Answered by Anthony Mancini M.D.
Dr. Mancini received his undergraduate and medical educations at the University of Arizona, and trained in pediatrics, pediatric dermatology, and dermatology at Stanford University. He is currently Associate Professor of Pediatrics and Dermatology at Northwestern University's Feinberg School of Medicine and Head of the Division of Dermatology at Children's Memorial Hospital in Chicago, Illinois.
Dr. Mancini has served as a member of the AAP Executive Committee, Section of Dermatology since 2001. He is a member of the AAP Super CME Planning Group and the AAP Pedia Link Pediatric Dermatology Project Team, and is Secretary-Treasurer of the Society for Pediatric Dermatology. His teaching accomplishments include the Faculty Excellence in Education Award from the Department of Pediatrics at Northwestern, which he has received for the last eight years. Dr. Mancini is a peer reviewer and/or sits on the editorial board for several academic journals, and has published over 75 peer-reviewed articles, abstracts, and book chapters. He is co-author of Hurwitz Clinical Pediatric Dermatology, 3rd edition, and is an associate editor for the comprehensive dermatology textbook Dermatology. His special interests include infectious skin diseases and exanthems of childhood, vascular malformations and hemangiomas, and neonatal skin maturation and skin disorders.
Dr. Mancini is a Fellow of the American Academy of Pediatrics and the American Academy of Dermatology. He and his wife, Nicola, a neonatal intensive care nurse, have three children (Mallory, Christopher, and Mackenzie) and reside in Evanston, Illinois.
Question
How can I help my 6-month-old, who scratches till she bleeds?
Answer
Such scratching is most commonly associated with either severely dry skin or with atopic dermatitis. Atopic dermatitis is a hereditary condition that causes a red, oozing rash that is frequently very itchy. Some children, though, begin with only the itch, with the rash developing later. This is the reason for the classic adage "the itch that rashes."
It sounds as if you are more-than-adequately moisturizing her skin, but there are a few other steps you can take. Give her short daily baths (no longer than 10 minutes), afterwards applying an anti-inflammatory cream or ointment (you can begin with over-the-counter hydrocortisone) followed by moisturizer to any red areas. Oral antihistamines are also useful, especially before bedtime if the scratching is interfering with her normal sleep pattern. Sometimes stronger medicines are required by prescription, and if secondary infection is present (as it often may be), an antibiotic may be necessary. Therefore, if the above measures are not helpful, have her evaluated by her pediatrician or a dermatologist, who can adjust the regimen as necessary.
