MedLink Health Connections Podcast

Tackling Allergies and Eczema in Kids with Dr. Elizabeth Reece, and Jennifer Rubner, CPNP

• MedLink Georgia • Season 1 • Episode 6

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Is your child struggling with eczema and allergies? Pediatrician Dr. Elizabeth Reese and nurse practitioner Jennifer Rubner share practical tips to help. Discover gentle soap alternatives, the best post-bath routine, and when to seek medical help for infections. Learn about the link between eczema and allergies, the impact of pets, and the benefits of consistent allergy medication. Get expert advice on when to see an allergist and effective management strategies for Georgia's allergy season.

Speaker 1:

Hello and welcome to today's episode. We're really glad you're here. Joining us today are Dr Elizabeth Reese, a pediatrician, and Jennifer Rubner, a certified pediatric nurse practitioner, both from our MedLink banks and Danielsville offices. They're going to be talking about allergies and eczema in kids, sharing some super helpful tips and insights. Our pediatric services are all about supporting you and your family, so sit back, relax and stay tuned for some great advice you won't want to miss. Let's talk a little bit about eczema first. I know my niece and nephew actually have eczema and there's things that I never think about that my brother's like oh, they can't use that, like certain lotions and things like that. So what are some things that you, or some advice or information about eczema that you have?

Speaker 2:

Okay, Well, most people's eczema has certain times of years that they flare up. So they'll definitely find that they have highs and lows. So sometimes their skin is just fine and can handle most of their lotions just fine. Certain times of years, like right now in Georgia in the spring They'll have eczema flare-ups and that lotion they normally use is just isn't good enough.

Speaker 2:

So always with eczema you want to treat with a nice unscented, gentle lotion. You don't want the strong scented stuff. You don't want the overly drying lotions everybody loves to use, like Dial and Zest, and that's very drying to the skin and I don't think a lot of people realize how drying it is to the skin. Better lotions to use or better soaps to use in general are, you know, aveeno, dove stuff that's gonna not take away the natural, get you clean, but not take away your natural body moisture layer.

Speaker 2:

And then the best thing to do is when you pop out of that bath or shower is to pat dry and then apply a layer of lotion, which nobody does, especially the teenagers. You know getting them to lotion is hard. But if you can lock in some of that moisture with a nice unscented lotion, once again it's, you know, dove, aveeno, cerave Cetaphil those thick lotions with no fragrance is really, really good for eczema care in general, and they get it really bad in their elbows, in their creases, behind their knees, you know extra lotion anytime they're getting like spots where they're flaring up and needing extra moisturizer. Those are great places to add lotions in kind of similar.

Speaker 1:

How does perfumes kind of? Does that have an effect on it as well?

Speaker 2:

I mean it can aggravate the skin, just like any perfume's. You know it's got that fragrance to it and so that fragrance just like if you would wash your hands with something perfumed it can aggravate the skin. Especially if you've already got an irritated, red, raw skin it's going to aggravate it more. So for the kids that you know they want to smell good, they want to smell good for their friends. I usually tell them to you know, get dressed, want to smell good for their friends. I usually tell them to you know, get dressed, do your routine, do your unscented lotion routine and put the spray on your clothes. Don't spray your body, spray your clothes, because they'll still get that good smelling stuff without it actually having to touch their skin.

Speaker 2:

Yeah, also with eczema, a lot of kids get really really bad certain times of the year You'll get, you know, same thing with allergies, but like fall and spring, and they just they can't clear those raw spots. Those are good times to use something that's got like an extra thick layer. So Aquaphor is very good. Vaseline and Aquaphor in the evening right over a lot of the raw spots to kind of walk in and moisture and soak in at night is really good, especially for the younger ones can you kind of explain exactly what eczema is, or is there an exact explanation for it?

Speaker 2:

well, it's an atopic dermatitis.

Speaker 3:

So it's, you know, a flare-up of the skin, a mild ear allergy, irritant to the skin, usually environmental a lot of people can can kind of go hand in hand with what we're going to talk about next, with allergy. They believe that it's kind of all in sort of one big cohesive thing that people that have extra sensitive skin might also suffer from allergies and when they do testing they actually might have a higher level of something called IgE, which is just one of the immunoglobulins that we have in our body, and people that are sensitive and have allergies and asthma and eczema can often have more of that too.

