Episode Transcript
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Speaker 1 (00:02):
Hello and welcome to
today's episode.
We're really glad you're here.
Joining us today are DrElizabeth Reese, a pediatrician,
and Jennifer Rubner, acertified pediatric nurse
practitioner, both from ourMedLink banks and Danielsville
offices.
They're going to be talkingabout allergies and eczema in
kids, sharing some super helpfultips and insights.
Our pediatric services are allabout supporting you and your
(00:24):
family, so sit back, relax andstay tuned for some great advice
you won't want to miss.
Let's talk a little bit abouteczema first.
I know my niece and nephewactually have eczema and there's
things that I never think aboutthat my brother's like oh, they
can't use that, like certainlotions and things like that.
(00:44):
So what are some things thatyou, or some advice or
information about eczema thatyou have?
Speaker 2 (00:48):
Okay, Well, most
people's eczema has certain
times of years that they flareup.
So they'll definitely find thatthey have highs and lows.
So sometimes their skin is justfine and can handle most of
their lotions just fine.
Certain times of years, likeright now in Georgia in the
spring They'll have eczemaflare-ups and that lotion they
normally use is just isn't goodenough.
(01:09):
So always with eczema you wantto treat with a nice unscented,
gentle lotion.
You don't want the strongscented stuff.
You don't want the overlydrying lotions everybody loves
to use, like Dial and Zest, andthat's very drying to the skin
and I don't think a lot ofpeople realize how drying it is
(01:30):
to the skin.
Better lotions to use or bettersoaps to use in general are,
you know, aveeno, dove stuffthat's gonna not take away the
natural, get you clean, but nottake away your natural body
moisture layer.
And then the best thing to do iswhen you pop out of that bath
(01:51):
or shower is to pat dry and thenapply a layer of lotion, which
nobody does, especially theteenagers.
You know getting them to lotionis hard.
But if you can lock in some ofthat moisture with a nice
unscented lotion, once againit's, you know, dove, aveeno,
cerave Cetaphil those thicklotions with no fragrance is
(02:17):
really, really good for eczemacare in general, and they get it
really bad in their elbows, intheir creases, behind their
knees, you know extra lotionanytime they're getting like
spots where they're flaring upand needing extra moisturizer.
Those are great places to addlotions in kind of similar.
Speaker 1 (02:34):
How does perfumes
kind of?
Does that have an effect on itas well?
Speaker 2 (02:39):
I mean it can
aggravate the skin, just like
any perfume's.
You know it's got thatfragrance to it and so that
fragrance just like if you wouldwash your hands with something
perfumed it can aggravate theskin.
Especially if you've alreadygot an irritated, red, raw skin
it's going to aggravate it more.
So for the kids that you knowthey want to smell good, they
(03:00):
want to smell good for theirfriends.
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 routineand put the spray on your
clothes.
Don't spray your body, sprayyour clothes, because they'll
still get that good smellingstuff without it actually having
to touch their skin.
Yeah, also with eczema, a lot ofkids get really really bad
(03:22):
certain times of the year You'llget, you know, same thing with
allergies, but like fall andspring, and they just they can't
clear those raw spots.
Those are good times to usesomething that's got like an
extra thick layer.
So Aquaphor is very good.
Vaseline and Aquaphor in theevening right over a lot of the
raw spots to kind of walk in andmoisture and soak in at night
(03:44):
is really good, especially forthe younger ones can you kind of
explain exactly what eczema is,or is there an exact
explanation for it?
well, it's an atopic dermatitis.
Speaker 3 (03:54):
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 handin hand with what we're going to
talk about next, with allergy.
They believe that it's kind ofall in sort of one big cohesive
thing that people that haveextra sensitive skin might also
(04:15):
suffer from allergies and whenthey do testing they actually
might have a higher level ofsomething called IgE, which is
just one of the immunoglobulinsthat we have in our body, and
people that are sensitive andhave allergies and asthma and
eczema can often have more ofthat too.
Speaker 2 (04:34):
And you'll see it too
with kids that have a known
allergy.
Certain things will affecttheir skin allergy-wise, you
know like dairy is a big onethat you will see the effects in
their skin sometimes.
