night before because of itching, they may be too tired to fully participate in school.
“Kids with severe, uncontrolled atopic dermatitis can miss days, and sometimes even weeks, of school,” says Anna Kirkorian, MD, a pediatric dermatologist at Children’s National Hospital in Washington, DC. “It’s really important that parents work closely not only with their doctors to get their child’s atopic dermatitis under control, but also with their educators to make sure they have everything they need.”
Set Up a Support Structure
At the start of the school year, or when your child starts day care, it’s important to set up a meeting with your child’s teacher and any support staff, like school nurses. Here are some things to do:
Talk to the teacher. If your child has atopic dermatitis, they may be very itchy in class. “You don’t want the teacher to reprimand your child and tell them just to stop scratching because that won’t work,” stresses Kirkorian. Other, better strategies include sending your child to the nurse to apply moisturizer, giving them a fidget toy to play with, or letting them leave the room for a short period for a break.
Give the teacher a written list of your child’s triggers along with any suggestions. If your child’s atopic dermatitis gets worse in the winter, they may need to sit away from radiators and heating ducts, for example.
Meet with the school nurse. You may need to talk to them about any medications that may need to be given during school hours, like topical steroid creams or allergy medications. If your child has food allergies and carries an EpiPen, then it will also need to be held in the nurse’s office. Some kids may also need to periodically go to the nurse’s office for 10 minutes so that they can apply ice to a particularly itchy spot.
Consider a 504 plan. Many kids with atopic dermatitis qualify for a 504 plan at school. This is a special plan that legally requires your child’s school to put certain accommodations in place for them. If your child has very severe hand eczema, for example, you may want to ask that they use a laptop for assignments and tests rather than pencil and paper. They may also need cotton or cotton-lined rubber gloves during arts and crafts time to minimize exposure to possible atopic dermatitis triggers like paint or glue.
Pick the Right Clothing
When it comes to clothing, cotton is best for kids with atopic dermatitis. “It does a good job of absorbing sweat, and it’s light enough to allow skin to ‘breathe,’” says Jessica Chacko, MD, a pediatrician at Blooming Bright Pediatrics in Lithia, Florida, whose son, Noah, has severe atopic dermatitis.
If your child is active, consider a moisture wicking fabric like Dri-FIT. “My daughter lives in Dri-FIT shorts year-round since they’re so soft and comfortable,” says Jacome.
It’s also a good idea to always send them with several changes of clothes, says Chacko, especially if they are an infant or toddler and prone to messes. “If their clothes get dirty and they borrow some, their skin may get irritated by whatever detergent they’ve been washed with,” she explains.
Older kids and teens who play sports may also need to take some precautions. “If they have to put on equipment like shin guards, they should coat their skin with a thick petroleum-based moisturizer such as Aquaphor,” advises Chacko. “It will prevent their sensitive skin from getting torn up from friction.” They should also shower immediately after all practices or games to wash away sweat that can be an atopic dermatitis trigger, followed by an atopic dermatitis-friendly moisturizer.
Pack an Atopic Dermatitis Care Kit
It’s a good idea to put together a care kit for your child at school or day care that they can leave either in their cubby, classroom, or in their school locker. Some things to include are:
- Gloves to handle materials that may irritate skin, like paint or glue
- Moisturizer
- Mild cleanser to use instead of harsh school bathroom soaps
- Antibiotic ointment
- Alcohol-free hand sanitizer
- Adhesive bandages and gauze pads
- Protective clothing, like a long sleeve cotton T-shirt for sports
Chacko also recommends that all kids, regardless of age, carry around a travel-sized bottle of moisturizer to apply to their hands after they wash them. It will help prevent any hand eczema flares. If they are at day care, make sure staff knows to apply moisturizer as well.
Be Alert for Bullies
Up to 40% of all school-aged kids and teens experience bullying because of their atopic dermatitis, according to the National Eczema Association. While you can’t always prevent this, you can help your child cope with it. Start by encouraging them to talk to you about their atopic dermatitis. Explain what it is and what possible triggers are. Ask them to share with you any questions or teasing they get from other kids.
There are other things you can do at your child’s school to raise awareness. These include:
- Make a fact sheet to pass out to the parents of your child’s classmates with information about atopic dermatitis.
- Ask your teacher to discuss atopic dermatitis in the classroom so students understand why your child may scratch or have an occasional flare up.
- Hold an Eczema Awareness Day at your child’s school.
- Start an Eczema Support Group for kids with atopic dermatitis at your child’s school. Invite both parents and kids to join.
Stay on Top of Flares
Severe atopic dermatitis is associated with poor school performance, according to a 2023 study published in the British Journal of Dermatology. Thankfully, there are a lot of treatments that can get serious flares under control.
“A decade ago, we had very few tools in our arsenal, but now we have many more medications that can improve a child’s quality of life,” says Kirkorian.
If your child is so tired they can’t concentrate at school, or their itching significantly impacts their ability to do work, talk to your doctor. Together you can come up with a treatment plan that will allow your child to thrive, both inside and outside of school.
Show Sources
Photo Credit: Moment/Getty Images
SOURCES:
Jennifer Jacome, parent advocate, Houston, Texas.
Anna Kirkorian, MD, pediatric dermatologist, Children’s National Hospital, Washington, DC.
Jessica Chacko, MD, pediatrician, Blooming Bright Pediatrics, Lithia, Florida.
National Eczema Association: “Tools for School,” “Eczema Stats.”
American Academy of Dermatology: “What Can Help a Child with Eczema Manage Triggers at School?” “Can a Child with Eczema Attend Gym Class and Play Sports?”
British Journal of Dermatology: “The Association Between Atopic Dermatitis, Cognitive Function and School Performance in Children and Young Adults.”
