Category: Family Health

By: Hatim Thaker, MD, FAAP

A penile adhesion is a condition where the skin of the penis, or the foreskin in uncircumcised boys, sticks to head of the penis. When these adhesions become dense, they can permanently fuse the skin to the head of the penis. This is called a skin bridge.

While this is not a dangerous condition, penile adhesions and skin bridges can sometimes cause discomfort and differences in cosmetic appearance. Here are answers to common questions parents may have.

What causes penile adhesions or skin bridges in babies and children?

After a circumcision, any excess foreskin or penile skin may “ride up” along the shaft of the penis and get stuck to the head. Similarly, if a boy has excess fatty tissue at the base of the penis (or suprapubic region), the head of the penis can “sink in” and become surrounded by extra skin (sometimes referred to as “buried” or hidden penis). In both situations, there is a risk of adherence between the two skin surfaces.

For
uncircumcised infants, it is normal that the foreskin does not retract completely to expose the head of the penis. However, if the foreskin does not become supple enough to fall back naturally, this may lead to more troublesome adhesions.

A consultation with your pediatrician, or a
pediatric urologist, can help distinguish which conditions require treatments, and which do not.

What are the symptoms of penile adhesions and skin bridges?

This condition typically has no symptoms, though in some cases, the foreskin may become irritated or inflamed. In older boys, dense adhesions may cause discomfort during erections.

How do I take care of and treat penile adhesions?

Not all penile adhesions need therapy, as some children may outgrow the condition naturally. If needed, a topical steroid ointment can be applied to the adhesions twice daily for six weeks. This will soften the foreskin to make it easier to retract the skin and expose the head of the penis.

Some dense adhesions, especially skin bridges, may not improve with topical ointments. These adhesions can be removed in the office with a topical anesthetic, or in the operating room under anesthesia.

Mild adhesions can develop into permanent skin bridges after circumcision. As a parent, ensuring that penile skin does not tether itself to the head of the penis during the healing process after circumcision will help prevent adhesions. This can be done by gently pulling the penile skin down.

In addition, general penile hygiene is always important. In the areas beneath the adhesion, dead skin cells can accumulate and form a white paste. This is called “smegma“. This should be gently wiped away during
diaper changes or cleansed during
baths.

More information

About Dr. Thaker Hatim Thaker, MD, FAAP, is a pediatric urologist at Boston Children’s Hospital/Harvard Medical School. He completed his residency training at the University of Southern California/LA County Medical Center, and a 3-year fellowship at Boston Children’s Hospital. Dr. Thaker has a clinical interest in robotic reconstructive surgery, genitourinary oncology, neurogenic bladder and urodynamics. Within the American Academy of Pediatrics, he is a member of the Section on Urology.

Envision a heart attack, and you probably think of someone clutching his chest in agony, being rushed to the hospital, maybe even dying before he arrives. While this scenario does occur, the reality is often quite different.

The reason is that heart attacks don’t follow a linear path. Symptoms can be severe or subtle. The underlying process that causes a heart attack can differ. People may experience significant heart damage or little to none.

“Not all heart attacks strike in the same way, so diagnosing a heart attack requires the combination of a doctor’s judgment, signs and symptoms, and test results,” says Dr. Peter Libby, a cardiologist with the Heart and Vascular Center at Harvard-affiliated Brigham and Women’s Hospital.

What exactly is a heart attack?

Most heart attacks occur when one of the coronary arteries (the vessels that supply blood to the heart) is unable to deliver enough blood to an area of the heart, or to deliver any at all. The most common underlying cause is formation of fatty plaque in one or more coronary arteries.

There are two different mechanisms that cause this compromised blood flow. Doctors define them as type 1 and type 2 heart attacks. “The distinction is important because the various types of heart attacks may be treated entirely differently,” says Dr. Libby. Here is a look at each one.

