Eczema Tips

Children Food Sensitivities – Confusing Gluten

There’s so much about gluten-free these days – it’s an industry in itself and marketing ‘Gluten-Free’ is seen in menus and food packaging. We hear of sports celebrities performing better after cutting gluten and we hear of celebrity moms choosing gluten-free diets for their children. But what is gluten and what happens when you eat it? As the 4th part of this series, today’s post explores the different types of gluten sensitivities.

TOP 5 Facts You Need to Know to Differentiate Your “Gluten Sensitivity Type”!

Gluten refers to the proteins found in wheat, barley, rye and triticale (a cross between wheat and rye). Gluten gives elasticity/stickiness to the dough.



CD Fact #1: Involves immune system, BUT not IgE-mediated reaction to the gluten.

CD Fact #2: Immune system attacks the villi in the esophagus when exposed to gluten protein gliadin, found in wheat, barley, rye, and sometimes oats. This lead to intestinal inflammation, flattening of the villi and long-term damage to the small intestine. Associated with high intestinal permeability whereby bacteria, antigens and undigested food ‘leaked’ through the gastrointestinal barrier.

CD Fact #3: Symptoms include diarrhea, abdominal bloating/pain/cramps, bone/joint pain, bruises, constipation, depression, failure to thrive for children, mouth sores, infertility/miscarriage, malnutrition, weight loss, chronic fatigue, anemia, blood or fats in stool, nausea, joint pain, tingling on hands/feet, Dermatitis Herpetiformis or no symptom. Related to malabsorption of nutrients due to the intestinal villi being compromised.

CD Fact #4: Diagnosis is straightforward with tests to detect AGA (Antigliadin) and EmA (Andomysium Antibodies). Cutting gluten before testing will affect results. Small intestinal biopsy is an accurate test for celiac disease.

CD Fact #5: Treatment is strict avoidance of gluten in order for the villi to heal. Note that oats can be tainted with gluten and some common medications, vitamin supplements and cosmetic products also contain gluten. Untreated gluten has been linked to intestinal cancer, liver disease, small bowel ulcers and other inflammation-related diseases of the digestive tract, heart, joint and even brain.


NCGS Fact #1: Does not involve immune system and is not celiac disease. However, patients clearly experience discomfort and symptoms after ingesting gluten.

NCGS Fact #2: No intestinal inflammation and not associated with high intestinal permeability, unlike celiac disease.

NCGS Fact #3: Symptoms are gastrointestinal symptoms like abdominal bloating, diarrhea, gas, cramps, headaches and fatigue.

NCGS Fact #4: Diagnosis is not straightforward with no proven medical test. It is typically diagnosed after elimination of other similar conditions (for instance, wheat allergy, Irritable Bowel Syndrome) and after observation and further consultations.

NCGS Fact #5: Treatment is avoidance of gluten ONLY after confirmation of this course of action by doctors. Doctors will eliminate the possibility of celiac disease, wheat allergy or other diseases before advising on treatment for NCGS.


WA Fact #1 : Involves an immune Ig-E mediated reaction to the wheat protein

WA Fact #2: The increase in IgE antibodies trigger chemical release that lead to allergic reactions, that can either be manifested via the skin, respiratory or gastrointestinal systems and other behavioral issues.

WA Fact #3: Wheat is one of the common food allergens in children and symptoms include eczema, rhinitis, asthma, urticaria, conjunctivitis, abdominal pain, diarrhea and angiodema. These symptoms could be immediate (swelling or hives) or be delayed, including low weight gain in children. There’s also exercise-induced anaphylaxis to wheat.

WA Fact #4 Diagnosis is via allergy testing.

WA Fact #5: Treatment is avoidance of wheat. There is no need to avoid barley and rye which contains gluten but not wheat.

There is recently studied that people with non-celia gluten sensitivity may actually not be sensitive to gluten, but instead to FODMAPs. FODMAPs stand for fermentable oligo-, di-, and mono-saccharides and polyols, which are sugars, carbohydrates that tend to be poorly digested, e.g. frutose. It could be that gluten-containing grains are high in FODMAPs and thus avoiding gluten makes one who is sensitive to FODMAPs feel better. (see this study conducted as double-blind cross-over trial).

