Neurodermatitis in children: Helping care and understanding

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If children have neurodermatitis, cortisone cream is often the treatment of choice. In the case of young children, it may make sense to combine daily use of the cream with entertaining rituals – such as drawing figures on the skin. © Kristen Klose / dpa-tmn

Rashes and severe itching – when a child has neurodermatitis, he needs more than just a good ointment. How can parents help their children.

Kiel/Munich – The skin is dry and reddened – and it is very itchy. Neurodermatitis can be behind these complaints, which in children often appear on the cheeks, on the eyelids, or on the outside of the arms and legs.

At a later stage, the inflamed areas can form blisters, which sometimes also ooze. What hurts the sufferers: The intense, intense itching disturbs sleep at night and focus during the day.

And that’s not all: “Many girls and boys are ashamed of the look of their skin and itchy and feel left out in nursery school or school,” says Professor Regina Follster-Holst, a dermatologist in Kiel. 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 for a sick child. “Once the diagnosis of neurodermatitis has been established, the daily lives of those affected can be made very bearable,” Fölster-Holst emphasizes. However, this requires some time and patience.

Everyone is required to do this, not only small patients themselves, Atopic Dermatitis is a rather chronic skin disease. It is run in stages and in different stages. “This means that there are phases in which sufferers are virtually free of symptoms,” explains Munich dermatologist Marion Moors Karppi.

Certain triggers, which vary from child to child, can trigger a new outbreak. “Trigger factors include wool, soap, tobacco smoke, but also sweat, stress, 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?

It’s important to know: “Atopic dermatitis is not a contagious skin disease, not even in the acute phase,” says Karby Morse. One of the risk factors for developing neurodermatitis is family-related predisposition on the one hand. But: “Studies show that neurodermatitis has increased in recent years — and it can’t just be due to genes,” says Moers-Carpi.

According to Moores Carpi, experts also discuss the so-called hygiene theory. According to this, people nowadays wash too much and are too clean, which weakens the immune system. So far, this is nothing more than a theory.

What does neurodermatitis treatment look like? “There is no standardized scheme,” explains Foolster Holst.

individual therapy

The dermatologist develops an individualized treatment plan for the child. Regular check-ups check if the prescribed treatment is still effective or if it needs to be modified. “The main management measure is a cortisone cream,” Moers-Carpi explains. They come in different strengths – from first class to fourth class.

According to Fölster-Holst, there are also medicines for children from the age of twelve that a doctor injects under the patient’s skin every 14 days. The best and last treatment is to take care of the skin according to the medical specifications. “It is also important that when a child is free of symptoms, it is ultimately important to avoid new flare-ups as much as possible,” says Fölster-Holst.

In case of severe disease progression, parents and children can benefit from neurodermatitis training. The AGNES Training Working Group has developed standardized concepts for this purpose.

Fat is important

It is also important to plan enough time to apply the cream. “It’s best to get up a little early in the morning and use lotion and not jump before you go to bed in the evening,” says Fölster-Holst. Last but not least, a hectic atmosphere can lead to neurodermatitis.

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

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

Just don’t scratch—this rule can be tricky with the itchiness of cramps, especially for the little ones. Medicines help in such cases, but sometimes they take a while to work. “So that children do not scratch the sore areas during this transition, it is a good idea for parents to ensure that their children’s nails are cut as little as possible,” says Fölster-Holst.

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

Talk about neurodermatitis

“It is also important to talk to the siblings of a sick child about neurodermatitis in an age-appropriate manner,” emphasizes Fölster-Holst. This is how parents promote mutual understanding. However, neurodermatitis should not be the dominant problem in the family. “If necessary, parents decide that the disease is not discussed at all at the dinner table,” says the dermatologist. She also advises parents to make sure that a sick child is not the only focus.

Parents should also monitor the child’s environment. Are hurtful remarks made at school or at a daycare center? Then parents can talk to teachers and educators and explore ways to improve the situation.

Education about neurodermatitis can be fun, too. For example, Fölster-Holst developed a musical with a teacher and composer, and developed a course for schools that deal comically with skin diseases and allergies.

The bottom line, according to Follster Holst, when it comes to neurodermatitis: “You can help sufferers in many ways.” Ultimately, the disease cannot be cured. dpa

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