Type 1. With a type 1 heart attack, the cap over a plaque deposit ruptures and releases chemicals that trigger the formation of a blood clot. The clot blocks the artery, interfering with blood flow to part of the heart.

Type 2. A type 2 heart attack does not involve a ruptured plaque. Instead, it happens when there is a mismatch between the amount of blood a portion of the heart muscle needs and the blood supply in the coronary artery feeding that area of the heart.

The trigger for this type of heart attack can be a condition that puts extra stress on the heart, like the flu or pneumonia, an abnormal heart rhythm resulting in an accelerated heart rate, or a significant spike in blood pressure.

Heart attack symptoms

When a heart attack strikes, it can trigger a variety of symptoms. The most common is the stereotypical chest pain, usually described as crushing, squeezing, pressing, heavy, or occasionally stabbing or burning.

Chest pain tends to be focused either in the center of the chest or just below the center of the rib cage, and it can spread to the arms, abdomen, neck, or lower jaw. It’s also possible to have a heart attack and not know it. This is known as a silent heart attack. Symptoms lack the intensity of a classic heart attack. Instead, they can appear as chest discomfort that comes and goes; pain in one or both arms, neck, or jaw; sudden shortness of breath; breaking out in a cold sweat; or feeling nauseated or lightheaded. “Because these symptoms can feel so mild and brief, they often get confused for regular discomforts like indigestion or heartburn,” says Dr. Libby.

Diagnosing a heart attack

If you have any suspicion that you may be having a heart attack, don’t hesitate: call 911. Once you arrive for medical care, the staff will do a quick review of your symptoms.

With any concern for a heart attack, the doctor will immediately order an electrocardiogram (ECG) and a blood test to measure levels of troponin, a protein in heart muscle cells that spills into the bloodstream when any type of heart damage occurs.

Doctors look for high troponin levels and certain changes in the electrical pattern on the ECG to make a diagnosis. Both tests are used because either one can be normal or show only minimal changes in the earliest stage of a heart attack.

In fact, even with normal ECG and troponin results, emergency department doctors will begin immediate treatment if your symptoms are highly suggestive of a heart attack, especially if you have multiple heart risk factors.

Initial treatment

If your test results suggest you’re having either a type 1 or type 2 heart attack, most often the doctor will give you several pills right away. These include aspirin; a high-dose statin, such as atorvastatin (Lipitor) or rosuvastatin (Crestor); and a beta blocker to slow your heart rate and reduce heart stress. You’ll also get an intravenous infusion of heparin, a drug that discourages blood clotting.

If you’re diagnosed with a likely type 1 heart attack with full artery blockage, the doctor will probably send you to the cardiac catheterization lab for angioplasty and stent placement, a minimally invasive procedure to clear the artery and prop it open. This can restore blood flow to the injured heart muscle and minimize permanent damage.

For a type 2 diagnosis, the goal is to restore the mismatch between blood supply and demand. In addition to the medications noted above, you’ll need treatment for any medical problem that stressed the heart, such as an infection or an abnormally fast heart rhythm.

Once your condition is stable, your doctor will design a strategy to help with recovery.

“The goal after the first heart attack is simple — to prevent a second one, and prevent further weakening of the heart muscle that can lead to heart failure,” says Dr. Libby. This includes diet changes, exercising regularly, a personalized medication regimen, and perhaps referral for cardiac rehabilitation.

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Brachytherapy is a type of internal radiation therapy in which seeds, ribbons, or capsules that contain a radiation source are placed in your body, in or near the tumor. Brachytherapy is a local treatment and treats only a specific part of your body. It is often used to treat cancers of the head and neck, breast, cervix, prostate, and eye.

What happens before your first brachytherapy treatment

You will have a 1- to 2-hour meeting with your doctor or nurse to plan your treatment before you begin brachytherapy. At this time, you will have a physical exam, talk about your medical history, and maybe have imaging tests. Your doctor will discuss the type of brachytherapy that is best for you, its benefits and side effects, and ways you can care for yourself during and after treatment. You can then decide whether to have brachytherapy.

