Dossier: Family

When children’s skin itches

Neurodermatitis afflicts one in five children in Switzerland. For parents, this means: moisturise, moisturise, moisturise. After all, sufficient moisturising and rehydration are essential for treating irritated skin in children.

Text: Nicole Krättli; Photo: iStock

It’s an unpleasant sensation that most of us know all too well: itchy skin that drives you mad. But what if you're constantly plagued by this condition? Neurodermatitis is one of the most common skin conditions in infants and children – up to 20% of all children suffer from this non-contagious skin condition.

Many parents are at a loss and look desperately for the cause. Is the washing powder to blame? The new shampoo? Or perhaps the exotic fruit that dad sliced into the muesli in the morning? In most cases, neurodermatitis is actually genetic. If a parent suffers from neurodermatitis or asthma, the child has a 50% chance of being affected, too. If both parents are affected, the probability even rises to 75%.

The cause: a weakened skin barrier

The root of all evil in neurodermatitis is a protein called filaggrin. This protein helps to regulate skin moisture and maintain the skin’s barrier function, explains dermatologist Dr. Marianne Meli. It is not sufficiently present in children with neurodermatitis. Unfortunately, children with neurodermatitis and their parents know the consequences of a weakened skin barrier only too well: the skin becomes more vulnerable and dries out more quickly. This leads to inflammation of the skin, and pathogens such as bacteria or viruses can penetrate the skin more easily. Other factors such as the weather, stress at school or certain products that can trigger allergic reactions make the situation even worse, says dermatologist Meli.

Subtle signs often announce the arrival of neurodermatitis. Sometimes whitish patches appear on the cheeks or a double wrinkle under the lower eyelid. However, the main signs are dry areas of skin that become red, itchy and often flake or weep. The elbow joints, back of the knees, neck and throat are particularly affected. In infants, an early form of neurodermatitis occurs in the form of cradle cap. Other typical areas for neurodermatitis are the cheeks, scalp and the outside of the arms and legs.

Treatment: Replenishing and moisturising provide the key to relief

Dry skin is like a collapsed protective barrier, so it’s crucial to rebuild this barrier. But how? Regular moisturising and oiling, especially after showering, is extremely important, emphasises Meli. She advises using pH-neutral and fragrance-free creams especially for children. And an occasional oil bath is like a short holiday for stressed skin. “Children with neurodermatitis can take a short bath every day, but it is important that the water is not too hot and that the child is moisturised again after an oil bath,” Meli continues.

Many doctors prescribe cortisone for acute neurodermatitis. Using such a strong substance on children worries some parents but dermatologist Meli gives the all-clear. If the cortisone cream is used correctly, it only brings benefits and no risks. “Cortisone helps to stabilise skin affected with neurodermatitis and reduce inflammation,” she says.

As neurodermatitis is closely linked to allergies, it is worth having allergies medically examined. But only if symptoms appear. "It doesn’t make sense to do an allergy test if there haven’t been any previous symptoms,” says the dermatologist. The expert also advises against avoiding potentially allergenic foods as a precaution. Not only is this not very helpful, but in extreme cases it can even encourage the development of an allergy.

Choosing suitable clothes can also have a positive impact on the life of a child suffering from neurodermatitis. Cotton or silk feel much better on irritated skin than scratchy wool. Even seams in underwear can be very uncomfortable, depending on the location of the rash. It may be enough to turn the underwear inside out so that the seams are on the outside.

The problem often resolves itself

Caring for a child with neurodermatitis can be challenging, but in many cases the right strategies can make everyday life easier for parents and children. The symptoms in many children also become less severe as they get older. This is particularly true for those who show signs in their first 12 months of life. By the time they reach young adulthood, around 60% of children affected by neurodermatitis no longer show any symptoms.

The Swiss Allergy Centre offers neurodermatitis training courses for parents and children. The training courses are run by experts from the fields of medicine, nursing, education and psychology to make everyday life easier for children with neurodermatitis and their parents.

Tea tree oil: a home remedy for neurodermatitis

Tea tree oil, a traditional Aboriginal remedy from Australia, is known for its antiseptic effect. It is worth trying this home remedy as it often reduces the redness and itching caused by neurodermatitis. It is important to pay attention to the quality of the tea tree oil when buying. It should be 100% pure and organically grown. Also make sure that the plant genus “Melaleuca alternifolia” is mentioned on the label. A high proportion of the active ingredient terpinen-4-ol (at least 30%) and a low proportion of cineole (less than 5%) are crucial for the best effect.