Dear Dr. Johnson: My toddler has dry skin. What can I do to help with this?
Teenagers and adults tend to have less of a problem because the oil glands in their skin are more active. That is usually true unless they have a history of eczema or are frequently washing their hands, like those of us in the health care field.
Eczema is a condition where the skin develops raised red bumps and scaling that can ooze. Both dry skin and eczema can cause itching. At times, eczema requires treatment with prescription medication because if it becomes more severe, it can cause thickening of the skin.
For milder eczema and dry skin, there are numerous things you can do to help alleviate the symptoms. Emollients are the first step. I prefer thick ointments (Vaseline or Aquaphor) or thick creams (these often come in tubs or tubes).
The ointments can do a good job of moisturizing but are too greasy for some. For these people, the creams are better. For older children, I often recommend the ointments before bed and the creams at other times during the day. They should be applied all over but especially to the dry areas a couple of times a day. You can’t apply them too much.
Baths and showers can help hydrate the skin but also can be drying. To have the benefit of moisturizing and not drying, baths and showers should be kept to less than 10 minutes and the water should not be too hot.
After bathing, the skin should be dabbed dry but not completely dry. The emollients should then be applied over the damp skin to push moisture into the skin.
For areas that are red and inflamed, a steroid ointment can help to decrease inflammation and facilitate healing. This should be applied twice a day. It can be used with the emollients, but the steroid ointment should be applied first, with the emollient on top.
Hydrocortisone 1 percent ointment is available over the counter without a prescription. I usually recommend using the steroid about 5 to 7 days. If you are not seeing any improvement at that point, a stronger prescription steroid may be needed.
I do not recommend using any steroid creams on the face of infants without physician approval. Steroids can thin the skin, and the skin on the face and genital area is thinner than other parts of the body.
Running a humidifier in the child’s bedroom can add moisture to the air and to the skin. Using mild soaps also can help. I like Dove unscented, Cetaphil Gentle Wash, Aveeno, Eucerin and Aquaphor.
Avoid any laundry detergents, fabric softeners, dryer sheets and soaps with fragrance, as fragrances can irritate sensitive skin.
If areas of the skin develop a honey-colored crust, pus drainage, pain or significant redness, care should be sought. The dry skin can become infected with bacteria, and topical or oral antibiotic treatment may be needed.
This column provides general health information and is not specific advice intended for any particular individual(s). It is not a professional medical opinion or a diagnosis. Always consult your personal health care provider about your concerns. No ongoing relationship of any sort (including but not limited to any form of professional relationship) is implied or offered by Dr. Johnson to people submitting questions.