Update on 17 October 2016 – A new study showed the possible group of proteins found in wheat – amylase-trypsin inhibitors (ATIs) – to trigger an immune response in the gut that can spread to other tissues in the body. From MedicalNewsToday

ATIs only make up a small amount of wheat proteins – around 4 percent – yet the immune response they induce significantly affects the lymph nodes, kidneys, spleen, and brain in some people, causing inflammation. ATIs have also been suggested to exacerbate rheumatoid arthritis, multiple sclerosis (MS), asthma, lupus, and nonalcoholic fatty liver disease, as well as inflammatory bowel disease.

Hope this 4-part series clarify! it did for me and I have a clearer picture and better appreciation of the complexities involved in understanding and diagnosing one’s gluten-related (or suspected!) condition.

For other posts in this series, do check out

Allergic, Intolerant or Hyper?

Top 10 Kids’ Food Sensitivities Myths

Outgrowing Food Allergy


MedicineNetFODMAP studyMayo ClinicWebMd

Eczema Tips

Children Food Sensitivities – Outgrowing Food Allergy

This blog has always been focused on eczema, rather than allergy. However, I came across a very good book by Dr Wayne Shreffler and Dr Qian Yuan on ‘Understanding your food allergies and intolerances‘ and found that it clarified many food allergy concepts. Thus, this 4-part series is to share that knowledge with you!

For the past 2 weeks, we’ve covered

This week, I’m doing something totally unscientific – I’m compiling all statistics I find online on outgrowing allergies to lay out in a graphical representation of  WHAT AGE will a CHILD (likely!) OUTGROW FOOD ALLERGY! It’s definitely not scientific because each study/report has a different focus but just to save time for you (paranoid moms and dads who would try to do the same), I figure I might as well make an attempt!

Age your Child will Outgrow Food Allergies

While reading up on outgrowing food allergies, I’ve found some interesting food allergy facts!

Fact #1 Shellfish allergy onset later in life (6 years and older) and usually lifelong. Same for fish allergy.

Fact #2 Shellfish allergy IS NOT THE SAME as fish allergy.

Fact #3: Shrimp, lobsters and crabs are more allergic than mollusks such as scallops, oysters, clams and mussels.

Fact #4: Allergy to one type of (fin)fish does not mean allergic to another BUT study in 2004’s Journal of Allergy and Clinical Immunology found that 30% of children and approximately 66% of adults reacted to multiple types of fin fish.

Fact #5: More women than men are allergic to fish (0.6% vs. 0.2%).

Fact #6: Egg allergy is most closely associated with eczema, among the other food allergens. (Does not mean that egg allergy is most likely the trigger for your child’s eczema, as house dust mite is the more likely suspect for older children)

Fact #7: You can be allergic to either egg white or yolk or both but avoid the whole egg as it’s not possible to ensure clean separation.

Fact #8: Eggs and Milk cooked under intense heat (say baking cakes) seem to be more well-tolerated but don’t experiment without doctor’s advice (study here).

Fact #9: Soy allergy tend to be mild

Fact #10: Highly refined soybean oil (not cold pressed, expeller pressed, or extruded oil) and soy lecithin is usually tolerated by people with soy allergy.

Fact #11: Food allergies developed from young (except peanuts, tree nuts, shellfish and fish) are more likely to be outgrown versus food allergies developed as a teenager or adult, which tend to be lifelong.

Fact #12: 26.6% of children outgrew their allergies by age 5.4.

Fact #13: The more severe the allergic reaction, the less likely to be outgrown.

Fact #14: Mean age of tolerance for egg allergy was age of 7.2; Milk 6 years; Tree Nut 9.6; Shellfish 11.6; Soy 7; Fin fish 9.3; Peanuts 8.4

Fact #15: Boys are more likely to outgrow allergies than girls.

When researching for this post, I actually found quite a number of websites carrying misinformation or unclear information where it’s either proven wrong in later studies (for instance, to delay introduction of foods) or information relating to intolerance being grouped as food allergy information (such as only larger amounts of food trigger a reaction).

