Eczema in Kids: What Parents Should Know

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The Young and Healthy Podcast. You’re listening to the Cincinnati Children’s Young and Healthy Podcast. 

Kate Setter 

Hello and welcome back to the Cincinnati Children’s Young and Healthy Podcast. I’m Kate Setter, your host for today. Following this episode, Young and Healthy will take a spring break in April. Stay tuned to our social channels for more information on our return. So diving in today, our topic of conversation is going to be eczema. And this is one of those that I hope parents are clapping about because this is definitely one of those health in childhood things that can be such a struggle for some families. And joining us for this important episode today are Jess Trygier, who is a general pediatrician here at Cincinnati Children’s, and Mariam Inqeibi, who is a pediatric dermatologist. So we are going to start with where we always start at the very beginning with what is eczema. Miriam, would you take this one for us? 

Mariam Inqeibi 

Yeah, it’s a good question. So eczema… Simple terms, also known as you might hear your providers call it atopic dermatitis. That’s the other name for eczema. It’s a chronic inflammatory skin condition. So what that basically means is that it’s a long-lasting, long-standing skin condition that really has two parts to it. So you have the impaired skin barrier, which basically means you have dry skin. And this dry skin, because you know, our skin is there to protect us from the environment and to protect us from all these like for an allergen. So when that’s impaired, anything can get into the skin and trigger your immune system. So then you have the second part of eczema, which is the inflammation. So you have that inflammation component. So the end result is you’re going to get this dry, sensitive, itchy, red skin. 

Kate Setter 

So following up on that a little bit, dry, red, itchy skin, is that what it always looks like? Or can like the presentation of it change as the kiddo gets older? Or is there anything we should know about like how it looks on different skin tones? 

Jess Trygier 

Absolutely. So like Dr. Inqeibi said, red, dry, itchy is kind of that hallmark presentation. Can be bumpy or flaky. Sometimes you’ll get some oozing, especially if they’ve been scratching a lot and you get some fluid leakage there. In darker skin tones, it can also appear a little bit more gray or purple or just darker than the skin. So that’s something to be aware of. And then typically in kids less than two, we notice that eczema tends to be more common on the cheeks, kind of the, we call them the extensor surfaces or the front of the legs, the back of the arms, those and the trunk tend to be areas that flare versus in older kiddos, it tends to be more on the opposite side of the body. So the back of the knees or the creases of the knees or the creases of the elbows. We call those the flexural surfaces. Now there can be some crossover, especially in kiddos who have more severe eczema. You can really see it in a lot of locations, but those are just some of the most common hot spots. 

Kate Setter 

So what do we know about what causes it? 

Mariam Inqeibi 

Yeah, that’s, I think, the golden question that parents always want to know, like, what is causing my kids? What can I do differently? Exactly. So unfortunately, like most things in medicine, it’s not a one thing is the ultimate cause. It’s multifactorial. So just means like a combination of factors. you have the genetic factor. So if anyone in the family or the child themselves have asthma, nose or eye allergies, something we call eosinophilic esophagitis, anything that really is basically a representation that you have a flare or you have a tendency to flare in something called the T helper 2 pathway of your immune system, that makes you more at risk to developing eczema. Because we said like it’s a two-part step and one part is inflammation. If you have that predisposition to get that inflammation, you’re more risk to get eczema. The other cause is environment, you know, weather, the dry weather, the exposure to things that can irritate our skin, fragrances, all these things can trigger eczema flares. So again, it’s not really just one thing. It’s a combination of, your internal genetic factors and your environmental factors as well. 

Kate Setter 

Makes sense. So when my kids have had eczema, I’ve observed that it comes and goes. And is that kind of what you’re talking about when you use the term flare? 

