Reducing Treatment Stress
Involving kids and teens in eczema management routines
A team approach between caregivers and children can help make eczema management easier. It’s important for kids to have a developmentally appropriate understanding of what eczema is, how treatments help, and how they can be involved in taking care of their skin. There are steps caregivers can take to support children and teens in eczema management routines and gradually build their skills and knowledge over time.
Sections below (toddlers/preschoolers; school-age; teen) are separate links to click on, to take you to the appropriate developmental stage on this page.
2-5 years
5-11 years
12+ years
Building Eczema Routines with Toddlers and Preschoolers (2-5 years)
In the early years, parents have primary responsibility for eczema management. Toddlers and preschoolers pay attention to what adults do and learn by imitation and play. This means that when you are consistent with daily eczema management routines, children will learn what to expect and that these routines are important.
Young children are also working on developing a sense of control and independence. Involving them in eczema management in simple ways can help to build their sense of control.
There are steps caregivers can take to help young children follow skincare routines – and other routines they are learning.
Start by talking about why the routine is important and how it helps
For example:
Your moisturizer can help make your skin strong.
Baths are like “a drink for thirsty skin” so skin will not feel as dry.
Your medicine can help keep the rash and itchies away.
Involve children in daily routines in simple ways
For example, a young child could gather their toys for the bath or help rub in moisturizer. Sometimes this means skincare gets messy or takes longer, but it can help them learn new skills and feel good about themselves.
Praise positive behaviors
Kids often get a lot of attention for misbehaving. One way to increase positive behaviors is to notice and comment on them.
Give praise right away if you can. The sooner praise is given, the more effective it is.
Be specific about what you liked. 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” are more helpful than “good job”.
Give children choices when possible
Parents make decisions about what eczema treatments are important for their child’s health and well-being. However, you can give your child a couple of acceptable choices to increase their sense of control:
“Do you want to put the moisturizer on your arm or leg first?”
Which toys should we bring in the bath tonight, the boats or the dolphins?”
Find ways to make routine fun
Some children enjoy a playful approach to skincare, which can set the tone for a more positive experience for the whole family. Some examples include:
Playing with toys or bath crayons in the tub, or listening to a special “bath book”.
“Painting” on the skin with moisturizer or pretending to “frost a cupcake”.
Playing with action figures in a basin of clean water to soak hands.
Listening to a story while moisturizer and medication soak in.
Turning wet wraps into a “superhero suit” to make their skin strong.
Use cues to signal transitions and help with learning the steps of the routine
When children know what is happening now and what to expect next, they usually feel more in control of their day.
For example, some children enjoy a special song they sing as they clean up their toys and get ready to start skincare.
Others may benefit from a visual schedule, like a chart with photos that show all of the steps of the evening routine, such as: take your bath, pat dry, put on creams, put on PJ’s, read books, and go to sleep. You can also give them a small reward like a sticker once they complete all of the steps. Once routines are built, you can phase out rewards.
Building Eczema Routines with School Age Children (5-11 years)
School-aged children can understand more about eczema and taking care of their skin. At this age, eczema management can be more of a team approach. Involving children in skincare with adult supervision can help them gradually build skills and confidence, with your continued support.
Start by talking about why the routine is important and how it helps
Every day, after we take a shower, we apply moisturizer to seal the water in. This helps keep your skin strong and healthy.
We use the topical medications on red and raised areas of your skin to help treat the rash and itch.
Older children can start to learn the names of their different medications.
Involve children directly in the skincare process
Parents can involve children in more eczema management routines over time.
Younger children can apply moisturizer on easy to reach spots.
Older children can apply their own moisturizer, with help from parents to reach hard to reach areas. They can also learn when and how to apply topical medications with adult supervision.
Parents should watch children the first few times they complete parts of the skincare routine on their own, as well as check in each day to make sure routines are being followed.
Find ways to make skincare easier and more enjoyable
Listen to an audiobook during the bath. Listening to a little bit each night can give your child something to look forward to.
Set a timer and try to “beat your best time” for skincare, with parents and children working together.
Read a book or watch a video while waiting for topic treatments to soak in.
Help your child remember the plan and stay motivated
To help your child with remembering the steps in skincare routines, it can help to create a written checklist. This could be a list you keep on the wall or a whiteboard or printed list that allows your child to check off the steps as they go along.
For goals your child is working on, it can also be helpful to develop a simple reward program. It’s important to choose goals that are attainable for your child. Rewards should be chosen with the child. They should be something motivating for the child, but not something that is so big or expensive that it’s impossible to follow-through or gives your child the message that the task being asked of them is very difficult. For example:
If a younger child gets in the bath within 5 minutes of being asked, they could earn an extra book with parents at bedtime.
If an older child applies their moisturizer without being asked at night, they could earn 5 extra minutes of screen time. They could also earn a point to save up for a desired reward, such as a new book or choosing the movie on family movie night.
Remember that your praise is very important to your child! It’s important to praise their efforts when they are working on building new routines, as well as let them know how proud you are of them for the role they play in everyday eczema care.
School-aged children should also learn what to do to manage their eczema at school.
Links to online resources for creating your own reward charts:
https://templatelab.com/reward-charts/
Building Eczema Routines with Teens (12+ years)
In the teen years, children start to become more independent in different areas of their lives. The responsibility for eczema management gradually shifts from the parent to the teen. Teens want more autonomy and can take on a greater role in their care, but they are also still developing problem-solving and organizational skills. Teens do best when they have continued family support during this transition.
There are steps you can take to help your teen build the skills and confidence to manage eczema independently in the future.
Review your teen’s eczema management plan together
There isn’t a “cure” for eczema, but there are steps your teen can take to keep their eczema in good control, and steps they can take when skin flares to treat it quickly.
Make sure your teen understands:
How to recognize flares.
The names of their medications and what each is used for.
What treatments use when their eczema is in good control.
What treatments to use when they are having an eczema flare.
How often to use each medication/treatment.
Where on the body to use each medication and how much to use.
Talk about who will be responsible for different management tasks so nothing gets forgotten.
Watch teenagers the first few times they do new things, such as put on topical steroids independently. Some teenagers stop skincare when skin is improved, so it’s important to check in both when skin is flared and when it is under good control.
Help your teen build problem-solving and organizational skills
Keep a copy of the skincare plan near the skincare supplies.
Consider creating a written checklist with all of the steps for when the skin is in good control and for when it is flared.
Use reminders for skincare, like sticky notes or a phone alarm.
Problem-solve with your teen about how to fit skincare into their daily schedule, including planning ahead for times when there are changes in the schedule, such as a late night activity.
Develop a system for letting you know when supplies run low.
Keep supportive lines of communication open
As your teen starts to manage their eczema more independently, it’s good to check in with them regularly about how things are going, so you can provide support and make adjustments as needed.
Remember that as your teen is developing independent eczema management skills, they may not do things exactly as you would as a parent. Be patient and remember this is a process!
Let your teen know they can always come to you with questions or tell you if they think they made a “mistake.” When you keep the lines of communication open, this is an opportunity to build problem-solving skills.
Remember to praise your teen’s efforts when they are working on building routines!
Help your teen participate in their medical appointments
Talk to your teen ahead of time about the reason for the visit.
Help them make a list of any questions, goals or topics they would like to talk about during their appointment with their healthcare provider.
Allow teens to have one-on-one time with their healthcare provider.
After the appointment, talk with your teen about what they learned.
More Resources:
GPER’s Eczema Breakthroughs Podcast: Episode 15 - To bathe or not to bathe, that is the question!