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Common skin conditions in kids are more than just an itch to scratch

Most new parents dream of their newborns with 10 fingers and 10 toes, and pretty, soft new baby skin. But as they grow, children can experience some very common skin conditions — some with an easy fix, and others a little more complex.

Eleven-month-old Marilyn Katzen was diagnosed with eczema at a few months old. Like most babies, she could grow out of the condition. But she may not.

“You want your little girl to look beautiful, and her skin is blotchy and red,” says her mom, Debby Katzen, who lives in Pikesville. “It was quite frightening at first.”

The condition began innocently on Marilyn’s face and chest and spread to her limbs. Treatment has included steroid cream and Vaseline petroleum jelly since the onset of the rash.

“People say to me, ‘What’s on her face? Why is her face red?’ and I don’t like it,” Katzen says. “Of course it will affect her (Marilyn’s) self esteem because it’s her face and everybody sees your face.”

Eczema (atopic dermatitis) is one of several common skin ailments that occur in children. Others include acne, molloscum and warts, and they can certainly affect a child’s self esteem according to Dr. Kate Puttgen, a pediatric dermatologist at Johns Hopkins Children’s Center.

When skin conditions affect the face, arms or legs, it can be particularly discouraging for children of middle school age and older, Puttgen notes.

“It is increasingly difficult for kids as they become more socially aware and experience social pressure with something they have to deal with that their peers do not,” she adds.

Such is the case for 12-year-old Aaron Goldberg, of Columbia, who has been dealing with Molluscum contagiosum for about a year. The wart-like virus began with dots on his chest and spread as a result of scratching. After using ointments and oral medications, the bumps worsen and get redder and larger before they finally run their course.

A recent study co-authored by Dr. Bernard Cohen, a colleague of Puttgen’s, concluded that the body’s likely response to molluscum is an itchy rash with blisters that often resolves with the use of topical emollients and antibiotics if the lesions become infected. If the child is asymptomatic, Cohen suggests more observation than treatment, which could enable the development of an immune response.

Like any child, Aaron tries to hide the bumps, especially when he changes for physical education classes.

“He doesn’t want a lot of people to see it,” says his mom, Robyn Goldberg. “Then they would talk about it and talk about it to other people and that would be embarrassing.” His closest friends, however, do know about his condition.

Because children may have difficulty dealing with severe skins conditions like acne or eczema and molluscum, the Johns Hopkins dermatology practice recently added a psychologist to the clinic. Sometimes children scratch out of nervousness and that aggravates the condition as well as the child’s mental state, which also can result in other problems like difficulty sleeping and withdrawal from friends and family.

Licensed clinical psychologist Carisa Perry-Parrish meets with children as young as 7 as they struggle to deal with their peers prodding them about their skin conditions.

Prevention from scratching is also essential, especially in younger children. Perry-Parrish suggests trimming nails frequently and limiting their access to the skin overnight by putting mittens on their hands.

Younger children can benefit from a positive reinforcement system like a sticker chart to reward them for not scratching and following the treatment. Also, taking pictures of the skin periodically as treatment progresses can show the child that there is improvement.

“It’s a tangible reminder of the effort they put into it and their skin is clearing and looks better,” she notes.

Older children need motivation to continue treatment. Perry-Parrish finds it best to teach them to be their own coaches, like on a sports team.

“It takes a lot of effort, like having a coach on the sidelines,” she says. “Some comes from me, some comes from them.”

Most importantly, they need to know that it is normal, that many other children deal with skin conditions.

“I try to make them feel it’s not personal,” Perry-Parrish says.

Eczema (Atopic Dermatitis)

What is Eczema?
“The word eczema comes from a Greek word that means to effervesce or bubble or boil over. Eczema is an itchy, red rash that can appear all over the body. Children and adults tend to have eczema on the neck, wrists and ankles, and in areas that bend, like the inner elbow and knee. As many as 31.6 million Americans have eczema.”

Course & Prognosis
“The eczema rash affects people differently in appearance, location and severity. In general, eczema causes dry, sensitive skin and an intense itch, which may cause sufferers to scratch until the skin bleeds. This worsens the rash, leading to even more inflammation and itching. This process is referred to as the itch-scratch cycle.”

“Over-the-counter (OTC) medications and moisturizers provide relief from itching. Regular use of these products may reduce the frequency of flare-ups. Prescription medicines are indicated for people suffering from more severe cases.”

Source: Johns Hopkins Department of Dermatology

American Academy of Dermatology:
The Skin Site:
The Society for Pediatric Dermatology:

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