Mariam Inqeibi 

Yeah, so that’s exactly, you’re exactly right. So that’s actually one of the more characteristic things about eczema is that it comes in, it goes, and that’s so frustrating, you know, for families, for the kiddos themselves, you’ll have days where, oh my gosh, everything’s improving. It’s as if we never had eczema, and then the next day it’s you’re back to square one. And this can happen because of like the things that we mentioned, like the environment, you know, the dry weather, exposure to things that can irritate your skin, just even things like stress, illnesses, that triggers your immune system to rile up and can trigger you to get a flare of your eczema. Sweating, you know, that can also irritate the skin and cause eczema. So all those things can push your skin to developing A flare. And that’s why, you know, it’s so important to not just address the inflammation, but also to address the dry skin and get a really good skincare routine that you do daily, regardless. Your skin looks good, your skin doesn’t look good. It can come back again. You need a good skincare routine. 

Kate Setter 

Quick question on the environmental factors for you. Does sun exposure impact eczema at all? 

Mariam Inqeibi 

That’s a really good question. So actually, funny enough, we do use sun therapy for eczema. Oh, okay. So it can help it. actually can help it. Not in all kiddos. So, but in there is a good proportion of kiddos where exposure to the sun, and we call it like kilotherapy, actually can help reduce the inflammation in your skin and help treat your eczema. And we have, and there’s also a specific therapy that you can use in the hospital, and it’s called phototherapy. where they take a specific wavelength of that sun, of that wavelength. And what they’ve noticed is that it helps actually reduce your immune system just on a skin surface level. And it’s actually used for treatment, not just for eczema, but for so many skin conditions where you have a flare-up of your immune system. 

Kate Setter 

Okay, well, we might circle back to that a little bit when we talk about treatment in a few minutes. I would like to ask about allergies. And is there an allergic component? I know we’ve talked about irritants, but can eczema be triggered by allergies? I feel like I’ve heard that before. 

Jess Trygier 

Yeah, this is a great question. And I think it’s something that can be kind of confusing because a lot of kids who have allergies, because they’re predisposed to that kind of inflammation, allergic kind of pathway, also have eczema. So there’s definitely an association between the two of them. However, for a while there was this discussion about, what about kids with food allergies? Is the food allergy causing their eczema? And what our data shows us at this point is that it’s not actually the food allergies that are contributing to the eczema. Even in kids who have like documented anaphylaxis does not typically cause eczema flaring. So we don’t usually recommend doing like elimination diets or things like that as part of eczema care. One, because it gets to be just incredibly tricky and difficult to do and can impact the quality of life for families and for their kiddos. And 2, because we don’t think it’s particularly effective. Environmental allergies are a little bit more tricky. We know that a lot of kids who have eczema are sensitized to things like grass pollen or other tree pollens, as well as dust mites. However, because those things are always in our environment to some extent, it’s really difficult to do studies to see like what kind of control measures are the most effective. And so we don’t really have great evidence about what to do about those kinds of things. how I usually approach this is it’s reasonable to take kind of some common sense precautions, right? Your kid’s been rolling in the grass and they’re allergic to grass. Have them take a shower before they go to bed. You know, you seems like they are really allergic to dust mites, you know, putting a dust cover on your pillowcase or something like that, closing the window at night. Those kinds of things I think are reasonable to do, but I never want families to go like crazy doing all kinds of like putting their kid in a bubble because we still want them to live their life. And we have lots of really effective strategies. to manage eczema so that they don’t have to rely on kind of that bubbling sort of thing. 

Kate Setter 

That makes a lot of sense. So the strategies that we have, I want to go to the skincare routine because I’m assuming that is part of the strategy for managing eczema. And we teed it up a little bit. Can you tell us more about what parents should be thinking about when they’re creating a skincare routine or working with their pediatrician on a skincare routine. 

