There are many reasons why children have itchy skin. During the winter months, excessive dryness is the most common cause of itchy skin. Another common cause is a harmless skin condition called keratosis pilaris. Scratching the skin too much can lead to more serious skin conditions, including infections. Seriously dry skin can also lead to other skin conditions, such as [CT1] eczema (atopic dermatitis). Using a simple moisturizer can relieve itchiness and prevent dry skin.
Dry Skin and the Itch Sensation
Water is the main "softener" of skin. Cold air and dry air from artificial heat act like a sponge to pull water from the skin. When the skin becomes overly dry, it becomes rough and scaly, then red, inflamed and itchy. Children with eczema may have flaky skin. Those with keratosis pilaris will have a sandpaper like feel to their skin from the flesh-colored to slightly red bumps.
The itch sensation occurs when nerve signals from the receptors at the free nerve endings at the outer layer of the skin (epidermis) and derma go through the spinal cord to the thalamus. There the itching sensation is picked up in the somatosensory cortex. The somatosensory cortex is the area of the brain that receives information from the general sensory receptors in the skin and from the skeletal muscles. After the information is processed, the part of the body being affected is identified and the data is interpreted. Then the motor areas (fingers, for example) are signaled to initiate the scratching. Without treatment, a vicious cycle of itching and scratching can interrupt your child’s daily activities.
Treating Dry Skin
Here are some tips on how to keep the winter itch (or just dry skin in general) under control:
Use a humidifier. When the relative humidity of air is low, artificial heat can dry out the skin.
What’s the problem? Identify other factors that worsen the problem of dry skin and minimize them. These factors include taking many baths and using harsh soaps. Products with alcohol will also dry out the natural oils from the skin.
Avoid hot water. Hot water removes the skin’s natural oils more quickly. Use warm water to bathe your child. Shorter baths or showers (5-10 minutes) add moisture to the skin. The skin is less hydrated after the bath the longer your child stays in the water.
Don’t forget to add the “softener.” Moisturize the skin with lotions, creams, or ointments. Keep it simple. Use products without perfume. Apply right after a bath or shower to retain moisture.
Which product? For severely dry skin and keratosis pilaris, try an over-the-counter moisturizer that contains urea or lactic acid. These ingredients help the skin retain water. Some prescription moisturizers also contain these ingredients. Children with eczema should avoid these ingredients because it may irritate the skin. Speak with the pharmacist about the different available products. Table 1 lists some common over-the-counter and prescription products. (Click here for PDF of Table 1) If the condition worsens, bring your child to the doctor.
What if it’s “angry”? If the skin is red and inflamed, your child may need a mild topical corticosteroid or an immunomodulator (tacrolimus, pimecrolimus). Apply sparingly. Check with the doctor first before using any products for this condition.
Prevention is key. Prevent dry skin by using a moisturizer every day. Keeping the skin moisturized will also prevent eczema flares.
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