Battling Eczema Itch in children

by amanda
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Our Night Time Eczema Woes

“Hands! where are his hands?!”

I mumble in my half-awake state as the baby monitor crackled next to my head. I struggled to open my eyes as the moving blur on the camera slowly came into focus. Peering at the clock in a dream-like state I see that it is 2 am.

Great I thought, another itchy night AGAIN.

People find it hard to believe when I tell them that at 3.5 years old, I am still watching Corey on the baby monitor. But then again, these people don’t have an extremely itchy eczema baby who has been known to scratch himself into a frenzy at night.

This baby monitor is hands down my best baby product investment. Some people have told me the only way they could monitor their eczema baby at night is to co-sleep. My husband has an innate fear of crushing our kids in his sleep so we’ve never done that. Our next best alternative is this baby monitor to watch him while he slept.

I’ve become so accustomed to this view, I spring into action at the slightest movement. It’s also comforting for me to watch him sleep soundly.

The night shift one-eyed mum

If you are a seasoned mum like me, you’d probably developed an acute ability to do things in the dark with one eye opened. Or maybe for some nights, both eyes closed.

My husband once asked me how I change diapers in the dark. To date, my success rate is 99%, the 1% being that one time I put my son’s diaper on inside out. The blood-curdling scream of “IM SO WET!” that woke half the neighborhood, will forever be etched in my mind.

You betcha I’ve NEVER worn a diaper in the dark and certain NEVER inside out ever again.

The good news is since starting this nightly ritual for the past 3 years, my body goes into autopilot, (hence only need one eye) with precision execution of duties that would make a brain surgeon proud.

The bad news? I still suffer from that 1% of judgment errors because of this one-eye habit. The resulting bodily injuries to myself (thankfully none to my son) have left me with more bruises than I can count. Buy me coffee and I might recount to you how I whacked my forehead on the holiday bunkbed in my hurry to attend to Corey’s needs. Son, when mum is old and bedridden please remember the sacrifices mummy made to give you the best care…

Ok enough of my mum blunders, back to our topic.

The night-shift one eyed mum who haven’t slept in 3 years

If I am lucky we would have only one night waking from the itch. More often than not however, it has been an average of two to three times a night after he turned one.

I tell people I haven’t slept through the night in the past three years. But that also means Corey hasn’t slept through either. So my goal was to fix this problem for everyone to have better rest.

There is hope!

The situation improved over the years as Corey’s eczema got better. He stopped itching in the day by the age of two. Nowadays his skin is so good, we can get through with one waking a night (YAY). I dare say it’s a combination of hard work on healing his skin, staying consistent with our bedtime regime and using our nighttime skin care tools.

Learning point: the more severe your baby’s eczema, the more extreme the night itchings. Be prepared with a game plan and skin care tool kit.

Why Eczema Itch is Worse at Night

Cortisol is the hormone that helps to control inflammation and itch. Our body cortisol levels peak in the morning, reduces over the day and lowers at bedtime. While this is a good thing in normal people as the body relaxes and signals bedtime is coming, it becomes a double-edged sword for eczema sufferers.

Eczema sufferers will notice they itch more at bedtime. Partly due to the lower cortisol, partly due to lesser body activity during this time. So focusing on getting the skin ready at bedtime is the important first step to reducing itch at night.

Learning point: Focus on getting the skin ready and comfortable at bedtime is important in eczema itch battle.

My baby eczema Itch tool kit

Eczema is the itch that rashes. “If there was no itch, there would be no eczema” that’s what our allergist told me. Therefore if we can stop the itch, that would be ‘the cure’. So far there is still no such cure for itch. Since we are still waiting on that magic cure, here’s my baby eczema itch tool kit.

You can adapt your own depending on the severity of eczema and itch.

  1. non-negotiable bedtime skincare routine
  2. night time emergency skin care battle kit – distract and soothe

1. Non-negotiable bedtime skincare routine.

Our bedtime skincare routine is absolutely non-negotiable. It is so ingrained into our time table that my kids know it goes hand in hand with brushing teeth and blowing noses. We do not skip a day, not even during holidays or late nights out.

When Corey was one and his eczema was infected and chronic, I added wet wraps with Tubifast to the equation. Now that his eczema is mostly confined to stubborn spots, I have simplified it to 4 steps. You can read about my specific steps in 4 Simple Steps to Healing Skin Care for Eczema Babies.