Jess Trygier 

Yes, absolutely. So I think the hallmark of eczema management is regular moisturization, right? You get that dry skin, that impaired skin barrier as well as we can moisturize the skin, then we’re going to have better outcomes. So I think sometimes people will be like, okay, I’m going to start these other medications. The moisturization is not as important. still a hallmark. We have to do this when we’re flaring, when we’re not flaring type of thing. So I think the key to this is just making it part of your routine, make it easy something to do. There’s a lot of different moisturizers out there on the market. You know, you think about all the way from like kind of thinner lotions to those like thick creams. We tend to favor the thicker moisturizers just because they’re a little bit more effective at moisturizing. But truthfully, the best moisturizer is one that a family and a kid can tolerate, right? So if you’re putting a thicker moisturizer on your kid and they hate it and it’s a fight and a battle. If it’s going to be easier to do something a little bit thinner, then that’s okay. When I’m talking about the thicker moisturizers, things that I’m thinking about are things like Aquaphor, Dermaphor, Vaseline, shea butter, cocoa butter, you know, really thick stuff to help out with that moisturization. I think in terms of frequency, we usually recommend trying to do twice a day, particularly after bathing. And something that can be really important is after bathing. So we recommend using like lukewarm water as opposed to like a super hot shower or bath, just because that super hot temperature can actually dry your skin out more. You want to pat them down with a towel rather than wiping them because sometimes when we wipe, especially with some force behind it, you can disrupt that skin barrier a little bit more. So you want to just pat them down. It’s okay if they’re a little bit damp and then put that moisturizer on right afterwards and that’s going to get you kind of the best bang for your buck. Other things that I think are important as a part of a skincare routine is really trying to avoid like fragrances in particular. So you want to find products that are fragrance free, not just unscented. Because sometimes unscented products actually have scenting and then descenting agents, which is totally counterintuitive. So looking for labels that say fragrance free for your detergents, for your laundry, as well as any soaps can be another like hallmark of that good skincare routine. 

Kate Setter 

So when flares happen and families that are following their skincare routine, they’re keeping up with it, or maybe, I mean, Twice a day is hard sometimes with these wiggly kids. So flares are going to happen. But we’re trying to keep that skincare routine going. What other evidence-based treatments should parents know about as tools in their toolbox that they might be able to use? 

Jess Trygier 

Yeah. Most of the time, the hallmark of treating eczema is going to be a combination of that moisturization plus also some topical steroids. Topical steroids work by decreasing the inflammation in your skin, okay? And they’re not systemically absorbed mostly, so you’re not gonna get like systemic side effects like we worried about by steroids by mouth. Your pediatrician or your dermatologist can absolutely help pick the best strength of steroid. We really try to tailor it to the age of the patient, where the eczema is flaring, like whether it’s a sensitive body part or, you know, a more robust body part, as well as how significant the flare is to determine what strength of steroid we think is going to be effective at controlling that inflammation. Usually with that steroid, our goal is twice a day, but again, if once a day is what you can do and be consistent with it, then that is going to get you some benefit as well. And we recommend putting that steroid on and then putting a thick moisturizer on afterwards to get that benefit of the moisturization. I think steroids sometimes get, you know, a little bit of a bad rap for concerns about side effects. However, I think what people oftentimes notice is either lightening of the skin or darkening of the skin after they’ve had an eczema flare. And typically that’s not related to the steroid itself, but a result of the inflammation that was in the skin that is now resolving and had that pigment change. That can take some time to go away. Just because you’re seeing that coloration change doesn’t necessarily mean it’s a result of the steroid, but it’s rather probably related to the eczema itself. 

Kate Setter 

Okay, that makes sense. So strength of steroids, steroid creams are available over the counter. Can those be helpful or is this a conversation if a family feels like they need to introduce it that they should be having with pediatrician and looking at more prescription strength steroids? 

Jess Trygier 

I think you’re never wrong to ask your pediatrician for advice, right? That’s what we’re here for. That’s what our job is, and that’s what we love to do. You know, there are some topical steroids that are available over the counter. Those are usually the lowest strength steroids. So sometimes, like maybe you have just a little teeny patch, those can be effective. Generally speaking, if it’s impairing your quality of life, you have large body areas where it’s not working, then that’s a great time to talk about prescription strength steroids. 

