Seasonal allergies: More than itchy eyes and sneezing

Spring has sprung early this year, which means allergy season will likely happen early as well. But for some kids allergies don’t cause itchy eyes and sneezing, they cause something not typically thought of as an allergic reaction: Eczema.

Just like seasonal allergies, also known as “hay fever,” eczema (or atopic dermatitis), occurs when a person with allergies comes in contact with triggers like pollen, dust mites or pet dander. But instead of the nose, lungs and eyes being affected, some people get dry, itchy, scaly skin and rashes on their cheeks, arms and legs. In the early spring, when pollen counts are high, it can be particularly bad for some people. The itching tends to get worse at night leading to many sleepless nights for some families.

“Depending on the severity of the case, eczema can be a real problem for some children and their parents, ” says Karol Timmons, RN, MS, CPNP, an eczema expert and pediatric nurse practitioner at the Division of Immunology at Children’s Hospital Boston. “In many cases the condition gets better as the child gets older, but for some kids it takes years of prevention and treatment to keep it from negatively affecting a child and family.”  

Pollen and other allergy triggers can cause eczema for some children.

Generally speaking, eczema can be defined by dryness, infection, inflammation and itching. And once inflammation and infection sets in, it can lead to an itch-scratch cycle that can be hard to break.

“It all starts when the dry skin of a person with eczema becomes infected after coming in contact with bacteria or other allergy triggers,” says Timmons. “Once that happens the skin becomes inflamed (red and slightly swollen) and starts to itch. But the more the person scratches the worse the inflammation becomes, often leading to an even itchier patch of skin.”

To stop the cycle before it starts, Timmons recommends parents take special care to try to prevent eczema flare-ups. To do so she recommends:

  • Keeping the windows closed to keep pollen outside. If you have an air-conditioning unit you may want to run it because it filters the air coming from the outside and keeps pollen and other triggers out.
  • Have children wear long sleeves and pants when outside. If your child has eczema, direct exposure to pollen and other particles in the air is likely to trigger a flare-up. By adding a protective layer of cotton between the skin and the triggers you can reduce inflammation.
  • Bathe kids after outside play. This removes pollen and other outdoor allergy triggers that may get stuck to their clothes and hair during play.
  • Clean the house weekly. A well-cleaned house has far fewer allergy triggers lurking inside. Vacuuming rugs, furniture and drapes, and washing linens, pillows and stuffed toys in hot water will remove any dust, pollen and other hard-to-see allergy triggers inside the house. If you have a pet, make sure it’s cleaned often because pet’s dander (dried, flaked skin) can lead to allergy symptoms.

If your child does have an eczema flare-up, it can usually be treated at home. The best treatment is a 10 to 15 minute bath. Sitting in the tub allows the skin to re-hydrate, which relieves the gnawing dryness that makes eczema so uncomfortable. Sometimes a small amount of bleach added to the water can help kill the bacteria that leads to infection, but consult with a medical professional before adding it to the bath.

After the bath, lather the child with a moisturizer. These creams, most of which are sold over the counter, will trap the fresh moisture inside the child’s skin.

“Your skin is like a sponge, it soaks up moisture very well,” Timmons says. “Then, once out of the tub, the moisturizer acts as a sealant, trapping that moisture in.”

If regular cleaning and moisturizers don’t relieve your child’s eczema, it may be time to speak with an allergy specialist. During the visit the clinician may give the child antihistamines or topical steroids to help with the itching. In her own practice, Timmons says she has found that many parents get quite nervous when she first mentions steroids, often because they associate it with disgraced baseball players.

It may take her a few extra minutes to explain to the parents how topical steroids differ from human growth hormones, but Timmons says those teaching moments are her favorite part of the job. It’s also very indicative of the nurse practitioner’s larger role in medicine.

“Sometimes a child with eczema will receive treatment and mom and dad will leave the appointment with creams and medication, but not a clear understanding of how they work,” she says. “That’s where a nurse practitioner can really help. In many cases we have more time to spend with patients and we are specially trained to interact closely with the family to meet their individual needs. Education and support really is the backbone of what we do, and for families with recurring eczema that can be very important.”

Does your child suffer from eczema or seasonal allergies? If so Children’s experts are here to help. With increased coverage at our satellite locations in Weymouth and Peabody – along with our Lexington, Waltham and Boston locations – allergy sufferers will be able to get an appointment with one of our allergy clinics, often within 24 hours or the next clinic day.

Visit our Allergy and Asthma program website or call 617-355-6117 or 888-IWHEEZE to make an appointment.