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Reducing Scratching in Atopic Eczema

Eczema is an itchy condition as most parents who have a child with atopic eczema know only too well. This is because the inflammation in the skin irritates the nerve endings in the skin. The itch of eczema stops or goes down when the eczema is better. Here are some ideas that may help to reduce your child's scratching:

Treat the underlying condition

There is no doubt therefore that treating your child's underlying eczema is one of the best ways of reducing the itch in atopic eczema. Treating the eczema with plenty of moisturisers, short bursts of topical steroids as outlined in your Skin Care Plan, early treatment of infections and avoidance of irritating clothes and harsh soaps are all ways of reducing the atopic eczema itch.

Reduce the habit of scratching

In some children, scratching the skin becomes a "habit", so that sometimes your child is not aware he/she is doing it. This often occurs when watching television or when changing clothes in the morning or at bed time. If you think this is a problem in your child, here are some simple tips which may help to break this habit:

1 Never say "stop scratching!". All this does is make your child more anxious which will make them want to scratch more when they are out of your sight. All advice needs to be positive and active.

2 Give praise when there is no scratching.

3 Try and make your child aware of how often they scratch their skin e.g. by getting them to make a note of how often they scratch their skin in a little diary. Making your child aware of how often they scratch their skin is often the first step in reversing the habit.

4 When your child feels the urge to scratch, teach your child a different way of dealing with the itch such as clenching the fist tightly for 30 seconds or pinching or tapping the skin where it itches. This takes the sensation of itch away without damaging the skin. This requires practice and a lot of encouragement.

5 It might be useful to use a star or sticker chart to praise your child for not scratching. You can either make a chart yourself, or buy a calendar with a space for each day on which your child could put the stars or stickers.

6 If you find that your child tends to scratch far more during certain times, for example when watching television or reading, you need to make your child aware of this and perhaps consider awarding extra stars for success at this especially difficult times.

7 Be aware of the difficult situations where bouts of scratching tend to occur. Plan ahead for what to do after the shower or when dressing etc.

8 Put on creams quickly and never put them on less than 20 minutes before going to bed.

9 Undress or dress your child quickly to give them little or no chance of tearing at their skin. Play and talk with your child at bathtime and pat the skin dry with a towel afterwards rather than rub the skin.

10 Try diverting your child's attention in activities which tend to make scratching worse.

Reduce the damage caused by scratching

There will be times when despite your best efforts, your child will just have to scratch their skin. You or you child should not feel guilty about this. There are ways however of reducing the damage of scratching. The most simple is to keep your child's nails well trimmed so that they are less likely to cut the skin when scratching. If your child tends to tear at their skin during the night when half asleep then make it more difficult for your child to get at their skin e.g. by wearing a one-piece night suit. Using bandages to the limbs at night (such as wet wraps) is another way of giving your child's limbs a holiday from the damaging affects of scratching.

Conclusion

If there is an obvious cause to your child's eczema such as a food allergy, or allergy to house dust, then it clearly makes more sense to avoid these things as outlined in our other handouts. In many instances, no single cause can be found and the above measures to reduce the urge to scratch and the damaging effects of scratching can be very helpful. All of the measures require time and a lot of encouragement from yourself. Not all measures will be useful for all children with atopic eczema but we hope that you may find at least one that is helpful for your child.

© The Eczema Team 1996