Another ‘sad’ news is that there is a study that children can develop a second (different) reaction to foods that they have outgrown. This is a study on Eosinophilic Esophagitis or EoE where it was found that 17 out of 1,025 patients in the study had initially outgrown IgE-mediated reaction to the foods but now suffer from EoE reaction (see for their interview with the researchers of the study). EoE is an inflammation at the esophagus due to increase of eosinophil cells, leading to narrowing of the esophagus.

Hope whatever age your child is, your family is managing the food allergies well. Share your outgrowing age below!


  1. ACAAI
  2. RaiseHealthyEaters (post by Dr Joneja)
  3. FARE
  4. Mayo Clinic
  5. Medscape
  6. Studies (egg) here and here
Eczema Tips

Children Food Sensitivities – Top 10 Kid’s Food Sensitivity Myths

Top 10 ids food sensitivity mythsThis blog has always been focused on eczema, rather than allergy. However, I came across a very good book by Dr Wayne Shreffler and Dr Qian Yuan on ‘Understanding your food allergies and intolerances‘ and found that it clarified many food allergy concepts. Thus, this 4-part series is to share that knowledge with you!

Last week, we clarified Food Allergy vs Food Intolerance which gave an overview of the differences between the two. Today we can put this to test by tackling these Kids’ Food Sensitivity Myths!

Myth #1: This Food Doesn’t Agree with Me, I’m Allergic to It!

This actually reminds me of my hubby (lol), most times we don’t agree (that is when we actually talk!) but no, I’m not allergic to him (hopefully he thinks the same!). As explained in last week’s post, food sensitivity can be either in the form of allergy or intolerance. Some doctors also allow for a 3rd category of food sensitivity, when they can’t classify it as either an allergic reaction or find the chemical the body is intolerant to.

However, these days, there’s almost a ‘cool’ factor to say you’re allergic to something. So while it is possible that more people think or say they have an allergy than they really have, food intolerance/sensitivity may also be underestimated as they are hard to diagnose. Do note too that adults can also have an onset of allergy at an older age, esp for certain allergy like shellfish.

Myth #2: Food intolerances can be tested using IgG antibodies test

There are many IgG tests available online and generally the medical community is against this test for identifying food sensitivity. The main reason is that elevated IgE implies an exposure to the food rather than an allergy to the food. Also while 80% of the foods are the common suspects in allergy, IgG test may test hundreds of foods and with false positives, lead to harmful elimination diet.

Myth #3: You are either Allergic or Intolerant

For some individuals the same foods can trigger both food allergy and intolerance. For instance, there can be an allergy to the milk protein while also lacking lactase digestive enzyme to break down lactose. This is why it is important to consult a specialist as it is not easy to figure it out on your own.

Myth #4: You can eat JUST A LITTLE of the sensitive food

This falls back to last week’s explanation of food allergy and intolerance. For severe food allergy, smelling the food can trigger a reaction, and it can be fatal one like anaphylactic reaction (that’s why there is so much debate about peanuts on plane!). However, for food intolerance, some people can eat certain amounts or in certain forms, e.g. food cooked with milk (I tried this fish recipe before, tasted horrible!) may give a different reaction to drinking milk.

Myth #5: I feel Bloated, I’m Allergic!

Bloating is more closely related to food intolerance but eating gassy foods cause bloating too. Pregnant women suffer more from bloating and constipation due to pregnancy hormones leading to relaxation of gastrointestinal wall muscles, thus foods stay in the tract longer.

Myth #6: I didn’t eat the food, how can I be allergic to it?

Food sensitization is when the body first comes into contact with the food protein and the body then ‘tag’ it as an enemy. The next time even small amounts of the food (in some cases, touched or smelled) can trigger an allergic reaction. So smelling peanuts on plane, touching or shaking hands with another child with peanut butter trace on hands can lead to an allergic reaction.

Myth #7: Delaying food introduction to a child can prevent the food allergy

Based on updated studies, the recommendation to delay introduction of common food allergens (usually peanuts, tree nuts, shellfish) is now revoked. The studies were contradictory – some showed late introduction helped as the child’s immune system is stronger while others showed early introduction helped as the child builds an immunity to it earlier. Thus the current recommendation is Just Eat (Whatever) a Balanced Diet. An update on a study on early introduction of eggs done in August 2015 showed that the elevated immune responses to egg were established prior to egg ingestion at 4 months and were not affected by whether eggs were introduced early.

