Dr. Betti Hertzberg Ressler is a Board Certified Pediatrician on staff at Miami Children's Hospital. Dr. Hertzberg developed the toilet training video "Let's Go Potty." She is the co-author of "The Doctor's Book of Home Remedies for Children."
Question: My 17-month-old son has had a bad, itchy rash looking localized spots on his upper arm by the muscle area, the front of his head, on his back upper neck down to his back and on the side of his face.
He's had this since he was four months. When he turned 13 months we visited a holistic pediatric MD who advised us to change his diet. Wwe did and sure enough it disappeared; not for long though.
We've seen several dermatologist who really have no diagnosis for it other than eczema and giving four different prescriptions for steroid creams on his baby skin such as elocon.
Any suggestions on how I can determine what it is? Could it be an allergic reaction? If so, how long can an allergy last in a rash form? If it is eczema will he have it forever? I do give him benedryl when the itching gets really bad, which unfortunately it has been.
Pediatrician Dr. Betti Hertzberg's Answer:
Dear Mrs. Rose,
Eczema is a term used to describe a condition of the skin that typically
appears early in life, just as you described. Since it usually takes time to
sensitize and "develop" allergies to environmental things, the culprit in
young children and babies is usually the food that is eaten. We do know that
milk protein is one of the most common offenders (found in formula). This is
probably why your baby's skin began showing signs of eczema at the age of
four months. The protein content of breast milk is easily digested, therefore
eczema is not as pronounced in these babies. It still may show up if there is
a genetic predisposition.
Eczema (also known as "atopic dermatitis" is common in children where there
is a family history of allergies and similar skin conditions. The treatment
is removing what we think may be causing the dry, itchy and rough skin that
you are describing.
The tendency of the skin to be dry makes it more important to keep skin
moist. Avoiding things like strong detergents, perfumes and foods that worsen
Lotions applied to keep skin moist as well as using cortisone creams or
ointments relieve the inflammation that is associated with eczema. Care must
be taken when using cortisone for long periods of time. Use these as directed
and apply sparingly.
Presently, there is no "cure" for eczema, although sometimes it does (with
time) get much better and appears to almost disappear. If the offending
causes are removed, it can be keep in control. Many times (as your child gets
older), symptoms will disappear.
Benedryl and other medications are used to control the symptoms of eczema,
not treat the cause. These medications should not be used for very long
periods of time. They do help to break the cycle of itching that can prevent
healing of the skin during flare-ups.
Continue discussing treatments with your doctors and remember to keep skin
moist, avoiding those things that make skin flare up.
P.S. Soaking in the tub for long periods of time will cause the skin to
dry out and make symptoms worse!!! Sorry kids!
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Ask Dr. Betti your questions
This information is not intended to be a substitute for visiting your pediatrician. If you or your child has specific concerns, you should see your doctor for a diagnosis and treatment.