Tips for minimizing scratching when eczema itches
It’s very hard for children to resist scratching when they are itchy, and they may feel ashamed or frustrated that others don’t understand how they feel. This can increase their stress – which triggers even more itch. Instead:
Let your child know that you understand how hard it is not to scratch when they are itchy, and you are not angry at them.
Explain to your child that scratching makes the rash and itch worse. That is why you will work as a team to find other ways to feel better.
Change the focus to what you and your child CAN do to relieve the itch to empower your child.
It can help to identify common triggers of scratching. Sometimes itch just happens - that’s what eczema does. But there may also be certain triggers - such as situations, emotions, or environmental conditions that make itch worse.
You might notice that your child scratches more when:
They feel stress, such as before a test or when a toddler is having a tantrum.
Their hands aren’t busy, such as when watching TV.
Their skin is uncovered, such as during diaper changes or when they get out of the shower.
They are tired.
They are hot or sweaty, such as after recess or a basketball game or with hot weather.
Noticing these patterns is a first step to making a plan to manage the itch. For older children, it can help to keep a “scientific journal” or “detective notes” for a week to notice common itch triggers. This could also include a rating of the intensity of itch (e.g. “on a scale of 0-10, how itchy is my skin?).
Sometimes your child may be very aware they are scratching and other times they may be scratching without even realizing it. This is very common. Increasing awareness of scratching can help them to take other steps to manage the itch instead of scratching. When you notice your child is scratching, remember that “don’t scratch” is not usually very helpful.
Instead, you could try: “You look itchy. Let’s do something to help you feel better.”
Some families develop a special signal with their child (such as a gentle hand on their shoulder), to alert them that they are scratching and that it would be a good time to do something to manage the itch. Include your child in deciding what this signal should be - it’s important they feel this is a team effort! Some kids like their cue to be a silly word, like an animal name (“rhinoceros!”)
Home remedies for your itchy child
Helping your child with eczema gain control and confidence over itch
When your child is itchy, it helps to have strategies to relieve the itch enough to break the itch-scratch cycle.
Examples of strategies to bring quick relief could include:
Putting a cold wet cloth or an ice pack over the itchy area for about 5-10 minutes.
Putting socks or t-shirts into the freezer and putting them on when feeling itchy
Rubbing in moisturizer (store in the fridge).
Taking a short shower or bath.
Changing into comfortable clothes.
Covering the skin.
Moving to a cooler place when it’s hot.
Consider having a portable fan that can be helpful during the hot summers
Patting the skin or place a hand firmly on the skin (instead of scratching).
For kids who are likely to get itchy at school, it is essential to communicate with the school team and ensure that they have access to moisturizers or ice packs in the nurses office.
For some children, understanding how these strategies work increases their sense of control. For example, “Sometimes the itchy messages from our skin to our brain become so strong that it’s hard to think about anything else. One way to block some of the itchy messages is by sending a different message to the brain, like a cold message from an ice pack.”
After your child gets some relief, it can be helpful to use other strategies such as distraction with a favorite activity or keeping hands busy to help prevent more scratching.
It is especially important to praise your child when they tell you they are itchy or try a new strategy to feel better. Be specific in your praise (“I love the way that you grabbed your cool pack when you started to feel itchy.”) Building new habits is hard work and takes time!
How can you distract your child from scratching?
Distraction works by shifting attention away from itch to other things. Distraction often works best if the itch is not too intense, or if you have also taken steps to make the skin feel better.
Play with toys
Play a game
Go for a walk
Try to solve brain teasers or crossword puzzles
Do something with your friends
Listen to favorite music
Read a good book
Watch a funny movie
Call a relative or friend
Activities that keep the hands busy are really useful, because they prevent your child from using their hands to scratch. It is especially helpful to think about things that involve 2 hands!
Sing songs with hand movements
Play with a fidget toy
Squeeze a stress ball
Try to solve a Rubik’s cube
Draw or sketch
Build with blocks or Legos®
Make origami designs
Ask your child to “help you” with a task that involves their hands or even start by tossing them a ball
How Can Mind Body Relaxation Skills Stop Itch?
Having eczema can be stressful. When we experience a stressful situation, the body increases production of stress hormones, such as adrenaline and cortisol. For people with eczema, when the body produces too much of these stress hormones, it also affects the immune system, leading to increased inflammation and itch.
You might notice the stress-itch response in your child’s everyday life. For example:
Your child gets itchy during a test at school and finds it hard to concentrate.
Or you may find it hard to manage your toddler’s temper tantrums because they start scratching when they feel frustrated.
Mind-body relaxation skills can be used to re-set the nervous system so it returns to a state of calm. For people with eczema, mind body skills can also focus attention away from itch. Here are three exercises you can try now: 1. Belly Breathing 2. Imagery 3. Mindfulness.
Handling Scratching During Tantrums and Meltdowns
Tantrums are a way that young children let out strong emotions before they can express or handle them in another way. Children with eczema may be more prone to tantrums when they are itchy or aren’t sleeping well.
Tantrums can be stressful for any parent to manage. For parents of children with eczema, there is the added challenge that children may scratch more during tantrums, when they are feeling frustrated, mad or upset. Parents often face the dilemma of not wanting to “give in” to stop the tantrum (which teaches the child that the tantrum works), but also not wanting their child to damage their skin.
The best approach is typically to help children develop other ways to express and manage frustration, while also attending to their unique eczema needs.
Ideas to prevent tantrums
Follow a regular schedule and routines for meals, naps, skincare and bedtime.
Give warnings for transitions (such as cleaning up toys to get ready for bath time).
Give acceptable choices to increase control (such as grapes or apples for snack).
Know your child’s limits - if they are really tired, hungry, or itchy, it may not be the best time to run extra errands.
Help children to label and name their emotions in everyday life, to learn these feelings are normal and can be managed.
Practice and model calm down activities before a tantrum begins. This could include relaxed breaths, or going to a “calming corner” to take a break.
What to do during a tantrum
Stay calm. Your child will pick up on your cues.
If your child is not yet in a full-blown tantrum, try distracting them with another activity or moving to another location.
Try labeling the emotion to show you understand “I can tell you are angry that you can’t have that toy right now.”
Ignore behaviors that are not dangerous, such as whining, screaming or throwing themselves on the floor. Ignoring means turning your eye gaze away from your child, starting another activity, and not speaking with your child.
Keep your child safe. Remove dangerous objects. You might need to hold your child so they don’t hurt themselves.
Handling scratching during a tantrum
If your child is doing some mild scratching during the tantrum, it’s usually best to ignore the scratching. You don’t want to give the scratching extra attention.
If your child is scratching intensely, you may need to step in to protect their skin. Try to do this without giving a lot of attention. For example, tell them in a matter of fact voice that you are going to hold them or put a cool pack on their skin while they calm down. Then, don’t talk or engage with them until they calm down.
What to do after a tantrum
As soon as your child stops the tantrum or shows positive behaviors, give specific praise for behaviors you want to see again. “Thank you for talking in your indoor voice.”
If your child is able to do so, talk about the situation that triggered the meltdown. Acknowledge and label their feelings. Let your child know you understand their frustration. Then, talk with them about other ways they could express their feelings or solve the problem.
If the tantrum started because of something that your child was asked to do, go back to the original request after they calm down. This can give them a chance to show positive behavior, earn praise and feel proud of themselves.