Reducing Treatment Stress

Some atopic dermatitis treatments are given by injections. Many children with atopic dermatitis may also need blood draws as part of allergy testing. Needle feels are common, but there are effective ways to help your child feel more comfortable. When children have a plan for injections, they have less fear and pain.

Coping with your child’s eczema injections and needle fears

Preparing Your Child

  • When you are calm and confident, your child will feel more confident too. Don’t apologize to your child – taking care of their health is important!

  • For example, for a young child: “The medicine will help you feel less itchy and help the rashes go away.” 

    For an older child or teen: This medicine can calm your immune system so you will have fewer eczema flares and itch. Try to use neutral words such as poke instead of “shot” and “pain.”

  • Give your child a chance to ask questions. Let them know you are listening and that there are steps you can take together to help them handle the situation. For example, “It’s normal to feel nervous. That’s why we will make a plan so you can feel more comfortable and in control.” 

  • Involve your child in deciding what strategies they want to use to feel more comfortable during the injection. Giving your child choices ahead of time will help them feel more in control. 

  • Especially for injections that happen regularly, it can help to plan a special routine your child can look forward to. This could include a small prize, a favorite snack or going to the park.

Turning Down Pain and Anxiety

  • You can numb the skin with an ice pack for about 2 minutes before an injection or ask your child’s healthcare provider about using numbing cream. Numbing creams take time to work, so you will need to plan ahead.

    You can also use vibration (like a Buzzy®) or a device like a ShotBlocker® to send “competing” sensory messages to the brain, so fewer pain signals can reach the brain. Place the device near the injection site to be most effective.

    For infants, Sweet-ease® sugar water on a pacifier may help reduce pain.

  • Have your child sit on a chair or on your lap. This helps them feel more in control than lying down. If needed, there are ways you can hold your child to both calm them and keep them safe.

  • Involve your child in choosing something to watch or do before and during the injection, to take the focus away from pain. Some examples include:

    • Watch a video.

    • Play a video game.

    • Play “thinking” games such as taking turns naming animals that start with A, then B, then C, etc.

    • Play “I Spy” with seek-and-find books or objects in the room.

    For infants, try singing, rattles or toys with lights and sounds.

  • Taking slow, easy breaths in and out helps to calm the body and the mind. For young children, try blowing bubbles or using a pinwheel.

  • Tell your child’s healthcare provider if your child has a severe needle fear that gets in the way of treatments or healthcare visits. It may help to meet with a mental health professional to learn ways to manage the fear. Exposure-based therapy is a type of treatment that helps people build comfort with needles in a slow, controlled way.

Other resources for coping with injections and needle fears:

Meg Foundation has many great printable and interactive coping plans to help kids, teens and their caregivers make plans to cope with procedural pain.  Many resources are also available in Spanish.