Speaker 2:

And you'll see it too with kids that have a known allergy. Certain things will affect their skin allergy-wise, you know like dairy is a big one that you will see the effects in their skin sometimes.

Speaker 3:

The biggest thing we tell families if they're doing their good eczema skin care and they are concerned that their kids are having those raw spots that aren't responding to treatment and they're worried that they're becoming infected, that's a real time when you wanna reach out to the doctor and have them be seen, because your skin is your first protective layer of your body against all germs and so if you have a break in that skin just when someone has a cut, that's a place where infection can get in. But somebody with eczema is going to be even more prone or can be more susceptible to infection because their skin already kind of has that loss of the protective barrier.

Speaker 2:

Yeah, and you're always trying to get the, especially the younger ones, or even some of the older ones, to not pick those areas to spread that breakdown of the skin as well, because that can spread the infection as well as they pick. And scratch.

Speaker 3:

Yeah, I used to tell called eczema. It's not the rash that itches, it's the itch that rashes. Because, if you just get so itchy and it's hard to tell them not to do that, and because it just feels so itchy, and then when they scratch, though, they make that breakdown in their skin even worse.

Speaker 2:

So overall, the best thing for eczema is finding that good skincare routine for your child. You know whether it's the Aveeno body wash and soap, and then you know doing a good lotion afterwards and then locking in more moisture in the evening with either an extra layer of lotion or Aquaphor and, in general, having a good skincare routine that you know works for your kid. That's what we want to encourage, you know, because it's the better way to go. A lot of times they do get so flared up and bad that there are, you know, some. You can use some of the mild prescription creams, the hydrocortisone, over-the-counter hydrocortisone or some stronger ones. But we like to use those as little as possible because once again, it's a steroid cream and it does have an effect on your on your skin and your body and it can cause some discoloration and thinning of the skin. Um, but when it's, you know just, they're downright miserable and, you know, can't get it under control.

Speaker 1:

You know, using it sparingly we can do at times too okay, and so with eczema and allergies kind of going not really hand in hand, but kind of hand in hand, um, can you say that you could give your child a benadryl or any other type of antihistamine instead of maybe the cortisone cream or something?

Speaker 2:

they're having like a very itchy kind of day and you're noticing that they just can't stop scratching. You know, um, and they're not on a regular allergy pill or regimen.

Speaker 2:

You know a Benadryl here and there is definitely helpful, especially if they've had that exposure like oh they were out last night running around in the pollen playing soccer, and now today they just can't stop scratching their skin, you know. So you know that can be helpful just to kind of calm down the itch for the day, to get them and then get back on their regular skin routine. And that kind of also is something environmental. If they're, you know, outside and it's high allergy season and they're doing their sports, you know it's really good to come home and take that shower real quick, even if it's just a real quick one, wash off that pollen before they get into bed and put that pollen into their sheets, and so just to keep more of the itch away. For you know, you're just, you're adding more to your household if you're, you know, just coming home and bringing it all into your house.

Speaker 1:

I never even thought about like having the pollen from outside on me, like I guess I don't see me coated in yellow, so I'm like I'm good. Yeah, I would have never even thought like considered that, yeah, you also sometimes have to consider too.

Speaker 2:

a lot of people say, oh well, my dog sleeps with me and it's like the dog you notice the dog is. You know, everything outside in Georgia is yellow today and the dog's been rolling in the ground. And then they hop right into your bed and you're like I wonder why I'm so itchy today, and it's like, well, the dog's not the allergen but, they're bringing in a lot of stuff that's not really helping your skin at that point in time.

Speaker 1:

Yeah, I wonder. My brother's dog makes me itch all the time, but he's like she's hyperallergenic. I don't know how.

Speaker 2:

So I'm like, okay, maybe that's what that is. Yeah, they can still bring it in on her. That's what she's been rolling. She's like um.