Kate Setter 

Sounds good. And is there any risk to staying on them long-term to continuing to use them? Is that something that there’s benefit to taking breaks at the appropriate times or should that become part of the skincare routine too? 

Jess Trygier 

That’s a great question. How I like to approach steroid therapy is when you have a flare, we want to be really aggressive at using the steroid every day until that flare is resolved. And usually that takes like one to two weeks, sometimes longer, just depending on the body part, how long the inflammation has been going on, those kinds of things. Then there’s actually really good evidence about doing something called proactive therapy with steroids to reduce the risk of flares and to reduce the amount of steroid needed long-term. And how proactive therapy usually works is 2 days in a row. So it works best on a Saturday and Sunday, just because that’s easy to remember. You do your topical steroid to the areas that tend to flare. So if it is always that right elbow that is flaring with eczema, put that on there on Saturday, put it on Sunday. And then over time, you’re going to decrease the risk of having a flare of that right elbow. 

Kate Setter 

Interesting. Okay. Well, that sounds like a great thing for families to talk to their pediatrician about if they happen to be in the middle, in the throes of managing eczema, that sounds like a great thing to ask a pediatrician about. So it sounds like steroids are first line. Are there any other options or anything else that is available that families should know? 

Jess Trygier 

Yeah. So particularly for more sensitive areas of the body, like your face, your armpits, groin, those kinds of areas, we tend to try to avoid especially the stronger strength of steroids, just because that skin is thinner, so you do have an increased risk of side effects in those spots. So in those cases, we use something called topical calcineurin inhibitors, tacrolimus, and Pimacrolimus are kind of like the generic names of those. That’s definitely something you’d get a prescription from either your dermatologist or your pediatrician for, but that can be an option that’s not a steroid for those more sensitive areas to help decrease the inflammation. So it works very similar to steroids in that they just decrease inflammation, but just in a little bit of a different pathway. 

Kate Setter 

It’s great to know that there’s something available for those more sensitive areas. So I love that option to be able to talk through. What about any newer therapies that families should know about? I think that’s probably that phototherapy that you, that we mentioned earlier. Will you tell us a bit more about that and what else there might be available? 

Mariam Inqeibi 

Yeah, so there is so, thankfully, there’s so many things available for eczema. Really, a lot of our targeted therapy has changed the game. So, but I, phototherapy is a nice option. So phototherapy is a light-based therapy, where you have to go in. It’s almost like a vertical tanning bed, I would say is the best way to describe it. And you have to go in. It’s usually, it’s huge. So usually it’s done in office. So you have to look for centers that have this. And you have to do it for at least two to three times a week. It’s not long. It takes like a few minutes, like I would say 2 to 3 minutes in the actual booth. But over time, you’ll notice like inflammation generally improves. The only downside to this is 1, you have to go to the office. You know, some patients are claustrophobic and they don’t like being in closed spaces. So that’s also another thing to consider. And this one takes a little bit of time. It’s a safe option, but it is not something that, I tend to tell parents that you’re going to see a quick, fast result. It’s going to be, you know, long and slow, but you will see results usually while you’re on this therapy. The other thing is we have so many topical therapies out there right now that are more like, was mentioned, like steroid sparing, targeted therapy. So in addition to the Tacrolimus and the Pamacrolimus, which is the Protopic and the Illidyl, we have other non-steroidal options. So we have something called Eucressa, and that’s actually the one approved for three months of age and older. And you have all these other topical agents that are approved at two years of age and older, like you have your roflumalast and your roxolitinibs and your tapanorol. And these are all great creams for not only insensitive areas, but also proactive areas. You want to be proactive with therapy and you want to use these creams. You don’t want to use steroids for a long time. You know, I definitely try to tailor management according to, you know, family’s needs and what they really want to focus on. If they really want to avoid steroids, I love to give them these options. The other thing that has really changed the game is is our biologic therapies. And that basically is very, very targeted. So unlike steroids, which kind of try to suppress your entire immune system, it’s not really targeted to one part of your immune system. Obviously, when you use it on the skin, it only affects the skin. It doesn’t get systemically absorbed and affects your other organs. these biologic therapies, they only target a few chemicals, the chemicals responsible for itch and eczema. So the side effect profiles are pretty low, you know. They usually do not need lab monitoring, so you don’t even have to do basic lab workups, and they work really, really well. Some example of these are our Dupixent, our tralquinumab, our libriquizumab, our nimolizumab. So All those loom apps, those tend to be hard biologics. 