Speaker 3 (04:49):
The biggest thing we
tell families if they're doing
their good eczema skin care andthey are concerned that their
kids are having those raw spotsthat aren't responding to
treatment and they're worriedthat they're becoming infected,
that's a real time when youwanna reach out to the doctor
and have them be seen, becauseyour skin is your first
protective layer of your bodyagainst all germs and so if you
(05:12):
have a break in that skin justwhen someone has a cut, that's a
place where infection can getin.
But somebody with eczema isgoing to be even more prone or
can be more susceptible toinfection because their skin
already kind of has that loss ofthe protective barrier.
Speaker 2 (05:27):
Yeah, and you're
always trying to get the,
especially the younger ones, oreven some of the older ones, to
not pick those areas to spreadthat breakdown of the skin as
well, because that can spreadthe infection as well as they
pick.
And scratch.
Speaker 3 (05:43):
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 soitchy and it's hard to tell them
not to do that, and because itjust feels so itchy, and then
when they scratch, though, theymake that breakdown in their
skin even worse.
Speaker 2 (05:59):
So overall, the best
thing for eczema is finding that
good skincare routine for yourchild.
You know whether it's theAveeno body wash and soap, and
then you know doing a goodlotion afterwards and then
locking in more moisture in theevening with either an extra
layer of lotion or Aquaphor and,in general, having a good
(06:22):
skincare routine that you knowworks for your kid.
That's what we want toencourage, you know, because
it's the better way to go.
A lot of times they do get soflared up and bad that there are
, you know, some.
You can use some of the mildprescription creams, the
hydrocortisone, over-the-counterhydrocortisone or some stronger
ones.
But we like to use those aslittle as possible because once
(06:44):
again, it's a steroid cream andit does have an effect on your
on your skin and your body andit can cause some discoloration
and thinning of the skin.
Um, but when it's, you knowjust, they're downright
miserable and, you know, can'tget it under control.
Speaker 1 (06:58):
You know, using it
sparingly we can do at times too
okay, and so with eczema andallergies kind of going not
really hand in hand, but kind ofhand in hand, um, can you say
that you could give your child abenadryl or any other type of
antihistamine instead of maybethe cortisone cream or something
(07:21):
?
Speaker 2 (07:21):
they're having like a
very itchy kind of day and
you're noticing that they justcan't stop scratching.
You know, um, and they're noton a regular allergy pill or
regimen.
You know a Benadryl here andthere is definitely helpful,
especially if they've had thatexposure like oh they were out
last night running around in thepollen playing soccer, and now
(07:41):
today they just can't stopscratching their skin, you know.
So you know that can be helpfuljust to kind of calm down the
itch for the day, to get themand then get back on their
regular skin routine.
And that kind of also issomething environmental.
If they're, you know, outsideand it's high allergy season and
they're doing their sports, youknow it's really good to come
(08:02):
home and take that shower realquick, even if it's just a real
quick one, wash off that pollenbefore 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 (08:19):
I never even thought
about like having the pollen
from outside on me, like I guessI don't see me coated in yellow
, so I'm like I'm good.
Yeah, I would have never eventhought like considered that,
yeah, you also sometimes have toconsider too.
Speaker 2 (08:34):
a lot of people say,
oh well, my dog sleeps with me
and it's like the dog you noticethe dog is.
You know, everything outside inGeorgia is yellow today and the
dog's been rolling in theground.
And then they hop right intoyour 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'rebringing in a lot of stuff
that's not really helping yourskin at that point in time.
Speaker 1 (08:54):
Yeah, I wonder.
My brother's dog makes me itchall the time, but he's like
she's hyperallergenic.
I don't know how.
Speaker 2 (09:03):
So I'm like, okay,
maybe that's what that is.
Yeah, they can still bring itin on her.
That's what she's been rolling.
She's like um.
Speaker 3 (09:09):
I think Jen had
mentioned this too, but we had
talked about the Benadryl.
Sometimes that's called afirst-generation antihistamine,
so those can definitely makekids sleepy.
So sometimes an evening dose ofthat can help, because maybe
you will make them not as itchyand scratchy at nighttime and
will actually help them to rest,but during the day they might
get too sedated with that.
(09:30):
So you can use what are calledsecond-generation antihistamines
, which are things like Zyrtecand Claritin and those are once
a day dosing and also tend tonot make people as tired.
