How to Help Your Child Stop Scratching at Atopic Dermatitis

If you have a child with atopic dermatitis, you know that scratching itchy skin comes with the territory.

Problem is, scratching only makes things worse. “Scratching itchy skin often triggers what’s known as the ‘itch–scratch cycle,’” says Jody A. Levine, MD, a pediatric dermatologist based in New York City. “Scratching damages the skin barrier, which increases inflammation and makes the itch even worse.”

Since scratching can interfere with just about every part of your child’s day (and night), it’s important to try some anti-itch strategies:

Limit the Scratching Damage

Minimize how much damage your child can do by keeping their nails trimmed and placing cotton mittens or socks on their hands at night. For younger children, you may have to put the gloves on once they’re asleep.

Manage the Itch

Teach your child that there are better ways to cope with the itching sensation than scratching:

• Tap the skin. Scratching can break already dry, cracked skin and let more irritants in (which then exacerbates the itchiness). But tapping the spot with a fingertip can sometimes relieve the itch without making it worse.
• Use a cool compress. Soak a clean washcloth or towel in cool water, wring it out until it’s damp (but not dripping wet), and apply it to your child’s itchy skin. After removing the compress, put moisturizer on the same spot.
• Wrap the skin with wet wraps after your child’s bath. After applying topical treatments and moisturizer, dress your child in a pair of damp PJs and then layer a dry pair on top. Make sure the room is warm and your child is covered in a blanket, so they don’t get cold. Keep the wet wrap on for at least 30 minutes, then reapply moisturizer.

Prevent the Itch From Starting

If your child has atopic dermatitis, there are ways to stop the itching from cropping up in the first place:

• Give your child warm — not hot — baths. Taking short, daily baths in warm water helps lock moisture in, which prevents dry, itchy skin. “Bathing every day actually does help,” says Teresa Wright, MD, division chief of pediatric dermatology at the University of Tennessee Health Science Center in Memphis. “It removes allergens and puts moisture into the skin. The key is in the details: Baths and showers shouldn’t be too long (not more than 10 minutes) or too hot. And make sure the soap is fragrance free.”
• Pat their skin dry after bathing. Rather than vigorously drying your child off with a towel, gently pat them dry instead. That will help the skin absorb the water better and is less likely to irritate it.
• Apply a thick moisturizer to your child’s skin right after bathing. Dr. Levine suggests “moisturizing within three minutes of exiting a bath or shower.”
• Keep your child’s sleeping environment cool, and avoid itchiness triggers. Because heat and sweat can cause eczema symptoms to flare, make sure your child is dressed in comfortable, light clothing for bed, and keep the room temperature moderate, not hot. Try to avoid eczema triggers, such as dust mites, fragrances, pet dander, pollen, tobacco smoke, and wool and synthetic fabrics.

Try Topical Treatments

Your child’s dermatologist may suggest various over-the-counter and prescription medications to treat the eczema and relieve dry, itchy skin. These can be nonsteroidal ointments or steroid/cortisone creams. Always apply your child’s topical medications before slathering on moisturizer.

Use Sensitive-Skin Remedies

What works for sensitive skin typically works for itchy atopic dermatitis. Use “fragrance-free” (not “unscented”) products, including fragrance-free soaps, laundry detergents, hair products, body and room sprays, and even candles.

Make sure your child washes their hands with a mild soap and avoids using hand sanitizer, if possible, which can further dry out skin and worsen eczema symptoms.

Try a Bleach or Oatmeal Bath

Adding colloidal oatmeal to your child’s bath and letting them soak in it for 10 to 15 minutes can help soothe itchy skin and stop them from scratching before they start. “Oatmeal baths can help reduce inflammation and improve hydration and pH balance of the skin,” says Levine.

Distract Your Child Before Bed

Just when your child is settling down for bed at night, the itching can seem even worse, leading to more scratching.

“During the day, children are busy with other things,” says Dr. Wright. “At night, there are fewer distractions. They lie down, try to relax, and realize, ‘I’m so itchy.’” Nighttime flare-ups also happen because the body temperature cools naturally at night, while the skin’s temperature rises, causing itchiness, says Levine.

Anything to take your child’s mind off the itch before bedtime may help limit the overnight scratching.

“I recommend keeping both their hands and minds distracted, especially during particularly rough flare-ups,” says Levine. “Try providing your child with fidget toys, stuffed animals, stress balls, or puzzles in the hours leading up to bedtime. To keep their minds distracted from the itchiness, try reading books aloud, playing calming music or audiobooks, and doing breathing exercises or kid-friendly guided meditations.”

The Takeaway

• Nighttime itching from atopic dermatitis can be intense, but scratching can increase inflammation and make the itch-scratch cycle harder to break.
• Help your child avoid scratching to protect their skin. Simple strategies, such as putting cotton mittens on them at night, having them tap the itchy spots instead of scratching them, trimming your child’s nails, trying wet wraps before bed, and using cool compresses, can calm itching.
• Have your child take short, warm baths every day; pat their skin dry after bathing and then immediately put moisturizer on them; use fragrance-free products; apply prescribed topical treatments; and provide a cool sleep environment to help your child sleep more peacefully.