How brachytherapy is put in place

Most brachytherapy is put in place through a catheter, which is a small, stretchy tube. Sometimes, brachytherapy is put in place through a larger device called an applicator. The way the brachytherapy is put in place depends on your type of cancer. Your doctor will place the catheter or applicator into your body before you begin treatment.

Techniques for placing brachytherapy:

• Interstitial brachytherapy, in which the radiation source is placed within the tumor. This technique is used for prostate cancer, for instance.
• Intracavity brachytherapy, in which the radiation source is placed within a body cavity or a cavity created by surgery. For example, radiation can be placed in the vagina to treat cervical or endometrial cancer.
• Episcleral brachytherapy, in which the radiation source is attached to the eye. This technique is used to treat melanoma of the eye.
• Radioembolization, in which tiny beads that hold a radioactive substance are place into the main blood vessel that carries blood to the liver. This technique is used to treat liver cancer or cancer that has spread to the liver.

Once the catheter or applicator is in place, the radiation source is placed inside it. The radiation source may be kept in place for a few minutes, for many days, or for the rest of your life. How long it remains in place depends on the type of radiation source, your type of cancer, where the cancer is in your body, your health, and other cancer treatments you have had.

Types of brachytherapy

There are three types of brachytherapy

• Low-dose rate (LDR) implants: In this type of brachytherapy, the radiation source stays in place for 1 to 7 days. You are likely to be in the hospital during this time. Once your treatment is finished, your doctor will remove the radiation source and the catheter or applicator.
• High-dose rate (HDR) implants: In this type of brachytherapy, the radiation source is left in place for just 10 to 20 minutes at a time and then taken out. You may have treatment twice a day for 2 to 5 days or once a week for 2 to 5 weeks. The schedule depends on your type of cancer. During the course of treatment, your catheter or applicator may stay in place, or it may be put in place before each treatment. You may be in the hospital during this time, or you may make daily trips to the hospital to have the radiation source put in place. As with LDR implants, your doctor will remove the catheter or applicator once you have finished treatment.
• Permanent implants: After the radiation source is put in place, the catheter is removed. The implants remain in your body for the rest of your life, but the radiation gets weaker each day. As time goes on, almost all the radiation will go away. When the radiation is first put in place, you may need to limit your time around other people and take other safety measures. Be extra careful not to spend time with children or pregnant women.

What to expect when the catheter is removed

Once you finish treatment with LDR or HDR implants, the catheter will be removed. Here are some things to expect:

• You will get medicine for pain before the catheter or applicator is removed.
• The area where the catheter or applicator was might be tender for a few months.
• There is no radiation in your body after the catheter or applicator is removed. It is safe for people to be near you–even young children and pregnant women.

For a week or two, you may need to limit activities that take a lot of effort. Ask your doctor what kinds of activities are safe for you and which ones you should avoid.

Brachytherapy will make you give off radiation

With brachytherapy, the radiation source in your body will give off radiation for a while. If the radiation you receive is a very high dose, you may need to follow some safety measures. 

• Staying in a private hospital room to protect others from radiation coming from your body.
• Being treated quickly by nurses and other hospital staff. They will provide all the care you need but may stand at a distance, talk with you from the doorway of your room, and wear protective clothing.

Your visitors will also need to follow safety measures, which may include

• not being allowed to visit when the radiation is first put in
• needing to check with the hospital staff before they go to your room
• standing by the doorway rather than going into your hospital room
• keeping visits short, about 30 minutes or less each day (the length of visits depends on the type of radiation being used and the part of your body being treated)
• not having visits from pregnant women and children younger than a year old

You may also need to follow safety measures once you leave the hospital, such as not spending much time with other people. Your doctor or nurse will talk with you about any safety measures you should follow when you go home.