Myth #8: Allergy testing is 100% accurate

Allergy testing (skin prick and IgE) is fairly accurate but not 100%. The only gold standard in food allergy testing is the oral food challenge. However due to the difficulty of conducting the oral food challenge (involves hospital stay), doctors form a diagnosis based on corroborated ‘evidence’, for instance the test results, parents’ observations and doctor’s knowledge of food allergens, family history.

Myth #9: Organic Foods are Safer

Organic foods (only the properly certified ones) may be safer in terms of free from pesticides but not safer in terms of allergic reaction to the food protein. Organic or not, the food protein is still present. For some people, peeling the fruit’s skin or cooking in a different way may help.

Myth #10: Allergy test can tell how Allergic you are

Allergy testing only tells you if you have an allergy, but it cannot predict the severity of the reaction. For instance, (see this previous post), the size of the wheal from skin prick test does not correlate with the reaction you will have.                                                                                                   

Eczema Tips

Living with Eczema Book Launch

Book launch eczemaIt was very nice meeting many moms at last Saturday’s Living with Eczema book launch. Both Professor Hugo and I shared, and in case you’re worried you missed something important from Prof Hugo’s talk, here are the salient points!

1. As the child ages, the type of eczema may change (for instance, from atopic dermatitis to contact dermatitis – saliva, ingredients in skincare products) and the triggers change too (an older child is more likely to be allergic to house dust mites).

2. Avoid antibiotic cream as it is more likely to destroy weaker strains of bacteria but stronger strains prevails (oral antibiotic is also not advised)

3. Psoriasis n pigmentation are possible to be present at birth, but not eczema (thus indicating that an environmental element is present in this skin condition) > further reinforced by studies that show moisturizing a newborn baby at high risk of eczema reduces risk of AD by 50%

4. Reduce contact with allergens in the air, including eggs which are present in food court and non-circulating air. Egg protein is airborne, small and light – can even be in our dust and our mattress.

5. Recommendation to adopt an outdoor lifestyle to reduce contact with indoor allergen.

6. Untreated eczema  can lead to infection, particularly with scratching. Infected eczema after healing leads to dark scars which are permanent. Scratch lesions which persist will also reduce pigment cells, thus leading to skin discoloration. (See also eczema complications series, where many complications arise due to scratching/infection).

7. Eczema has a genetic component – 25% if both parents don’t have eczema, 60% if mom has eczema, 50% if dad has eczema.

8. In terms of food allergens in Singapore, egg is the most common, followed by milk, soy and wheat.

There is much more that is shared in the book Living with Eczema: Mom Asks, Doc Answers, watch this video to see what it covers. Furthermore, from now till 8 May 2015, Prof Hugo and I will answer any question you have from reading the book on GooglePlus, read here to find out how!

Eczema Tips

Children Food Sensitivities – Allergic, Intolerant or Hyper?

This blog has always been focused on eczema, rather than allergy. However, I came across a very good book by Dr Wayne Shreffler and Dr Qian Yuan on ‘Understanding your food allergies and intolerances‘ and found that it clarified many food allergy concepts. Thus, this 4-part series is to share that knowledge with you!

Each week is a different concept de-mystified, so let’s get started!

Kids Food Sensitivities – What is Sensitivity?

What does it mean to be sensitive to a food? In layman’s term, it could mean a range of symptoms from headaches to tummy upset, but medically, it covers two main terms:

Food Allergy and Food Intolerance – both have similar symptoms but the cause and treatment is different, which is why it is important to differentiate the two.

Food Allergy Food Intolerance
Direct immune system’s response to food protein Not a direct immune response but different causes (not all known), e.g. lack of specific enzymes to digest the food (not necessarily a protein)
Cause is the reaction to food protein, can be tested with fair accuracy with allergy tests Cause is not always known and not easy to test a food intolerance
Symptoms can be immediate (few hours) or delayed, and include

Itch, hives, breathing difficulty (including anaphylaxis), eczema, runny nose, coughing, vomiting, diarrhea, abdominal pain, swallowing difficulty, chronic chest pain, heart burn, constipation, weight loss, swelling of facial features

Symptoms can affect the skin, intestines, respiratory tract and cause behavior change

Symptoms may take place gradually – nausea, stomach pain, gas (bloating)/cramps/bleeding, vomiting, diarrhea, heartburn, headache or migraine


Symptoms typically affect intestines.

