Neurodermatitis in children: help for care and understanding

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If children are affected by neurodermatitis, cortisone cream is often the treatment of choice. If we are talking about small children, it may make sense to combine the daily application of cream with entertaining rituals – such as drawing figures on the skin. © Christin Klose/dpa-tmn

Skin rashes and unbearable itching – when a child suffers from neurodermatitis, he needs more than just a good ointment. How parents can help their child.

Kiel/Munich – The skin is dry and red – and it itches so much. Neurodermatitis can be behind such complaints, which often appear in children on the cheeks, on the eyelids or on the outside of the arms and legs.

At a later stage, the inflamed areas may form blisters, which sometimes also ooze. What a pain for those affected: The extremely severe itching disturbs sleep at night and concentration during the day.

And that’s not all: “Many girls and boys are ashamed of the appearance of their skin and the itchiness and feel excluded at daycare or school,” says dermatologist in Kiel, Prof. Regina Fölster-Holst. This can limit the quality of life for children and their families.

Make everyday life bearable

But in many cases countermeasures are possible – with good skin care and loving care of the sick child. “Once the diagnosis of neurodermatitis is established, everyday life can be made very bearable for those affected,” emphasizes Fölster-Holst. However, this requires some time and patience.

Everyone should do it, not just the little patients themselves. Atopic dermatitis is a rather chronic skin disease. It runs in phases and in different phases. “This means that there are phases in which those affected are almost symptom-free,” explains dermatologist Marion Moers-Carpi in Munich.

Certain trigger factors, which vary from child to child, can trigger a new flare-up. “Trigger factors include wool, soap, tobacco smoke, but also sweat or stress or heat or cold in general,” says Fölster-Holst. Certain foods, such as milk or peanuts, can sometimes trigger an eczema flare-up.

Where does the disease come from?

Important to know: “Atopic dermatitis is not a contagious skin disease, not even in the acute phase,” says Carpi-Moers. A risk factor for neurodermatitis is, on the one hand, a family-related disposition. But: “Studies show that neurodermatitis has increased in recent years – and this cannot only be due to genetics,” says Moers-Carpi.

According to Moers-Carpi, experts also discuss the so-called hygiene theory. According to this, people today wash too much and are too clean, which weakens the immune system. For now, this is nothing more than a theory.

And what does the treatment of neurodermatitis look like? “There is no one-size-fits-all system,” explains Fölster-Holst.

Individual therapy

The dermatologist prepares an individual therapy plan for the child. Regular check-ups check whether the prescribed treatment is still effective or whether it needs to be adjusted. “The most important therapeutic measure is the cortisone cream,” explains Moers-Carpi. They come in different strengths – from class one to class four.

According to Fölster-Holst, there is also medicine for children from the age of twelve, which a doctor injects under the patient’s skin every 14 days. The be-all-and-end-all therapy is skin care according to medical specifications. “It is also important when the child is symptom-free, after all it is important to avoid a new flare-up as far as possible,” says Fölster-Holst.

In cases of severe disease progression, parents and children can benefit from neurodermatitis training. The working group for neurodermatitis training (AGNES) has developed uniform concepts for this.

Cream is important

It is also important to plan enough time for cream. “It’s better to get up a little earlier in the morning and apply lotion and not rush before going to bed at night,” says Fölster-Holst. Last but not least, a hectic atmosphere can trigger neurodermatitis.

Sufficient time should be planned for the daily application of cortisone cream. Even a hectic atmosphere can trigger neurodermatitis. © Florian Schuh/dpa-tmn

If the child needs help because it is still small, parents should combine the application of cream with an entertaining ritual – such as drawing shapes on the cheek, singing a song together or telling a story. With increasing age, it makes sense for the girl or boy to take care of the skin independently – this is how parents strengthen the child’s personal responsibility.

Just don’t scratch – this rule can be difficult with the itching that comes with spasms, especially for the little ones. Drugs help in such cases, but sometimes they take a while to work. “So that children do not scratch the inflamed areas during this transitional phase, it is a good idea for parents to ensure that their offspring’s fingernails are cut as short as possible,” says Fölster-Holst.

In case of acute itching, it can help to cool the skin with, for example, a cold washcloth. Thin cotton gloves can be worn to prevent the child from scratching the inflamed skin while sleeping.

Talk about neurodermatitis

“It is also important to talk to the sick child’s siblings about neurodermatitis in an age-appropriate way,” emphasizes Fölster-Holst. This is how parents promote mutual understanding. But neurodermatitis should not be the dominant problem in the family. “If necessary, the parents determine that the disease is not discussed at all at the dinner table,” says the dermatologist. She also advises mothers and fathers to ensure that the sick child is not the only focus.

Parents should also keep an eye on the child’s surroundings. Are there hurtful remarks at school or in day care? Then mothers and fathers can talk to educators and teachers and explore ways to improve the situation.

Teaching about neurodermatitis can also be playful. For example, Fölster-Holst has developed a musical with a teacher and a composer, and she has developed a course for schools that playfully deals with skin diseases and allergies.

According to Fölster-Holst, the bottom line when it comes to neurodermatitis is: “You can help those affected in many ways.” Ultimately, however, the disease cannot be cured. dpa

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