Kate Setter 

I feel like those are the ones we see commercials about. So that are always a little bit like, I wonder what this is. So All of these options that you’re talking about, are these kind of first line options or are these things that families likely would consider if eczema is something they’ve been struggling with for quite a while? 

Mariam Inqeibi 

Yeah, that’s a good question. So they are, so it depends. So if it is limited areas of the body and they have not tried topical therapies, you haven’t tried creams, and topical steroids or non-steroid agents, then I would tend to do that first. But if it’s like too much body surface area to reasonably cover by creams, then I would do these medications first line. So it depends on like how much body surface area are we talking about? Have we tried, you know, our basic skincare routines? Have we tried topical agents? And also sometimes for me, what is a main driving factor is how much is this affecting, the patient and the family? even if they come to me and to me, it looks like mild eczema, but if they’re like, I, the patient’s, the kiddo’s not sleeping, he’s awake all night and he’s frustrated, he’s miserable. That alone, that is enough for me to be like, you know what, I’m gonna give you something that’s gonna help you sleep and focus and live your best life. So a lot of factors come into play. Yeah, and we also have some oral agents, because the problem with those biologics are their injections, which I know a lot of people, understandably so, do not like. We also have some oral agents, like our abracidinib, our upadecidinibs, but those, they work very, very well, but those do need lab monitoring. So that’s the downside with those. 

Kate Setter 

Well, I think what I’m hearing is that there are options. And so I think we started this by saying like, this can be a frustrating condition to manage. And so that’s great to hear that if the steroid creams or the steroids aren’t working, that talking to a dermatologist and learning about some additional options is probably a really good additional step in consultation with your pediatrician, your general pediatrician. So I love all these options. I think we’d probably stay away from the needles, but it makes sense for a lot of people too. So I would like to also, so you were talking about trying things. What non-medication approaches should parents also be aware of? 

Jess Trygier 

Yeah, so I think things that I talk about with a lot of our families is really that moisturization. You guys are hopefully getting the point that that’s really, really important and avoiding those scented products. Other things that you can do, trying to keep your nails short. So if kids are scratching, they’re less likely to damage the skin barrier and open the skin up. Trying to avoid overheating. We know that sweat can kind of dry out the skin. So if you do get super sweaty, trying to wash that off with like a lukewarm shower afterwards quickly. You know, you want to avoid clothes that are irritating, right? If they’re really scratching and they’re making them itch and that kind of thing. So soft cotton is oftentimes a good bet in terms of a clothing choice. And then there’s a couple of other therapies that you can use. You would usually talk about these with your pediatrician or your dermatologist, but there’s something called bleach baths where you put a little small amount of bleach in there and that can help with some of the itch associated with eczema, as well as can help with some of the bacteria that live on the skin. Or there’s this thing called wet wraps, which is essentially when you’re doing your topical therapies and then you put on either a pair of wet pajamas or a pair of, or like some gauze that’s wet around a specific area to help get extra moisturization into that area. So again, if you have questions about those, ask your pediatrician or dermatologist. 

Kate Setter 

Perfect. Two of my three kids struggled with eczemo when they were younger and have luckily grown out of it, which I actually, I would love to chat a little bit about that kind of growing out of it concept. But we had also somewhere along the lines, oatmeal had come into the conversation. Is there any evidence that an oatmeal bath can help? Or is that one of those, like it came from the internet and there’s no truth there? 