Body mass index (BMI) is a calculated measure of weight relative to height. For adults, BMI is categorized into underweight, healthy weight, overweight, and obesity. Obesity is further subdivided into three classes. This BMI calculator is for adults 20 and older.

A not-so-favorite game played by many older adults is “pain of the day,” where they share what currently hurts and how much.

Most often, new aches, known as acute pain, are short-term and go away on their own or diminish with a combination of rest and over-the-counter remedies. But sometimes, acute pain persists and worsens until it becomes a serious chronic pain.

“People may shrug off the occasional acute pain as the price of advancing age and learn to live with it,” says Dr. Edgar Ross, senior clinician of the Pain Management Center at Harvard-affiliated Brigham and Women’s Hospital. “But ignoring any level of pain often leads to greater problems that become difficult to treat and manage.”

Pain names

Most acute pain comes from damage to body tissues. It’s known as nociceptive pain and results from physical trauma like a sports or exercise injury, a broken bone, a medical procedure, or a household accident like stubbing your toe, cutting a finger, or bumping into something. The pain can feel sharp, aching, or throbbing and often heals within a few days to a few weeks.

In comparison, chronic pain lasts at least two to three months, often long after you have recovered from the injury or illness, and may even become permanent. Symptoms and severity of chronic pain vary and may include a dull ache, shooting, burning, stabbing, or electric shock–like pain and sensations like tingling and numbness.

Chronic pain can be related to ongoing tissue injuries or inflammation, as with arthritis. However, more often long-lasting pain signals originate in the brain even when nociceptive pain has resolved. The brain itself has been rewired to experience pain even when there is no active involvement from body tissues.

According to the CDC, 20% of adults have chronic pain — with people ages 65 and older affected the most — and 7.4% experience chronic pain that limits their activities.

Seeking help

Sometimes acute pain becomes chronic because not enough attention was given to addressing the problem early on. “People feel they can live with it, or they adjust their lifestyle to accommodate the pain, so they don’t get appropriate treatment,” says Dr. Ross.

Another barrier is psychological. “Sometimes people need regular movement, exercise, or physical therapy as part of their acute pain treatment, but because it may hurt or be uncomfortable to do, they avoid it, which can worsen their condition,” says Dr. Ross.

Avoiding treatment and allowing acute pain to linger also may make people more sensitive to pain. “This makes their pain feel worse than it is and makes it harder for people to cope,” says Dr. Ross.

The best way to stop acute pain from becoming chronic is to confront it straight on. “Don’t ignore it. Seek medical advice, and follow proper pain management, whether that’s heat and ice therapy, physical therapy, medication, rest, or some combination,” says Dr. Ross. “The longer your acute pain lingers without proper treatment, the more likely it could become chronic.”

Individual treatment

Chronic pain can be difficult to reverse, and sometimes even impossible, in which case the goal may be to restore function, manage flare-ups, or reduce symptoms.

Of course, every treatment strategy depends on the person’s medical history, the source of the chronic pain, and its severity. A traditional course of action is to work with a pain specialist to devise an individualized treatment plan. This could include a combination of options like prescription pain medication, steroid injections, physical therapy, complementary treatments, and behavioral therapy.

Sometimes a psychological evaluation is recommended. Chronic pain can be traumatizing and cause depression and anxiety that must be addressed. There also could be personal stressors that exacerbate chronic pain, like relationship issues or financial problems.

“It is not easy sharing personal issues, but exploring them can support and improve your treatment and management strategy,” says Dr. Ross.

Addressing chronic pain takes time and dedication. Depending on how long the pain has been around, therapy could last several months or even years. “Even so, dealing with chronic pain is not a hopeless situation,” says Dr. Ross. “There are many options to help people improve their quality of life.”

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You were recently started on antibiotics for an infection and you are now doing well. But slowly your skin begins to itch, and the telltale signs of a rash are already popping up — first on your torso, and now spreading to your arms and legs. What do you do? Should you worry? Should you see a medical professional?

