Clinical Reference Systems: Pediatric Advisor 10.0
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DESCRIPTION

Too much bathing and soap removes the skin's natural oils. This is the main cause of dry skin. Dry climates make it worse, as does winter weather ("winter itch"). Dry skin is less common in teenagers because their oil glands are more active.

Dry, rough, bumpy skin on the back of the upper arms is called keratosis pilaris. Dry, pale spots on the face are called pityriasis alba. Both are complications of scrubbing dry skin with soap. The dry areas are often itchy, and this is the main symptom of dry skin.

Cracked skin most commonly occurs on the soles of the feet, especially the heels and big toes (called juvenile plantar dermatosis). Deep cracks are painful and periodically bleed. The main cause is wearing wet shoes and socks or swimming a lot.

Cracks can also develop on the hands of children who frequently wash dishes or suck their thumbs. Children who have the habit of licking their lips may get cracked (chapped) lips. Lips may also become chapped from excessive exposure to sun or wind.

HOME CARE

1. Soap and bathing

   If your child has dry skin and is not yet a teenager, avoid all soaps, detergents, and bubble baths. They take the natural oils out of the skin. Have your child bathe or shower with plain water, perhaps twice a week. Don't let a bar of soap float around in the tub.

   For teenagers buy a special soap for dry skin. Teenagers can get by with applying soap only to the armpits, genitals, and feet. Do not use any soap on itchy areas. Don't lather up (the skin of the outer arms often becomes dry for this reason). Rinse well.

2. Lubricating cream for dry skin

   Buy a large bottle of lubricating cream (special hand lotion). Apply the cream to any dry or itchy areas several times a day, especially after bathing. You will probably have to continue this throughout the winter. If the itch persists after 4 days, use 1% hydrocortisone cream (nonprescription) for a week.

3. Humidifier

   If your winters are dry, run a room humidifier. If you have static electricity in your home, the air in your home is much too dry. During cold weather, your child should wear gloves outside to protect against the rapid evaporation of moisture from the hands.

4. Bath oils

   It does not make much sense to pour bath oils into the bathwater; most of the oil goes down the drain. It also makes the bathtub slippery and dangerous. If you prefer bath oil over hand lotion, apply it immediately after baths. Baby oil (mineral oil) is inexpensive and keeps skin moisture from evaporating.

5. Ointments for cracked skin

   Even deep cracks that have been a problem for years can be healed in about 2 weeks if they are constantly covered with an ointment (like petroleum jelly). If the crack seems mildly infected, use an antibiotic ointment (no prescription needed). Apply ointments four times a day. Covering the ointment with a Band-Aid, socks, or gloves speeds recovery even more. For chapped lips a lip balm can be applied frequently.

CALL YOUR CHILD'S PHYSICIAN DURING OFFICE HOURS IF:

• No improvement occurs within 2 weeks.
• The cracks develop a yellow discharge (pus).
• You have other concerns or questions.