Mariam Inqeibi 

So the oatmeal baths actually can help. So there have been studies that show that it does help with the itching, you know, and the inflammation. So I do recommend those. There are also some like products out there that have oatmeal in them. So I would look out for those. I’ve seen on, to be quite honest, I’ve seen like mix, I’ve seen parents that love it and they say, oh my gosh, my kid’s doing so much better with the oatmeal baths and it’s really helping with their itching. And I’ve seen parents like, this has done nothing. So it doesn’t hurt to try. I always recommend try it out. Patients don’t follow textbooks. So try it out and if it helps, great. If it doesn’t, we have other options available. 

Kate Setter 

But there’s no harm in it. Exactly. It’s worth a try if it, if it might help. And everybody is different. Exactly. So that makes a lot of sense. On that concept of growing out of it, is that true? I mean, am I just like burying my head in the sand that they actually still have skin conditions or is that a thing that happens? 

Jess Trygier 

It absolutely is a thing that happens. So, you know, eczema is incredibly common. Like one in five kiddos will have eczema and then, you know, that can vary a little bit. But about 70% of kids will outgrow their eczema by puberty. So the vast majority do get better. So that can be a piece of reassurance that you can offer to families like this is hopefully not going to be forever. And even if it is, we have a lot of these options to help treat you. 

Kate Setter 

Perfect. Are there any complications or anything that we should know about keeping an eye out that this could be something different than eczema or there’s an infection happening? Like, what should we know about what could happen simultaneously? 

Mariam Inqeibi 

So yeah, that’s always a big… proponent of my talk with families about eczema, because eczema, to me, it goes beyond the skin. So that’s something that’s really important. So not only does eczema, obviously you have an impaired skin barrier, and if your skin’s not functioning the way it’s supposed to be functioning, then you’re more at risk of, you know, getting a bacterial infection and getting a viral infection on top of your skin. And that can sometimes be life-threatening. So that sometimes requires you going to the emergency room. because it can spread then, later on to the bloodstream or can involve vital, organs like the eye, et cetera. So in addition to that, it also, when you have poor sleep and you’re having frequent itching, these kiddos are not focusing well in school. They’re stressed out all the time. We’ve actually noticed that these kiddos with eczema have a predisposition to get other conditions like ADHD, like attention deficit hyperactivity disorder. And in addition, like we’ve noticed that patients or, kiddos that get on treatments for eczema, they actually start gaining weight because their body was consuming all that energy to help repair the skin. But now they finally can use those essential nutrients to actually grow and develop. So it goes just beyond treating like, you know, the skin at a superficial level of making them look good. It helps them with their mentality. They’re no longer itching. They’re no longer stressed. They can focus. It helps them sleep better. It helps them gain, when you treat eczema properly, it helps their mood, it helps their weight. And it also helps families because if the kiddo’s not sleeping, the parents aren’t sleeping, you know. So it’s really life-changing for everyone involved when you treat it appropriately. 

Kate Setter 

Thank you for that outline. What should parents be looking for that would indicate that it is time to be further checked out? It’s time to mention it to their pediatrician, or if it’s been going on a while, it’s time to look at seeing a specialist like a dermatologist. What are some of those kind of milestones that we can help families? have in their back pocket. 

Mariam Inqeibi 

So I would say when it is either you’re doing all the right things, you’re moisturizing, you’re using those topical therapies, and it’s not improving, or you feel like you’re still not getting there fully, then it’s time to, you know, see a specialist. When sometimes of eczema can be misdiagnosed. when especially I see that a lot with patients who have just hand eczema, they’re continuously getting eczema in special locations, like just around the eye or on the hands. That is not necessarily the one thing that couldn’t be eczema, that could be eczema, but it also can be a lot of other things. Like it could be a irritation or it could be a contact dermatitis. So having those looked at, When it’s significant, like it’s not, it’s impairing their quality of life, the itching is affecting their mood. I think those are all good starting points for, yeah, I need to, I need more help. You know, these topical therapies aren’t doing it. I need to seek a specialist. 