Rashes are a common and pesky side effect of many medications. It can be so disheartening to be getting better from one ailment only to discover that you have another issue to address. While these itchy eruptions can be annoying, they usually run their course over a week or two and can be treated with topical medications.

But not all drug rashes are created equal — and some can even be deadly. Luckily the scary ones are pretty rare, but it’s still a good idea to know how to spot them. How can you tell the serious rashes from ones that are just a nuisance, but will get better with time and treatment?

Types of drug rashes

There are two main allergic rashes that may happen after taking a drug. The most immediate type of reaction happens within hours. Hives appear and move around the skin. Since this process is related to the release of histamine, antihistamines (available over the counter at a drugstore) are the typical treatment.

There is also a delayed type of drug rash that comes up four to 14 days after you start taking a medication. Pink and red bumps appear on your chest and back, and spread to the arms and legs over the course of days. Unlike hives, these bumps don’t move around, and after a few days things may start to get better, but you may have peeling skin much like a healing sunburn.

This delayed type of rash doesn’t respond as well to antihistamines, but an over-the-counter topical cortisone cream (or one of its stronger prescription-strength versions) can help speed the healing process along.

When is a drug rash cause for concern and a visit to the ER?

With hives, the main concern is that you’re experiencing a whole-body reaction that goes beyond the skin, one that can make breathing difficult or dangerously drops your blood pressure. If you experience either of these symptoms, it’s very important to get to the ED.

These immediate, life-threatening reactions can be treated with steroids, epinephrine, and higher-dose antihistamines than you can find at the drug store. While they are scary, these types of allergic reactions to a drug are not hard to identify, and many doctors are skilled at spotting dramatic changes in your breathing or blood pressure. It’s important to tell the doctor you see what medications you have taken and how long ago you took them.

Know the signs of severe cutaneous adverse reactions (SCARs)

In the more delayed type of rash, symptoms can be more difficult to diagnose. The most common triggers for these types of rashes include antibiotics, antiseizure medications, antigout medications like allopurinol, and even over-the-counter medications like NSAIDs. (This isn’t a complete list, and any new medication should be regarded with caution.)

As for the rash, when it’s just itching things are usually fine, but still a nuisance. When the skin starts to hurt, or turns a deeper purple color, doctors worry about something more serious. If your skin starts to blister up or you see pustules, or if you notice sores in your mouth, eyes, or your genitalia, these are red flags and you should get to an urgent care clinic or the ER and ask for a dermatology consultation. Sores in the mouth can be so severe that drooling becomes a common symptom, because patients avoid swallowing due to the pain.

If you start to feel ill, like you have the flu, or if you’re getting puffy from swelling, especially in the face, this could mean it’s a severe drug hypersensitivity syndrome. Sometimes people develop a fever, a drop in their blood pressure, or their liver, kidneys, and heart can all be affected by drug hypersensitivity syndromes. These are so severe that most patients need to be admitted to the hospital, and sometimes even to the burn or intensive care unit.

While there are different names for different types of severe drug reactions, including Stevens-Johnson syndrome (SJS), drug rash with eosinophilia and systemic symptoms (DRESS), and acute generalized exanthematous pustulosis (AGEP), they are often grouped together as severe cutaneous adverse reactions (SCARs).

What happens if you develop a SCAR from a medication?

The first step is getting evaluated by a specialist, either in a dermatological clinic or the hospital. Finding someone who has expertise in managing these types of reactions is critical. A doctor (usually a dermatologist) may biopsy your skin, and they may have to start systemic medications that suppress your immune system. Sometimes, patients with SCARs also require a stay in a hospital.

The most important thing you can do is to keep an eye on your skin and its symptoms if you’re taking a new medication, or even if you’ve increased the dose of an old medication. If you suspect that you may be dealing with one of these SCARs, be sure to seek help from an expert, like a board-certified dermatologist, so that you can rest assured that you’re getting the care you need. Patients who are treated appropriately generally do well. Your doctors should also report these reactions to the FDA.