Happens every time May not happen for the tolerated amount or in certain forms; the more you take, the more severe the symptoms and symptoms may differ in each incident
Small amount triggers Certain amounts may be tolerated (trial and error process to figure out)
Common food allergens: Milk, soy, egg, wheat, peanuts, tree nuts, fish and shellfish Common food intolerances: Frutose, Sucrose, Lactose, MSG (monosodium glutamate), sulfite, tyramine, histamine
Except for peanuts, tree nuts, fish/shellfish that are harder to outgrow, other food allergens tend to be outgrown at older age May actually onset at older age
Genetics play a role Genetics play a role

As seen above, there are distinct differences between food allergy and food intolerance although the symptoms of both are similar. However, to be concerned that there is indeed a food sensitivity issue, there has to be a reproducible reaction with the food – i.e. not referring to a one-time stomach upset after eating prawns in the past year (that might be food poisoning!).

The diagnosis of food intolerance is generally difficult, except for lack of digestive enzymes lactase, frutase and sucrase. The lack of the digestive enzymes result in lactose, fructose and sucrose not being broken down and result in pain, bloating, spasm and diarrhea.  Even stress or anxiety associated with a certain food can cause an intolerance.On the other hand, symptoms such as swelling are closely associated with allergic reaction.

The diagnosis of immediate food allergy is more straight forward than delayed food allergy, with allergy testing and blood test to detect elevated levels if immunoglobulin E (IgE). The common food allergens differ in different country (taken from

  • Worldwide – milk, egg
  • USA, UK, Australia – peanut and tree nuts
  • France – mustard seed
  • Italy, Spain – peach, apple, shellfish
  • Israel – sesame
  • Spain, Japan – fish
  • Japan – buckwheat
  • Singapore – birds’ nest, shellfish

For those in Singapore, it is interesting that fish isn’t on our list of common food allergens possibly due to it being so much part of our diet. Birds’ nest on the other hand is given as ‘tonic’ to children early and may actually trigger an allergy!

Treatment wise – for both food allergy and food intolerance, avoidance is key. For food allergy, children can undergo another allergy test to see if they have ‘outgrown’ it. For food intolerance which usually does not result in fatal reaction, small amounts of food can be re-introduced in different forms to see which form/amount can be tolerated. There is no cure for allergy or intolerance; however, for certain food intolerance, enzyme supplements can be taken beforehand to digest the food to be ingested e.g. lactose.

Here’s a graphic for recap!

Is it Food Allergy or Food Intolerance? Graphical representation
Is it Food Allergy or Food Intolerance?
Eczema Tips Youtube EczemaBlues Channel

(Video) How to Moisturize Baby Sensitive Skin

This is the fourth of baby skincare series, focusing on shower. The previous three videos were on Common Baby Rash I Sun Protection for Kids I How to Shower Baby. I NEED YOUR SUPPORT, do subscribe to my EczemaBlues channel here. As I’m just starting out, and camera-shy, the video is my voice over slides that I prepared. Do share your comments pleeease on how I can improve them.

Firstly, for babies with normal skin, it may not be that critical to moisturize (but good practice since baby’s skin is thinner and more susceptible to moisture loss). However, for babies with dry skin or eczema, moisturizing has been studied to reduce the need for topical medication and lessen the severity of eczema.

Many parents ask what is the best moisturizer to buy? In short, there isn’t a best one in terms of formulation but one that your child likes and within your budget to use generously. The functions of  moisturizer deal with maximizing moisture for the skin while acting as additional protective layer. Choosing a moisturizer that is without the top irritants is a wiser purchase than starting with the cheapest (and leading to irritated skin).

How to moisturize is also covered in the video, and the main thing to remember is always right after shower. For expert tips on reading skincare product label and moisturizing, click on the links.