Speaker 1 (09:40):
I know, when I take a
Benadryl I'm out Because my
favorite animal is a cat, butI'm allergic to cats.
So certain ones make ithorribly bad.
Speaker 3 (09:59):
And then I'm like
like, okay, I'll just take one
Benadryl.
Speaker 1 (10:00):
And then I'm sitting
on my couch and I'm like I can't
keep my eyes open, so it wouldbe hard for you to go to school.
Oh yeah, for sure.
I can't imagine if I was likein school struggling to fight
that Benadryl sleep.
Speaker 3 (10:07):
And if parents have
been trying, like Zyrtec or
Claritin over-the-counter, andthat doesn't seem to be working
as an antihistamine.
There are other allergy.
There's other allergy.
They do sell itover-the-counter, but most
people get it by prescription,something like Singulair
Montelukast.
That's a different kind ofallergy medicine.
So they found that some peoplereleased what are called
(10:28):
histamines and other peoplerelease something called
leukotrienes, which are just adifferent irritant chemical that
comes into your body.
But you can't look at somebodyand say you're a leukotriene or
you're an antihistamine.
So if they aren't responsive toone a lot of times we'll try the
other one just to see if we cangive them some relief.
So, that's another thing.
Talk to your provider about.
Speaker 2 (10:47):
That also leads into
just allergies in general.
You know we live in Georgia andhave just these terrible
allergy seasons.
Right now we're right in themiddle of spring and pollen is
everywhere, and so the kids willfeel very sneezy, itchy, runny
nose, you know, post-nasal dripcongestion, and so using those
(11:10):
daily allergy medicines can helpwith a lot of kids.
And the misconception is oh,when they have a sneezing nose,
I give them one Zyrtec.
And that's not really the bestway to use Zyrtec or Claritin.
You know those are meant to beused.
They're a once a day medicine.
They're one, you know one doseevery 24 hours.
Once a day medicine.
(11:33):
They're one, you know one doseevery 24 hours.
And they're more effective ifyou use it for a season um, so
you know, if you're know, yourseason is pollen, um, and pollen
really affects you and you havebad allergies during pollen
season.
You know, right before thatpollen hits, it's good to go
ahead and start on that allergymedicine once a day.
And then you know, once thatpollen levels we see them drop,
then you come off your allergymedicine.
Um, some kids are pollen kidsfor the spring, some kids are
(11:55):
ragweed kids in the fall, somekids are both.
So um, you know, parents canusually tell you.
You know, yeah, they getfalling in spring allergies or
really just spring allergiesreally affect them.
Um, but a lot of um, a lot ofmy patients will won't do their
allergy medicine until theystart having symptoms.
And then they do it.
They'll say they do Zyrtec andClaritin as needed, and so
(12:16):
they're not getting that fullbenefit of taking an allergy
pill for the season and gettingthat relief that they need for
the high pollen levels or aroundlevels that we're seeing in
Georgia.
Speaker 1 (12:27):
That makes sense,
because the pollen's still there
.
It's not like you take theClaritin and then the pollen
also went away.
Okay, okay.
Speaker 3 (12:37):
Anything else you
guys want to talk about, I would
say that if your children areon adequate allergy medicine and
they have tried various onesmaybe they're doing topical
creams and they're still nothaving any change in their
symptoms that sometimes is thetime when we might send them to
an allergist.
And just to know that, a lot oftimes it's not so much to just
(13:01):
find out, we might have alreadyhave a good guess about what
they're allergic to.
This is a lot of the times whenwe're deciding they actually
might need intervention withallergy shots to try to make
them less sensitive to allergens.
So many times if parents comein and tell us they're concerned
about allergies, they want togo to an allergist, we might
direct them to try some of theeasier treatments first, because
(13:23):
a lot 90% of the time that'llprobably do the trick.
But in some kids where they'rereally having still severe
symptoms and we, you know, willagree that they might need to
see an allergist to really diginto what's bothering them and
then possibly talk about therapyfor that- Thank you for tuning
in to the MedLink HealthConnections podcast.
Speaker 1 (13:42):
We hope you found
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Remember, the informationshared in this podcast is for
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(14:02):
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