"Parents are the cornerstone of atopic dermatitis management in children. Key players in the process, they should be persuaded of the benefits of care products; most importantly, they should understand how the disease works. Parents should be confident in daily care products as well as in treatments and their ability to implement best practices and teach them to their children". - Dr Magali Bourrel-Bouttaz, Dermatologist
Atopic dermatitis is not a contagious disease. However, when children have very dry and atopic skin, their quality of life and that of their family is affected. This disease cannot be cured but it usually disappears on its own during childhood (before the age of five in 50% of cases)1 if the symptoms are adequately controlled. Only 4% of atopic dermatitis cases continue into adulthood, in which case they are generally severe1. To keep the disease from progressing in this manner, here are the official recommendations to be followed concerning hygiene and care for the dry and atopic skin of babies and children.
Education, patience and regularity are key to address itchy skin
Most dermatologists explain that the management of atopic dermatitis is multi-dimensional2. This means that it calls on the knowledge of several experts, yours included. Dr Magali Bourrel-Bouttaz, Dermatologist, is convinced that “parents are the cornerstone of atopic dermatitis management in children. Key players in the process, they should be persuaded of the benefits of skincare products; most importantly, they should understand how the disease works. Parents should be confident in daily skincare products as well as in treatments and their ability to implement best practices and teach them to their children”. She also emphasises that “parents should stop feeling guilty. They aren’t responsible for their child’s disease. The modern world has transformed the skin of certain children, making it more permeable to harsh external factors”.
The daily love and gentle attention that parents show their children are essential to successfully manage atopic dermatitis. A great deal of patience and consistency is required when it comes to cleansing and skincare practices.
Remember that you’re not alone. There are solutions that can help soothe itchy skin and make life easier for the whole family3.
Teach your child to become autonomous so they may have good knowledge of cleansing and care practices when they’re older. When your child is learning to brush their teeth, they’re ready to be taught some basic hygiene and moisturising steps to care for their skin. Successful learning is a long process that lasts six years on average.
My “gentle cleansing” to-do list
1. Take showers to avoid dehydrating the skin
«Atopic skin doesn’t need to be washed every day. Showering twice a week is sufficient for children. » Dr Magali Bourrel-Bouttaz, Dermatologist
- Take short showers2 (no more than five minutes to wash your body and hair): you can refer to a timer that will tell you exactly how much time is left. Your child will naturally learn the length of a shower suitable for their atopic skin.
- Do not exceed 34°: provide your child with a thermometer with fun shapes and colours so they can take the temperature of the water themselves.
2. Bathing is fine, but with caution
«For skin that is dry and slightly itchy, bathing twice a week is sufficient. A child whose atopic dermatitis isn’t controlled and whose skin is superinfected should shower once a day until their skin becomes dry again without any other complications» Dr Magali Bourrel-Bouttaz, Dermatologist
Bathtime bonding between a parent and a young child can be a wonderful experience. Having atopic skin doesn’t mean this moment of relaxation is prohibited. Choose :
- A lukewarm temperature (maximum 34°C),
- For no more than 10 minutes or so,
- With suitable (soap-free) cleansing products,
It is important to take short baths, as seldom as possible, because they cause the skin to dry out faster and increase the risk of irritation for dry and atopic skin4. You should avoid putting additives in the bath water (essential oils, for example), because this could cause contact allergies
3. The advantages of a dermatological cleansing
“Never use soap, whether at home, at school, at friends’ houses, during sports activities, etc. Soap was created to remove fat. And yet the lipids of dry and atopic skin need to be preserved» Dr Magali Bourrel-Bouttaz, Dermatologist
- A soap-free cleanser
- Tailored to dry and atopic skin
- Reduces skin dehydration
- Protects the hydrolipidic film
- Allergen-free
- A pH suited to the skin
4. Moisturise after cleansing for an enhanced experience
Endless hug :
Wrap your child in a towel instead of wiping them off. A hug to pat the skin dry instead of wiping is perfect to calm reactive skin
Cocooning :
Make the enjoyment of bathing or showering last longer: apply an emollient care product immediately after showering to damp skin, to promote the penetration of the active ingredients.
Cool temperatures :
- In the summer, use a chilled towel (put the towel in a clean bag or package and then place it in the refrigerator for a few minutes).
- All year long, moisturise with a refrigerated emollient product to reduce itching and relieve the skin more quickly3.
As soon as skin is washed, it should be moisturised. Even if just your child’s hands or face have had to be rewashed a few hours after showering, they should still be moisturised again with an emollient product. When the skin is red, itchy or rough, it’s experiencing an atopic eczema flare-up. It’s normal for the emollient to sting or burn. You don’t need to change moisturisers. Immediately apply your topical treatment prescribed by your doctor to keep the lesions from spreading.
Advice by Dr Magali Bourrel-Bouttaz, Dermatologist :
Ultra-moisturising nightwear consists in applying a very thick layer of an emollient product (with or without topical corticosteroids) to completely cover a very dry or atopic area of skin or even the whole body. The skin’s colour shouldn’t be visible once the product has been applied. The skin is “white with cream”. You then slip on a tight-fitting garment, such as leggings or a long-sleeved t-shirt. You wear it all night long. This technique is called dry wrapping and has an immediate skin rehydrating effect. It can be used once a week for a skin-moisturising boost.1
One cleansing product + One care product :
Use two specially formulated products to preserve and further moisturise your child’s atopic skin. Use a cleansing product to gently cleanse the skin while preserving its natural moisture + an emollient care product to moisturise the skin and recreate a barrier against external stresses.
“Moisturising creams restore the skin’s impermeability to the outside world. They fill the holes of atopic skin for around 24 hours. They should therefore be applied every day, once or twice a day, even if you only shower or bathe twice a week. Moisturising atopic skin should become a daily routine”..
Dr Magali Bourrel-Bouttaz, Dermatologist
Références :1- Dermatite atopique (eczéma atopique), Inserm 2016, https://www.inserm.fr/information-en-sante/dossiers-information/dermatite- atopique-eczema-atopique
2- Conférence de consensus - Prise en charge de la dermatite atopique de l’enfant, Ann Dermatol Venereol 2005 ;132 (HS1) : 3-295
3- Sathishkumar D and Moss C. Topical therapy in atopic dermatitis in children. Indian J dermatol 2016;61(6):656-661