Once you’re on the mend, things can start to get back to normal, but it’s important to follow up with your doctors because there are some long-term issues that are important to pay attention to. Ultimately your doctors and healthcare team will advise you on what exactly is safe in the future. Remember that if you’re worried about one of these reactions, it’s important to stop the medication as soon as possible, but with the input of your doctors.

This sheet is about having atopic dermatitis in a pregnancy or while breastfeeding. This information is based on published research studies. It should not take the place of medical care and advice from your healthcare provider. 

What is atopic dermatitis?  

Atopic dermatitis (also called atopic eczema or eczema) is a medical condition that makes skin red and itchy. Symptoms can include dry and itchy skin, red to brownish-gray patches (especially on the hands, feet, ankles, wrists, neck, upper chest, eyelids, inside the bend of the elbows and knees), small, raised bumps that might leak fluid and crust over when scratched, thickened, cracked, or scaly skin, and/or raw/sensitive skin from scratching.  

Atopic dermatitis can be mild, moderate, or severe. For most people, atopic dermatitis starts in childhood, but it can also start in adulthood. For some people, atopic dermatitis is a chronic disorder with symptoms that can be ongoing for a period and then symptoms go away but come back on and off (flares).   

I have atopic dermatitis. Can it make it harder for me to get pregnant?  

It is not known if atopic dermatitis can make it harder to get pregnant. One study suggests that atopic dermatitis might make it harder to get pregnant. 

Does having atopic dermatitis increase the chance of miscarriage?  

Miscarriage is common and can occur in any pregnancy for many different reasons. Studies have not been done to see if atopic dermatitis can increase the chance of miscarriage.  

Does having atopic dermatitis increase the chance of birth defects?  

Birth defects can happen in any pregnancy for different reasons. Out of all babies born each year, about 3 out of 100 (3%) will have a birth defect. We look at research studies to try to understand if atopic dermatitis might increase the chance of birth defects in a pregnancy. It is not known if atopic dermatitis can increase the chance of birth defects.  

Does having atopic dermatitis increase the chance of other pregnancy-related problems?  

It is not known if atopic dermatitis can increase the chance of pregnancy-related problems, such as preterm delivery (birth before week 37) or low birth weight (weighing less than 5 pounds, 8 ounces [2500 grams] at birth). There have been reports of atopic dermatitis symptoms becoming worse or flaring during the 2nd or 3rd trimester of their pregnancy. 

One study suggests that having atopic dermatitis can increase the chance of high blood pressure in people who are not pregnant. High blood pressure can increase the risks to a pregnancy. If you have questions or concerns about your blood pressure, talk with your healthcare provider.  

Does having atopic dermatitis in pregnancy affect future behavior or learning for the child?  

Studies have not been done to see if having atopic dermatitis can increase the chance of behavior or learning issues for the child. 

Can I take my prescribed medication for atopic dermatitis during pregnancy? 

It is important that you talk with your healthcare providers about your medication when planning pregnancy, or as soon as you learn that you are pregnant. Sometimes when people find out they are pregnant, they think about changing how they take their medication or stopping their medication altogether. However, it is important to talk with your healthcare providers before making any changes to how you take your medication. Your healthcare providers can talk with you about the benefits of treating your condition and the risks of untreated illness during pregnancy. There are a variety of medications that are used to treat atopic dermatitis. Information on specific medications can be found in our fact sheets at https://mothertobaby.org/fact-sheets/ or by contacting a MotherToBaby specialist at 866.626.6847. 

