Kate Gambey, 45, has lived for years with the challenges of her 9-year-old daughter Stella’s atopic dermatitis. “Every fall and winter, she flares up,” says Gambey, a consultant for the United Nations in Paris, France. “She develops patches all over her body, but especially in the crooks of her elbows and knees. She will scratch so hard her skin bleeds. It’s frustrating for her — and for me.”
Gambey takes basic steps to keep Stella’s atopic dermatitis under control. She keeps her nails short, cuts back on bathtime, and lathers her up with heavy moisturizers whenever they leave the house. Still, “I feel bad for Stella, especially since she’s old enough to be self-conscious,” she says.
Up to 20% of kids have atopic dermatitis, or eczema, according to the National Eczema Foundation. Though the condition isn’t dangerous, it’s more than just an annoyance. A 2024 study published in the Journal of Clinical Medicine found that living with AD had a considerate impact on both patients and their caregivers. “If a child’s atopic dermatitis isn’t well controlled, it can lead to depression, anxiety, and sleep problems, which can cause trouble both at home and at school,” says Anna Kirkorian, MD, a pediatric dermatologist at Children’s National Hospital in Washington, D.C.
But while there are challenges associated with atopic dermatitis, there’s also plenty you can do to help your child cope with it. Here’s advice, from both parents and pediatric dermatologists.
Subdue Scratching
For most kids with atopic dermatitis, itchiness is the worst symptom. It can make it hard to concentrate at school and make sleep difficult, if not impossible. Gambey's son, Louis, who is 18 months, also occasionally has atopic dermatitis flares. When that happens, he’s up at all hours of the night scratching, which means that both he and his mom don’t sleep.
When you have atopic dermatitis, the urge to itch is so strong that it’s impossible for a child to ignore, points out Kirkorian. During the day, she recommends that caretakers distract them as much as possible, whether it’s with a book, a toy, or a video game. Another option is a fidget toy: there are some designed specifically for kids with conditions like atopic dermatitis.
To help promote sleep at night, you can try wet wrap therapy, where you place a wet cloth on your child’s medicated skin to help it absorb treatment. “It also soothes skin, to reduce itching and help your child sleep better,” says Daniela Russi, MD, a pediatric dermatologist at Phoenix Children’s Hospital in Phoenix, Arizona. After your child’s shower or bath, slather them in their prescription topical creams, top their itchy areas with a layer of wet cotton gauze, then put them in their pajamas.
Get a Handle on Stress
Stress can worsen atopic dermatitis and vice versa, says Lawrence Eichenfield, MD, chief of pediatric and adolescent dermatology at Rady Children’s Hospital-San Diego. A 2023 study published in the Annals of Dermatology found that triggers like school exams or family problems can trigger an atopic dermatitis flare.
“Stress raises levels of hormones such as cortisol in your body, which causes inflammation,” Eichenfeld explains.
Research also shows that atopic dermatitis and chronic itch activates areas of the brain similar to chronic stress and pain. This can cause a vicious cycle. “When your atopic dermatitis flares up, it can lead to depression and anxiety, which makes stress worse,” says Eichenfield.
Here are a few ways you can help your child with atopic dermatitis manage stress:
Connect them with other kids with atopic dermatitis. It can help them to talk to others who have faced similar challenges. The American Academy of Dermatology hosts Camp Discovery, a weeklong overnight camp for children with skin conditions like atopic dermatitis, each year.
Practice relaxation techniques. These can help to relieve stress, distract from itching, and improve symptoms like depression and anxiety, says Eichenfield.
Research shows that these techniques may also improve both skin symptoms and emotional well-being in kids with eczema. One option is guided imagery. Encourage your child to visualize a trip that makes them happy. It could be a beach, being up in a spaceship, or at an amusement park. Encourage them to use all their senses: for example, if they’re at a beach, they can feel the sand on their feet, hear seagulls, see waves crashing, and taste sea salt.
Stay active. Kids with atopic dermatitis may shy away from exercise. They may feel self-conscious about being in workout clothes or a bathing suit. As a caregiver, you may also worry that sweat will worsen their symptoms. But physical activity is important to keep kids healthy and to boost their mood, says Russi. A 2023 study found that people with atopic dermatitis who exercise regularly report less depression, anxiety, and trouble sleeping.
Swimming is actually a great option for kids with atopic dermatitis, says Russi. “A lot of parents worry that a chlorinated pool will trigger a flare, but it actually helps because it’s antibacterial and an anti-inflammatory,” she explains. “It’s similar to a bleach bath, which we recommend for patients.”
Involve Kids in Their Treatment
When kids are involved in their own care, it makes them feel more in control. This in turn can help to relieve stress. Gambey encourages her daughter Stella to take an important role in her own self-care.
“Everytime she has a flare, we make a game of it: We take bets as to how many days it will take the eczema to go away and mark it on a calendar,” says Gambey. “This way, she’s motivated to do things to help it disappear faster, like applying moisturizer to her skin herself. It gives her a sense of ownership over her own health.”
If you run into a problem — for example, bath refusal — then work with your child to find a solution. If they fight a bath before bedtime, they may be more open to one right after dinner. Older kids and teens can keep a journal to track changes in their skin and measure progress.
It’s also important to make treatment fun. When your child has an atopic dermatitis flare, applying topical treatments like steroid creams can sting. Gambey has Stella apply moisturizer by herself at night and makes it into a game by having her draw pictures with it on her skin. If you have a teenager, Russi recommends that you let them talk to their dermatologist on their own to come up with a list of products that they like. “They’ll often listen to a doctor more than their own parents,” she explains. “If they push back, we can explain why treatment — including moisturizer — is so important.”
The Importance of Treatment
When atopic dermatitis is well-controlled, it’s less likely to cause symptoms that can impact your child’s everyday life, stresses Kirkorian. “We have so many new treatments now, including biologic medications,” she explains. These drugs “can dramatically improve children and teens’ quality of life.”
If your kid’s atopic dermatitis affects their sleep or mood, or they are distracted by itching, then talk to your doctor about the various treatment options. “Parents are often afraid of certain treatments, such as prescription topical steroids, but we know they are very safe and can really improve symptoms,” says Kirkorian.
Show Sources
Photo Credit: Stone/Getty Images
SOURCES:
Kate Gamby, atopic dermatitis parent advocate, Paris, France.
Anna Kirkorian, MD, pediatric dermatologist, Children’s National Hospital, Washington, D.C.
Daniela Russi, MD, pediatric dermatologist, Phoenix Children’s Hospital, Phoenix, Arizona.
Lawrence Eichenfield, MD, chief of pediatric and adolescent dermatology, Rady Children’s Hospital-San Diego.
National Eczema Foundation: “Eczema Statistics,” “Meditation and Eczema,” “Itch and Meditation,” “Natural Treatment, Helping Your Child Cope With Eczema,” “Atopic Dermatitis and Kids.”
Journal of Clinical Medicine: “The Burden of Pediatric Atopic Dermatitis: Quality of Life of Patients and Their Families.”
UpToDate: “Patient education: Eczema (atopic dermatitis) (Beyond the Basics).”
Annals of Dermatology: “Psychological Stress and Atopic Dermatitis: A Focus Group Study.”
Children and Youth Services Review: “Effectiveness of an Integrative Body-Mind-Spirit group intervention in improving the skin symptoms and psychosocial well-being in children living with atopic dermatitis: A randomized-waitlisted controlled trial.”
JEADV Clinical Practice: “Physical activity and mental health among patients with atopic dermatitis or chronic spontaneous urticaria: A cross‐sectional study.”
