If your child has atopic dermatitis, you know flares will happen. Even if both you and your kiddo are dedicated to a skin-care routine — and adapt your lifestyle habits to the changing seasons — it’s not always possible to prevent eczema from rearing its itchy head.
Spotting the earliest signs of a flare, though, can help keep symptoms from intensifying and may also shorten the duration of the itchy episode.
Here are a few signs a flare might be coming on — plus, how to cut it short.
1. An Invisible Itch Appears
Even before there are any visible signs of atopic dermatitis, you might notice that your child is scratching their skin more frequently or rubbing a specific area, especially at night, says Shira Wieder, MD, a board-certified dermatologist at Montefiore Einstein in New York City.
2. Skin Changes Color
You might not think twice about skin that seems a little redder or a little darker than usual, especially if your child shows no other eczema symptoms, but these subtle changes can hint at an upcoming flare, Dr. Wieder says.
3. Skin Can Feel Like Sandpaper
Even if you don’t notice visible changes to the skin, it may feel dry or rough to the touch, almost like sandpaper, before a flare, Wieder says.
4. There May Be Pinpoint Bleeding
You might notice specks of dried blood on your child’s pajamas or bed sheets, a sign that their skin is dry and cracking — a possible sign of an upcoming flare, says board-certified dermatologist Amreen Sitabkhan, MD, of U.S. Dermatology Partners Carrollton, in Carrollton, Texas.
5. They Toss and Turn at Night
Itching can get worse at night, so if you notice your child tossing and turning more, that might be a sign of irritation. “They’re not sleeping as well, and they’re waking up frequently because they’re uncomfortable,” Dr. Sitabkhan says.
6. The Weather Is Changing
Environmental factors matter too. “When it gets really cold and the humidity drops, we can pretty much, unfortunately, expect a flare,” says Sitabkhan. Similarly, traveling somewhere very hot could trigger flares too.
What to Do Next
Once you’ve spotted some signs of a flare, it’s time to act. Here are a few steps you can take to ward off, or lessen, your child’s atopic dermatitis symptoms.
- Minimize your child’s exposure to triggers. Make sure to remove fragrances, adhesives, and irritating fabrics from your child’s environment. This is a key component of managing atopic dermatitis at home at any time — not just when your child has an impending flare, Wieder says.
- Moisturize, moisturize, moisturize. Most importantly, it’s time to moisturize. “If parents recognize these symptoms before the flare begins, they can start generous use of moisturizers to try to prevent the progression of the inflammatory pathway,” Wieder says. Look for “boring” products, Sitabhkan says: “They don’t smell like anything and they don’t have any dyes … but they are the ones that tend to do the trick.” Good moisturizers for atopic dermatitis include emollients, like ceramides, to soften the skin; humectants, like glycerin, to draw in moisture; and occlusives, like petroleum jelly, to lock in moisture.
- Reevaluate their treatment. Talk to your child’s pediatrician or pediatric dermatologist about making any changes to their maintenance plan. They may recommend using a prescription medication, such as topical corticosteroids or nonsteroidal medications, twice a week to prevent flares, Wieder says. “If the flare is prevented, the patient ultimately won’t need to be treated for as long of a time,” she adds.
- Rethink bath time. Hot baths can be too drying for kids with atopic dermatitis, so keep baths short and lukewarm if you’re concerned that your child might be about to flare, Sitabkhan says. “As soon as you’re done with the bath, use moisturizer,” she adds.
- Run a humidifier. When the humidity outside drops, consider running a humidifier in your home or in your child’s bedroom. It may not stop a flare entirely, Sitabkhan says, but it can help restore some moisture to the skin.
The Takeaway
- Some early physical signs of an atopic dermatitis flare in kids include changes in skin color and texture.
- There are also behavioral signs of an atopic dermatitis flare, including increased itching and trouble sleeping.
- If you recognize these signs, remove any known triggers from your child’s environment and step up their moisturizing routine. Talk to a healthcare provider about possibly implementing a maintenance plan with any prescription treatments your child uses.