This is a guest post from Mei, aka MarcieMom, who blogs about child and toddler eczema on EczemaBlues.com. Mei has a baby girl with eczema, and is passionate about helping other families with eczema. She leads many eczema initiatives, including a national eczema fund, a support group and illustrates an eczema picture book ‘A to Z Animals are not Scratching!’.
Eczema is a chronic condition, characterised by itchy, sometimes red, rashes. It’s also described as the itch that rashes! My baby, Marcie, has eczema from two weeks old and ever since then, I must have said ‘Stop Scratching!’ countless times (whether or not she understood it!). However, asking (or shouting!) our child not to do something is less effective than rewarding him/her for not doing it. It can also be annoying to the child to be told time and again not to scratch, when it’s something so terribly difficult to control. Marcie, being almost 3 year-old now, has started to proclaim:
“I WANT TO SCRATCH”
Why do children (and even adults) scratch their eczema?
Scratching is like a reflex and a relief to the itch – apparently, by scratching, the nerves trigger the body to release endorphins that gives a feel-good feeling and block pain information. Also scratching damages the itch nerves temporarily, which takes from a few seconds to hours to be repaired.
Scratching can also sometimes become habitual, where a normal response (i.e. scratching) becomes habitual and more situations result in the scratching. Dr Christopher Bridgett, explains more in this post on habit formation and how to reverse the scratching habit.
Definitely, No Scratching!
Scratching is however, very bad for the child, as it:
- Damages the skin barrier, making it even more vulnerable to irritants
- Damages the skin cells, resulting in the release of more itch signals (that leads to even more scratching!)
- Causes inflammation and infection.
Toddler eczema – Rewarding the Child instead
To reduce the scratching, the eczema has to be managed – good skin care routine, moisturizing, being aware of known allergies and avoiding them, appropriate topical treatment under doctor’s supervision are needed. While we are managing our child’s eczema, there would still be itchy and scratchy times.
We can manage these by:
- Using habit reversal techniques, such as replacing the scratching with holding the itchy skin
- Distracting the child, for instance with sign language and colouring.
- Protecting the skin with short finger nails, eczema clothing that wraps the fingers and last but not least,
- Rewarding the child for not scratching!
Some milestones that you can set up to reward your child might include:
- Not scratching during bedtime
- Not scratching in the day
- Not scratching the particular patch of eczema flare
- Moisturizing himself/herself after shower
- Soaking in the bath oil in the bath tub
- Did a craft instead of scratching today
- Replaced the scratching with another action, e.g. holding tight/ tapping the skin.
It’s not going to be easy for both us the parents, and our children, to stop the itch and the scratching in toddler eczema.
We try our best to make life happier by a using a happy reward chart instead of shouting: