Managing Your Child’s Eczema Skincare Anxiety & Discomfort

• Supportive messages validate that something is hard for your child AND that you have confidence they can do it.

• Example:

  • “I know that you feel worried about how the bath will feel, and I know you can get through it. We’ll make a plan so you feel more comfortable.”

• Anxious thoughts signal the brain that a situation is dangerous and should be avoided. This alarm system works well when there is real danger!

• Skincare may be uncomfortable for your child at times, but it is not harmful or dangerous to them. When your child replaces anxious thoughts with coping thoughts, this helps to turn down the volume on warning signals and can help to reduce pain.

• Examples could include:

  • “It’s uncomfortable, but it will help my skin heal.”

  • “I don’t like this part, but I’m getting used to it.”

  • “When I’m finished, I get to read a book with mom.”

  • “I’ve got this!”

• When children are worried about parts of the skincare routine, caregivers can help them break the task into smaller steps. This helps children get used to doing the thing that is hard or scary for them and gives them an opportunity to see they can handle it.

• For example, if your child has a hard time with full body wet wraps, you could start with wrapping one arm to help them get used to it. Or start by having your child wear wraps for an hour while they watch a favorite video. Also, using something familiar (like cotton socks or fitted pajamas) for the wrap – instead of something less familiar (like gauze) – can help a child feel more comfortable doing something new. 

• Medical play allows children to understand and become more comfortable with medical supplies and treatments. Examples of medical play include:

  • “Drawing” or “painting” with moisturizer on paper. You can then build up to the child drawing on a parent, and eventually on themself.

  • Some children may enjoy playing the role of the doctor or parent. They can “wrap” their stuffed animal, give their doll a bath, or apply moisturizer to your skin.

• Distraction works really well to refocus attention away from uncomfortable physical sensations. The classic example is when your child scrapes their knee but doesn’t notice until after they stop playing.

• Distraction for eczema management could include:

  • Listening to an audiobook or playing with toys while soaking in the tub

  • Watching a favorite video or playing tic-tac-toe with parents while moisturizer soaks in

• It’s hard to feel worried and silly at the same time. Sing silly songs as you apply topical treatments to your child’s skin. Or let your child take a “silly bath” with a bathing suit on. The soaking will work just as well!

• Have your child imagine they are a superhero, with each body part getting stronger as you apply moisturizer.

• Older children and teens may enjoy treating bath time as their personal spa time and listening to relaxing music while they soak.

• Your child doesn’t get to choose whether or not to complete their eczema management routine. However, simple acceptable choices can increase control.

• Examples:

  • “Do you want your boats or your fish toys in the bath tonight?”

  • “Should we wrap your arms or your legs first?”

• When something is challenging for your child, they may need some extra incentives to complete it. Reward programs are different from “bribing” your child because they are planned ahead of time (instead of offered out of desperation!) and are given after the brave behavior (not beforehand). Reward programs can help reduce stress and motivate your child.

• Young children may benefit from immediate rewards, such as a sticker, an extra story at bedtime, or choosing from a “treasure chest” of dollar store treats after the bath. Older children may prefer earning points towards a larger reward.

• It helps to set achievable goals and build on them over time. Make sure your child knows what they need to do to earn their reward.

• Remember that your praise, hugs, and attention are very reinforcing for your child. It’s important to praise their efforts and steps towards goals.

Example of a rewards chart.

Links to online resources for creating your own reward charts:

https://templatelab.com/reward-charts/

https://www.freeprintablebehaviorcharts.com/

https://www.rewardcharts4kids.com/behaviorcharts/

• Tell your child’s medical provider if there are parts of your child’s eczema management routine that are difficult for them.

• They may be able to adjust the products or routine to fit with your child’s needs and preferences.