Ask The Doctor: Children and D... Health Article

Henry (Hank) Bernstein, D.O. is a Senior Lecturer in Pediatrics at Harvard Medical School and Professor of Pediatrics at Dartmouth Medical School. Formerly the Associate Chief of General Pediatrics and Director of Primary Care at Children's Hospital Boston, he currently is the Chief of General Academic Pediatrics at Children's Hospital at Dartmouth. He has extensive and varied experience as a primary care pediatrician, and is a spokesperson for the news media on a variety of pediatric health care topics, including vaccination, common childhood illnesses, and practical information for caregivers.

Question:

I have a 17-month-old grandson who has very dry skin — so dry it cracks and oozes either clear or sometimes a bloody discharge. He itches all the time and appears to be allergic to almost everything he eats. No cream seems to work on it. Can you suggest anything to help him?

Answer:

Dry skin is a very common problem in people of all ages, even infants and toddlers. Many things play a part in dry skin, including the environment (for example, dry air, cold weather or exposure to the sun), too much bathing or showering, strong scrubbing of the skin, harsh soaps, or skin disease (for example, eczema).

Figuring out the cause for his dry skin would make it easier to help your grandson. In the meantime, you can also try to ease his itchiness, scratching, and discomfort by doing the following:

• Limit how long (and how often) you bathe him each day. Use comfortably warm water and be sure to avoid scrubbing.

• Use a mild soap that either has a high fat content or contains glycerin, which draws moisture into the skin.

• After each bath, gently pat him dry and then apply a moisturizer while his skin is still a little wet. Greasy ointments, such as Aquaphor and Vaseline, work best to seal in the moisture.

• Be sure to cover any of his exposed skin when he is outdoors, using either clothing or a moisturizing sunscreen.

• If the air is dry (like during the winter months) and making his condition worse, use a humidifier to add moisture to the air.

• Be sure not to apply any preparations with alcohol, which tends to be very drying. Creams and ointments are better than lotions at staying in the area where you put them.

• It's OK to give him a little medicine by mouth for itching, but be sure to use the right amount for his age and weight.

• You may need to trim his nails back a bit because the skin can get infected, especially from all the scratching. If it's infected, he will need an antibiotic to treat the infection.

If you think he's really allergic to almost everything he eats, you should try to monitor what things are causing a problem for his skin and making it get worse. If you know what he's allergic to, it would be best to avoid it. Unfortunately, it's usually not very easy at all to know which food is the problem.

If your grandson's problems aren't getting better after trying the above suggestions for a few weeks, give his doctor a call. The doctor may have other ideas or want to see the rash to be sure it's not infected. Specialists like a dermatologist or an allergist aren't usually necessary early on, unless everything else you're doing doesn't seem to be making a difference.