Do watch the video for more details and as always, appreciate you sharing your experience, thank you!

Video Photo Credit: lupinoduck via Compfight cc

Eczema Tips Youtube EczemaBlues Channel

(Video) How to Shower Eczema Baby – More or Less?

This is the third of baby skincare series, focusing on shower. The previous two videos were on Common Baby Rash and Sun Protection for Kids. I NEED YOUR SUPPORT, do subscribe to my EczemaBlues channel here. As I’m just starting out, and camera-shy, the video is my voice over slides that I prepared. Do share your comments pleeease on how I can improve them.

Now on how to shower your baby, the foremost is to recognize that your baby’s skin is different from adult skin – it is thinner and more susceptible to loss of natural oil and moisture. Also, babies (despite all their poop and pee) are not ‘dirty’ and showering can be limited to once in 1-2 days, depending on the weather, humidity and sweat.

Showering is drying to the skin, as it is akin to washing off the protective layers of skin cells and therefore, long and hot shower is to be avoided. For babies with eczema, it is MOST important to moisturize right after shower. As to what shower to use, it can be non-fragrance bath oil, colloidal oatmeal bath and for babies who are bathed in a tub, it’s good practice to shower the hair after bathing the baby so that he/she won’t be soaking in used shampoo. For more expert tips on how to bathe your baby, check out the tag link ‘bath’.

Do watch the video for more details and as always, appreciate you sharing your experience, thank you!

Eczema Tips Youtube EczemaBlues Channel

(Video) Common Baby Rash – Ok or Not?

First of all, I’m starting to incorporate videos into my blog, so that parents who are busy or who likes to view videos on Youtube can access to the vast skincare, nutrition and parenting tips for eczema families! I NEED YOUR SUPPORT, do subscribe to my EczemaBlues channel here. As I’m just starting out, and camera-shy, the video is my voice over slides that I prepared. Do share your comments pleeease on how I can improve them.

So, this video is part of baby skincare series, where the first thing to do is to recognize if the baby rash is one of those common ones which you needn’t be worried about, or eczema (which you have to be). Common baby rash are:

Baby acne – due to hormones and will clear on its own

Milia – due to trapped skin and will disappear on its own

No specific treatment needed for above, only gently cleanse the baby’s skin.

Heat rash – due to clogged pores as baby’s sweat glands are underdeveloped and occlusion from thick clothes and blanket can trigger the heat rash. Choose light clothing and don’t over-wrap the baby! Baby’s skin is not able to regulate body temperature as well as adult’s.

The other common rash is cradle cap, where you can find more in link here.

Diaper rash is also another common rash, which is a form of irritant contact dermatitis. Air the baby’s bottom, gentle cleanse it and choose a non-fragrance barrier cream.

Eczema is one of the common  baby rash (affects 20% of children) which is NOT OK to leave untreated, particularly if your child’s eczema is more than mild. I made the mistake of not recognizing it, and on hindsight, I ought to have known as my baby was twitching and trying to rub her face on the pillow.

Do watch the video for more details and a transcript is also included (in case you want to tune out my voice!). This is my very first skincare video, appreciate your comment, good and bad! Thank you!

Eczema Tips

Speaker for Baby care Festival 2014 on Skincare

My talk 'Caring for Baby's Skin' at Singapore Expo, Babycare Festival
My talk ‘Caring for Baby’s Skin’ at Singapore Expo, Babycare Festival

Last Saturday I was invited by Bayer Healthcare to speak at the BabyCare Festival 2014, a national baby expo held in Singapore. As Bayer was introducing their nappy barrier ointment Bepanthen to parents, they invited me to share about baby skincare. I delivered a 30-minute info-packed presentation on ‘Caring for Baby’s Skin’ that covered common baby rash, shower, moisturizing, sun protection and washing/use of detergents. These topics will be shared with all of you via video next month on my blog and EczemaBlues youtube channel.

It turned out that I enjoyed the speaking engagement thoroughly and was thinking before my talk that the time spent would be worth it if I can help just one parent to care for their child’s skin (20% of children have eczema, so it may be a 1 in 5 chance that I helped!). I would love to do this more often, and discovered that after so much time learning and writing on this topic, I could speak without looking at the slides (which I didn’t really get to as the speakers were obscuring my view), good that I know the topic inside out.