Speaker 3:

I think Jen had mentioned this too, but we had talked about the Benadryl. Sometimes that's called a first-generation antihistamine, so those can definitely make kids sleepy. So sometimes an evening dose of that can help, because maybe you will make them not as itchy and scratchy at nighttime and will actually help them to rest, but during the day they might get too sedated with that. So you can use what are called second-generation antihistamines, which are things like Zyrtec and Claritin and those are once a day dosing and also tend to not make people as tired.

Speaker 1:

I know, when I take a Benadryl I'm out Because my favorite animal is a cat, but I'm allergic to cats. So certain ones make it horribly bad.

Speaker 3:

And then I'm like like, okay, I'll just take one Benadryl.

Speaker 1:

And then I'm sitting on my couch and I'm like I can't keep my eyes open, so it would be hard for you to go to school. Oh yeah, for sure. I can't imagine if I was like in school struggling to fight that Benadryl sleep.

Speaker 3:

And if parents have been trying, like Zyrtec or Claritin over-the-counter, and that doesn't seem to be working as an antihistamine. There are other allergy. There's other allergy. They do sell it over-the-counter, but most people get it by prescription, something like Singulair Montelukast. That's a different kind of allergy medicine. So they found that some people released what are called histamines and other people release something called leukotrienes, which are just a different irritant chemical that comes into your body. But you can't look at somebody and say you're a leukotriene or you're an antihistamine.

Speaker 3:

So if they aren't responsive to one a lot of times we'll try the other one just to see if we can give them some relief. So, that's another thing. Talk to your provider about.

Speaker 2:

That also leads into just allergies in general. You know we live in Georgia and have just these terrible allergy seasons. Right now we're right in the middle of spring and pollen is everywhere, and so the kids will feel very sneezy, itchy, runny nose, you know, post-nasal drip congestion, and so using those daily allergy medicines can help with a lot of kids.

Speaker 2:

And the misconception is oh, when they have a sneezing nose, I give them one Zyrtec. And that's not really the best way to use Zyrtec or Claritin. You know those are meant to be used. They're a once a day medicine. They're one, you know one dose every 24 hours. Once a day medicine. They're one, you know one dose every 24 hours.

Speaker 2:

And they're more effective if you use it for a season um, so you know, if you're know, your season is pollen, um, and pollen really affects you and you have bad allergies during pollen season. You know, right before that pollen hits, it's good to go ahead and start on that allergy medicine once a day. And then you know, once that pollen levels we see them drop, then you come off your allergy medicine. Um, some kids are pollen kids for the spring, some kids are ragweed kids in the fall, some kids are both. So um, you know, parents can usually tell you. You know, yeah, they get falling in spring allergies or really just spring allergies really affect them. Um, but a lot of um, a lot of my patients will won't do their allergy medicine until they start having symptoms.

Speaker 2:

And then they do it. They'll say they do Zyrtec and Claritin as needed, and so they're not getting that full benefit of taking an allergy pill for the season and getting that relief that they need for the high pollen levels or around levels that we're seeing in Georgia.

Speaker 1:

That makes sense, because the pollen's still there. It's not like you take the Claritin and then the pollen also went away. Okay, okay.

Speaker 3:

Anything else you guys want to talk about, I would say that if your children are on adequate allergy medicine and they have tried various ones maybe they're doing topical creams and they're still not having any change in their symptoms that sometimes is the time when we might send them to an allergist.

Speaker 3:

And just to know that, a lot of times it's not so much to just find out, we might have already have a good guess about what they're allergic to. This is a lot of the times when we're deciding they actually might need intervention with allergy shots to try to make them less sensitive to allergens. So many times if parents come in and tell us they're concerned about allergies, they want to go to an allergist, we might direct them to try some of the easier treatments first, because a lot 90% of the time that'll probably do the trick. But in some kids where they're really having still severe symptoms and we, you know, will agree that they might need to see an allergist to really dig into what's bothering them and then possibly talk about therapy for that- Thank you for tuning in to the MedLink Health Connections podcast.

Speaker 1:

We hope you found today's episode informative and inspiring. If you enjoyed the show, please subscribe, rate and leave a review on your favorite podcast platform. Remember, the information shared in this podcast is for educational purposes only and should not replace professional medical advice. Always consult with your health care provider for any medical concerns. Stay connected with us on social media and visit our website at medlinkgaorg for more resources and updates. Until next time, stay healthy and take care.