Breastfeeding while having atopic dermatitis: 

Atopic dermatitis does not appear to affect a person’s ability to breastfeed. Talk with your healthcare provider and your baby’s pediatrician about any medications you take for atopic dermatitis while breastfeeding. Information on specific medications can be found in our fact sheets at https://mothertobaby.org/fact-sheets/ or by contacting a MotherToBaby specialist at 866.626.6847. Be sure to talk with your healthcare provider about all your breastfeeding questions.  

If a man has atopic dermatitis, could it affect fertility or increase the chance of birth defects?  

One study suggests that men with atopic dermatitis could have more trouble with fertility (ability to get a partner pregnant) then men without the condition. Studies have not been done to see if atopic dermatitis could increase the chance of birth defects. In general, exposures that fathers or sperm donors have are unlikely to increase risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/. 

MotherToBaby is currently conducting a study looking at eczema (moderate-to-severe)/atopic dermatitis in pregnancy. If you are interested in taking part in this study, please call 1-877-311-8972 or sign up at https://mothertobaby.org/join-study/. 

Please click here for references.

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Coping with eczema (atopic dermatitis) is sometimes be challenging for children and teens. The itchy rash of flare-ups can cause both physical discomfort and mental distress. They need to know that they are not alone.

Here are ways you can support your child with eczema and help them learn strategies to build confidence and resilience.

Listen & show you understand

One of the most important things you can do as a parent is listen. Instead of rushing to answer or solve your child’s problem, simply listen and show them you understand. Giving your child an outlet to express themselves is important. An open line of communication can prevent your child from holding in their feelings and negative thoughts about themselves.

Focus on the positive

At the same time, help your child realize there is more to them than eczema. Think about what you say to them and how you say it. Model positive coping skills by focusing more on other facts about your child, such as their talents or hobbies. (Also see “Stress & Eczema: How to Help Kids Cope With the Itch.”)

Help your child explore their strengths and become a well-rounded and confident person. Remember that your outlook and everyday behavior plays a big part in shaping your child’s outlook and behavior.

Equip your child with answers

It’s natural for children to ask questions about something they do not understand. Prepare your child to answer questions others ask them about eczema. Help your child create a simple statement to describe their condition.

For example, they can say “Eczema is like an allergy that makes your skin dry and itchy. It’s not contagious.”

When children are prepared and have something to say, they can confidently and effectively answer questions. Role-playing conversations can help your child present themselves confidently. Young children are more likely to respond in a positive and accepting way once they are informed.

Be prepared to discuss bullying

Ask your child directly if they’ve experienced
bullying; they may not share this information on their own. Let them know that being bullied is not their fault.

If your child is being bullied by peers, encourage them to make friends with other children. Support activities that interest your child. Participating in activities such as team sports, music groups or social clubs can help your child develop new abilities and social skills. When children feel good about how they relate to others, they are less likely to be picked on.

Discuss when and how to ask for help. Alert school officials to problems and work with them on solutions. Because bullying often happens outside the classroom, talk with the principal, guidance counselor and playground monitors as well as their teachers. Write down and report all bullying, including
cyberbullying, to your child’s school. By knowing when and where the bullying occurs, you and your child can better plan what to do if it happens again.

Seek & accept help from others

For many children, dealing with eczema is a lifelong journey. If your child needs mental health support, their school or their doctor can refer you to a professional counselor or therapist. A licensed professional can provide regular support and coping techniques to your child and your family.

Your child may benefit from connecting with other children dealing with eczema. For some teens, seeing others with eczema thrive and be confident in their condition can help build personal confidence. Connecting with other children with eczema in a support group can greatly reduce feelings of isolation.

More information

Kids often like to try different makeup and hair color products once they reach their teen years. If your teen has eczema (atopic dermatitis), they will need to pay extra attention to what’s in these products. Here’s how they can avoid common skin irritants, manage acne alongside eczema and choose makeup, sunscreen and hair care options that won’t trigger flare-ups.

Eczema-friendly skin & hair care tips for teens

With such a variety of products available, finding eczema-friendly skin and hair care products may seem overwhelming. When choosing products:

• Check the ingredients (see a list of ingredients to avoid below).