For those of you who would like to invite me to speak, just drop a comment here or fill in the Contact Me form.

Doctor Q&A Eczema Tips Youtube EczemaBlues Channel

AAD Skincare Video Series: Skincare for Eczema

How to Get the Most from Skincare Products with Dr Joshua Zeichner AAD Video

Today’s video is “How to get the most from your Skincare Products“. For this video, I’ve interviewed Dr Joshua Zeichner, M.D., who is the Director of Cosmetic and Clinical Research in Dermatology, Mount Sinai Medical Center in New York and board-certified in Dermatology. He is Board Certified in Dermatology and considered one of the country’s key opinion leaders in treating acne and rosacea.

  1. Face Washing 101
  2. How to Get the Most from Your Skincare Products
  3. Eczema Tips: How to Help your Child Feel Better
  4. How to Apply Sunscreen

MarcieMom: Dr Zeichner, thank you for taking time to help with this AAD video series. 

Cross-Reactivity in Beauty & Skincare Products

For individuals with sensitive skin using multiple products, say facial cleanser, moisturizer and make-up, is there any guideline to ensure that there is no cross-reactive ingredient? e.g. choosing the same brand or ensuring that each does not have certain ingredient?

Dr Joshua: If you are sensitive to skin care products, your dermatologist can perform patch testing, an exam to determine what ingredients you may be allergic to.  You should avoid products with those particular ingredients.  Unfortunately, you cannot necessarily just stick to one brand because individual products do vary in their composition.  However, some brands in general do stick to being fragrance free, etc.

Medication or Moisturizer – Which to Apply First?

MarcieMom: It is recommended to wash the face first, followed by medication, then moisturizer or sunscreen, followed by make-up. What is the interval between applying moisturizer and sunscreen? Does the moisturizer have to dry before applying sunscreen? 

Dr Joshua: We do not have great data on this.  We do not really know if it is best to moisturize or medicate first.  In general, I recommend applying one product in a thin layer, allowing it to dry for about 60 seconds, then applying the next layer.  If you apply too much cream it may take longer to dry.

Does sunscreen have moisturizing effect and therefore, can skip applying moisturizer? 

Dr Joshua: Only if you are specifically using a facial moisturizer with sunscreen. Straight sunscreens for the beach are not designed to be moisturizers.

Common Irritants for Children Eczema Skin

MarcieMom: What are the ingredients that frequently irritate a child’s sensitive/eczema skin?

Dr Joshua: Usually fragrances and preservatives

MarcieMom: Thank you Dr Joshua for your reply, I’d be sure to remember applying moisturizer even when I’d be applying sunscreen for my child with eczema, and thankfully, we found skincare products that don’t irritate her eczema skin.

Doctor Q&A Eczema Tips Youtube EczemaBlues Channel

AAD Skincare Video Series: Face Washing

I’m inspired by the efforts of like-minded individuals and organizations around the world to help eczema families via social media platforms. I came across American Academy of Dermatology (AAD) on Pinterest and they had pinned a Dermatology A: Z Video Series. I asked to feature their videos here, and their team of public relations is helpful and responsive, and made the special effort of introducing me to dermatologists who assisted with my questions and together, we made this series available to you.

  1. Face Washing 101
  2. How to Get the Most from Your Skincare Products
  3. Eczema Tips: How to Help your Child Feel Better
  4. How to Apply Sunscreen

Today’s video is Face Washing 101 and I’ve interviewed Dr Jessica Krant MD MPH, who is a board-certified dermatologist, member of the American Academy of Dermatology, 2017 Castle Connolly Top Doctor, and founder of

Face washing Dr Jessica Krant AAD video baby sensitive skin

MarcieMom: Thank you Dr Jessica for kickstarting this AAD video series! Today’s video sounds pretty basic, but I’ve some questions that still puzzle me, particular for those with sensitive skin. 

Face Washing for Toddlers

How should the face of a toddler be washed? Should the cleanser or bath oil for the body be used for the face? or is it not necessary to specifically wash the face except a quick rinse during shower?