2. Night time emergency skin care battle kit – distract and soothe

Distraction can come in many forms. My favorite is calamine lotion, ice packs, and a cooling moisturizer that gives the skin a different sensation. Applying pressure or massaging with your hand also works to take the mind off the itch for a while. Sometimes this works, sometimes it does not so try different combinations and experiment with what works for you.

If the itch is overwhelming, your baby will keep going at it. If all else fails and it looks like the rash is getting bigger, its time to consider administering allergy medicines as directed by your doctor.

Learning point: Build a regular, consistent skin care routine that works. Built an emergency skincare tool kit for night time itching. Adapt your tools according to the intensity of the itch and rash.

Real time walk-through: think fast, act faster

Now that you know my tool kit, here’s my one-eyed mum walk-through of what happens when I make it to his bed (in one piece) at 2am:

Time is always of the essence in these moments.

I zero in on his hands and look at what they were doing. If he’s scratching, I check the area to assess how much damage he has done. Broken, weepy skin means I need to clean with antiseptics (I use chlorhexidine gluconate) before applying anything else. Read about this antiseptic at Chlorhexidine gluconate eczema skincare beyond moisturizers.

The itch can perpetuate itself. It would start in one spot and spread to totally unrelated areas (that have no rash at all?!). I have to work fast, otherwise, we would be in for a very long night indeed.

Next, I swiftly reach into the emergency skincare tool kit placed next to his bed. If the patch is red and angry I usually start with calamine to soothe it. Once the itch calms, I wipe off the calamine and put a layer of moisturizer. Disclaimer: I have been known on more than one occasion to layer the moisturize over the calamine in my sleepiness. But hey, who’s counting?

Mopiko is used only for small localized eczema patches. I learned this lesson after my son scratched off the Mopiko and rubbed it into his sleepy eyes. Yep, don’t say I didn’t warn ya..

If these calm him down he usually goes back to sleep fairly quickly. But if this is an uncontrollable pruritus itch I’d have to consider giving him allergy medicines as directed by my doctor. How to tell if it’s pruritus? Oh, you definitely will know when it becomes uncontrollable.

In our case, his eyes would be closed but his brows furrowed like a madman as his hands keep going for it. The offending itch would spread to clear skin and soon he is wide awake in minutes.

Learning point: Learn to work fast. Develop an itch soothing routine which works. Make your itch battle tools available at a moments notice.

2am is not time for whats and whys of investigating itch/rash triggers

In our first year of battling his chronic eczema, I would keep wondering what the heck is causing these itch attacks. Every time I asked our allergist why it gets so bad at night? He reminds me how complex eczema and allergy is,

“For babies, it could be anything from pain, dreaming, even dust. Or a combination of all three.”

“Just great, how do I counter DREAMING?”

“You can’t counter dreaming and stress that causes eczema itch at night,” he said. “Just do your best to keep baby comfortable using as minimal meds as possible”

It’s tempting to throw my own tantrums at 2 am night itches. And to be fair I have done my fair share of getting frustrated at Corey for being itchy at this unforsaken timing. I’d regret it the instant the explosive ‘DON’T SCRATCH!’ leaves my lips. I’d see this poor boy clawing at his skin with his eyes closed, scratching at his skin like a drug addict going through withdrawal, and realized that he just simply cannot help it.

By my second year, these nightly itch wakings had worn me down to the point I stopped bothering about the WHYS in the middle of the night. No amount of normal brain function at 2 am could add value in investigating his triggers anyway. At times like this, it is more important to ensure he goes back to sleep faster, and I get more rest to dissect the night’s events in the morning.

Learning point: Important for both eczema babies and mums to get as much well-rested sleep as possible.

In Conclusion

There are other itch strategies that have not been mentioned. Some like to wear gloves or scratch mittens at night. We swaddled Corey till he got too big for the swaddling cloth. I used mittens and then socks when he outgrew those. We knew it was trouble once he figured out how to take them off.

One dermatologist taught me to use plastic wrap/plastic bandages to cover the eczema patch after moisturizing to reduce moisture loss. I’ve not had much success with these as I have a very opinionated 3-year old whose “I DON’T WANT” means back off lady or you’ll regret it.

I like to file away these other tips for future reference. I may not use them now but might need to in the future if his eczema changes. Remember to experiment and see what works for you.

Try building your own comprehensive skin care tool kit and itch tool kit. Put multiple kits around the house so they are within reach at a moments notice. Just remember to have at least one eye opened when you grab for them!

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