Establishing an Eczema Care Routine for Your Preschooler

Research suggests that young children, including toddlers and preschoolers, thrive on a consistent routine. It helps them feel safe, secure and more in control in their day-to-day life. Implementing routines for young children with eczema can help them manage symptoms, while also helping parents feel more confident and reassured that their child is starting to learn the importance of caring for their own skin, even at a young age.¹

To help develop these routines, the National Eczema Association partnered with Nickelodeon and Understand AD, to create an educational program featuring characters from the “Blue’s Clues & You!” series in an original digital storybook, Blue and Frida Felt Become Ecz-tra Special Friends. In the book, Blue’s new friend Frida has eczema (atopic dermatitis or AD), which can make her skin itchy and irritated. But with some support from her family and friends, Frida’s empowered to make choices that don’t let eczema get in her way.

Inspired by how Frida incorporates eczema care into her daily activities, we pulled together tips and advice to help parents, caregivers and other important figures in childrens’ lives learn age-appropriate ways to teach their preschoolers the value of routine eczema care.

1. Explain why the routine is important and how it helps

“Preschool-aged children are working on developing a sense of control and independence,” said Dr. Jennifer LeBovidge, a psychologist at the Atopic Dermatitis Center and the Food Allergy Program at Boston Children’s Hospital and a member of the Harvard Medical School faculty.  “Predictable, consistent daily routines give them a sense of security. When children know what is happening now and what to expect next, they usually feel more in control of their day.”

Some ways to help young children feel more in control is by talking them through their routine. For example, LeBovidge recommended saying, “Taking care of our skin can help the eczema get better and feel less itchy,” or, “Your bath and creams help make your skin strong and keep the itchies away.”

2. Provide specific, positive reinforcement

“When you give attention to the behaviors you want to promote, it is more likely you will see them again,” explained Dr. LeBovidge. “For example, ‘I’m proud of you for sitting still while we put on your wraps’ or ‘I like the way you got in the tub as soon as it was ready for you.’”

Morgan Maier, a physician assistant in dermatology at Seattle Children’s Hospital, also advised that rewarding kids with a sticker chart or stones in a jar every time they complete a routine can help them visualize their success, reinforcing the routine. Children can also be rewarded as they learn to speak up when their eczema is bothering them, like in the book when Frida Felt knows to tell her father it’s time to cool off after she gets too warm from playing in the park.

“Once routines are built, you can phase out rewards,” said Dr. LeBovidge.

3. Present two options (instead of zero options)

“Give children choices when possible to increase control and independence,” advised Dr. LeBovidge. “Children don’t get to choose whether or not to care for their eczema. However, you can give your child several acceptable choices.”

Even though caring for their skin is not a choice, how they care for it can be. For example, Maier advised that some kids prefer a greasier texture of moisturizer because it can feel warmer when rubbed into the skin, while others prefer the cooling sensation of a thicker cream. Similarly, in the book, when Frida Felt’s mom gives her a hat to protect her skin from the sun, she could offer Frida two hats to choose from.

Some other choices parents can offer their kids may include:

• “Do you want to put the moisturizer on your arm or leg first?”
• “Which song should we listen to during your bath tonight?”

4. Make it a game (instead of a fight)

“Some children enjoy a playful approach, such as ‘painting’ on their skin with moisturizer or pretending to ‘frost a cupcake,’” said Dr. Lebovidge.

Bath time and post-bath time routines can be a struggle for any toddler. For young kids with eczema who might complain of feeling cold when moisturizing after bath, Maier advises parents to play a game where kids imagine they are a turtle. “Your child lays on their back with a towel over them,” Maier said. “You take out one arm and [moisturize] the arm, then you get the other arm, then a leg and a leg and the turtle tummy. That makes it fun.”

5. Use cues to signal transitions or help with learning the steps of the routine

“Some children enjoy a special song they sing as they clean up their toys and get ready to start [caring for their skin],” said Dr. LeBovidge. “Others may benefit from a visual schedule, like a chart with photos that show all of the steps of the routine.” Example steps may include:

• Take a bath
• Pat dry
• Put on creams
• Put on pajamas
• Read a book
• Go to sleep

Additionally, kids in preschool may benefit from keeping a similar chart at school for them and their teacher to reference throughout the day as needed.

Talk through any challenges with your child’s doctor

“Adding daily eczema care to already busy family schedules can be difficult. It’s important for parents and other caregivers to have self-compassion,” said Dr. LeBovidge.

“It can also be helpful to talk to your child’s healthcare provider about challenges you are having with the routine,” she said. “When they understand barriers to consistency, they can often help problem-solve. A good routine is one you can follow consistently!”

Find more tips on eczema and parenting here.

Check out Blue and Frida’s Story

Helping kids be proactive in understanding their eczema can empower them to feel more confident and set them up for success as they gradually transition into caring for themselves. Just as Frida demonstrated in Blue and Frida Felt Become Ecz-tra Special Friends, even young children can understand the importance of managing their eczema as part of their regular routines. For more eczema-friendly tips and activities, visit UnderstandAD.com.

References:

1. Zajicek-Farber ML, Mayer LM, Daughtery LG, Rodkey E. The Buffering Effect of Childhood Routines: Longitudinal Connections Between Early Parenting and Prekindergarten Learning Readiness of Children in Low-Income Families. Journal of Social Service Research. 2014;40(5):699-720. doi:https://doi.org/10.1080/01488376.2014.930946