Kate Setter 

And Jess, with, from your pediatrician lens, when you’re seeing, especially these babies, pretty regularly, Is this something that you would want a family to flag at an appointment or that you might notice and help them understand what’s going on too? 

Jess Trygier 

Absolutely. The second the question crosses your mind as a parent, is that eczema? Ask your pediatrician. That’s what we’re here for, sure. A lot of times we’re going to notice these things when we’re doing exam. Hey, have you noticed they have a little bit of a rash here? That kind of thing. Tell me some more about it. Have you been putting anything on it? Those kinds of things. But the second that a parent is worried about something, that’s when I want you to call our office, send us some pictures or come in to be seen. 

Kate Setter 

Perfect. So my final question for us for our conversation today is what reassurance would you like to offer to families who have a child who is struggling with eczema or even a family who’s brand new to it and they’re still trying to figure it out? What words of advice would you have for them? 

Jess Trygier 

Yeah, I think one of the most helpful things that you can do when you think about eczema is think about it as a chronic disease. You go into the lens expecting that this isn’t going to be a, oh, we had this one time rash, we put some steroids on it, it’s gone forever. So we need to like reframe that idea that This may be something we’re dealing with for a little while. Luckily, we’ve got lots of options that we can have to help treat. You know, we talked about the regular moisturization. We talked about proactive application of topical therapies, things like that. Because our goal isn’t only to treat the flare that we’re seeing right now in the office, which might be the worst it’s ever been, but really to develop a sustainable plan that’s going to work for you and your family to manage this long term so that our kids can do all the things that they want to do. Because that’s our goal, right? to get them doing, to sleeping well, focusing in school, playing sports, all that kind of stuff. And so we, our job as your care team is to really create a plan that’s gonna help do that. So if that involves, you know, seeing a specialist and doing some extra therapies or things like that, we’re always happy to help facilitate that. We also want you to have an action plan to use when you do have a flare that we can treat it quickly and get you back to your regular activities. I’ll also just say, like I mentioned earlier, eczema is incredibly common, so you are not alone. And the vast majority of eczema is going to resolve by the time of puberty. And even really by school age, about half will get better. So it’s not a forever thing, but we do have a plan in place that we can help with to help kids reach their full potential. I think the other big thing to know is like, don’t be frustrated in silence, right? You’re doing the things at home. It’s not getting better. don’t hesitate to reach out because then we can talk about escalating therapies in the pediatrician’s office or if it’s time to involve one of our dermatology or allergy colleagues. We are here to help. 

Kate Setter 

It’s my favorite. That’s a fantastic way to wrap that up. Thank you for that. Appreciate it. I think those words of encouragement will feel really good to families who are in the middle of managing it. That was all of my questions for you today. Any final words of wisdom or anything that you can think of that we haven’t covered that you’d like to? Please moisturize. 

Mariam Inqeibi 

As often as possible. I think that’s where we started. 

Kate Setter 

That was like a full circle moment. 

Mariam Inqeibi 

Don’t be scared of steroids. and there’s even if you are not interested in steroids, we have so many other options available. 

Kate Setter 

Excellent. Treat it though. Exactly. Don’t let this go. Yes. Okay. Anything else? 

Jess Trygier 

Nope. I think we’ve got it covered. 

Kate Setter 

You’re awesome. All right. Well, so grateful to both of you for being here today. Thank you for this great conversation and we will see you next time. Thank you for listening. And if you know a family dealing with eczema, we hope you will share today’s episode with them. This episode was recorded on March 11th, 2026. The information of the Young and Healthy Podcast is intended for informational and educational purposes only. This episode was produced by Kayla McNeal and our theme music was created by Stephen Grieco.