• Do a patch test when using new products (apply a small amount to see if your skin reacts).

• Watch for signs of irritation whenever skin and hair care products are used. Stop using products that irritate the skin, and let your teen’s doctor know.

• Check with your teen’s doctor if you have questions before using a new product.

Check the ingredients to avoid eczema triggers

Take time to read the ingredients label of new skin care and beauty products you plan to use. Some ingredients are known irritants and can cause eczema flares. In general, look for products say they are “fragrance free,” “hypoallergenic” and made for “sensitive skin.”

Ingredients that may irritate the skin

Keep in mind that each person may have no reaction, or different reactions, to these ingredients.

• Fragrance (some fragrance-free products have masking fragrances like cinnamic alcohol, cinnamic aldehyde, eugenol, isoeugenol, geranoil (added to essential oils), hydroxycitronellal and oakmoss).

• Essential and botanic oils

• Urea (helpful for some skin conditions but not eczema)

• Lanolin (derived from oil glands of sheep; can be an allergen)

• Retinoids (used for acne but can trigger eczema).

• Cocamidopropyl betaine (foaming agent derived from coconut oil)

• p-Phenylenediamine (PPD), which is added to many hair dyes

• Alcohols like ethanol, isopropanol and propanol.

• Preservatives

• Parabens (methylparaben or butylparaben)

• Methylchloroisothiazolinone and methylisothiazolinone

• Benzalkonium chloride (found in eye care products such as contact lens solutions)

• Sulfates like sodium laureth sulfate and sodium laurel sulfate can strip hair of its natural oils

• Phthalatates (solvent added to help dissolve ingredients in cosmetics, shampoos, soaps, lotions, nail polish and aftershave). May be listed as di-n-butyl phthalate (DBP), deithyl phthalate (DEP), dimethyl phthalate (DMP) or Benzyle butyl phthalate (BzPB).

Learn about gentle skin care routines and products to avoid for teens and tweens, including those with eczema, in this video below. Also listen to the Healthy Children Podcast episode, “Safe Skincare for Tweens and Teens.“

Daily facial care routine for teens with eczema

Cleaning and moisturizing are key elements of a good facial care routine for a teen with eczema. Teens should wash their face at least once a day, but twice a day is recommended.

Cleanser

Oil-or water-based formulas are best when looking for an eczema-friendly cleanser. Use an alcohol-free, nondrying facial cleanser or soap substitute to gently cleanse the face, remove bacteria and prevent clogged pores. Apply the cleanser with your fingertips and gently rinse it off with lukewarm water. Gently pat dry with a towel. Rubbing, hot water or anything else that irritates your skin can cause eczema or acne to flare.

Moisturizer

A moisturized base layer is needed before applying makeup. While skin is still slightly damp from washing, apply medicine, if needed, and then moisturizer. The moisturizer can be cream or lotion. Consider using a moisturizer with sunscreen, which provides extra protection.

Makeup remover

All makeup should be removed before bedtime. Use a gentle water-based makeup remover using a clean cotton makeup remover cloth. After wiping off the makeup, use your regular cleanser and moisturizer. Be cautious with makeup wipes, which can irritate the skin.

Makeup

Eczema flares around the eyes, around the lips, on or around the eyebrows and on the cheeks can be a concern for teens who use makeup. During a flare, it is best to pause makeup use in affected areas and focus on moisturizing, hydrating and repairing the skin. On healthy skin, makeup application should be tailored to individual skin needs and should always start with a clean face.

Eczema-safe hair care tips for teens

Washing, styling and coloring hair can cause eczema flares in areas touched by hair care products. In addition to fragrance, preservatives, parabens, teens with eczema should also avoid PPD. PPD is found in hair dye, henna tattoos and many teens hair products. It is one of the most common allergens and is known to trigger symptoms such as itching and flaking.

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