Dr Jessica: Just like every adult has different skin, every toddler does too. Some might also be a little messier. It’s safe to wipe your toddler’s face clean with a towel soaked in warm water. Soap is really not needed, except on rare occasion, or if your own dermatologist has suggested something specific for certain medical conditions like seborrhea, eczema or baby acne. Cleansing bath oils or lotions that are soap-free are safe to use during bath time, as long as they are kept away from the baby’s eyes.

Face Washing for Child with Eczema

If the child has facial eczema, say weepy cheeks, how should the face be washed? Is that a sign of infection, and if so, what different measures ought to be taken?

Dr Jessica: Facial eczema with weepy cheeks can either be a sign of moderate to severe eczema with a broken down skin barrier but no infection, or a sign of skin infection in some cases. If unclear, it’s best to take the child to see a dermatologist so any risk of scarring is minimized, since babies and toddlers will definitely scratch itchy face skin and it’s hard to prevent that. No change should be made in the facial washing routine except to be extra gentle so as not to further irritate the rashy areas. Make sure any moisturizers aren’t stinging the skin and making it more itchy, and use ointment-based topical medicines rather than creams where possible.

Cleaning a Child’s Eyelids

In the video it is mentioned that the skin around the eyelid is delicate, and I would assume that for a child it is even more so. Would wiping with lukewarm soaked cotton pad be sufficient to clean the skin and remove the oil on the eyelid?

Dr Jessica: When necessary, wiping with warm water is a good way to clean a baby’s or toddler’s eyelids, but just make sure that any item used like a cotton pad, won’t come apart and leave small cotton fibers behind on the lids or lashes which could irritate the baby’s eyes.

It is recommended in the video to wash the face twice and after sweating. Is this recommendation the same for a child?

Dr Jessica: No, I think it would be best to wash a baby or toddler’s face as little as possible with anything other than warm water. A gentle soft cloth with warm water would be fine if there is any food or mucus at any time, but cleansing with anything else should be once per day or less often. And babies don’t really sweat, so there should be no extra cleaning unless there is actual dirt or mud present.

MarcieMom: Thank you so much Dr Jessica, indeed, I’ve to be careful of the cotton pads leaving residue on the eyes, particularly as my toddler tries to do it herself!

Eczema Tips

Itchy Scalp of Eczema Child

It’s my monthly Take-To-Twitter for tweet wisdom, and for this month, I’ve asked dermatologists ‘How to Deal with Itchy Scalp of Eczema Child?’ It’s not the first time I’ve covered scalp in my blog – there’s the scalp eczema series with celeb hairstylist Kristan Serafino (who styles A-list celebs like Matthew McConaughey), and various posts on cradle cap here. But still, MY OWN CHILD’s Scalp is Itchy every night! It sparked my curiosity and I took to twitter to ask skin experts for their tips:

@MarcieMom asks experts on how to deal with itchy scalp of eczema toddler
@MarcieMom asks experts on how to deal with itchy scalp of eczema toddler

Dr Claudia Aguirre says “Try an oil scalp massage – relaxes baby and dissolves flakes. Follow with SOFT brush and then wash gently. You can use even coconut oil for a little massage to loosen the flakes and comb it through. Then wash off gently.”

Dr Anne Ellis says “Frequent application of bland moisturizer like Glaxal Base, sparing use of low dose hydrocortisone with canesten 1 percent each.”

Dr John Ashworth says “The scalp is another area of skin that needs moisturising like anywhere else; problem is there is lots of hair on scalp, and therefore treating the scalp is tough and time consuming, but can usually be helped with the right approach.”

Dr Jessica Krant says “Itchy Scalp of Toddler, cradlecap, can be improved by dissolving flakes with olive oil first.”

Dr Robin Schaffran says “For eczema itchy scalp, try a dandruff shampoo with zinc, a 1% hydrocortosone lotion 2 times daily or ask your doctor for a prescription.”

From the above replies, it seem like there is still a need to treat and moisturize the scalp. Frankly, I haven’t been doing either because it seems like an impossible task to get through the hair onto the scalp to apply lotion. Especially, when given how late we get back home, getting Marcie into bed by 11pm is already a challenge. We’ll see… how about you? Share in the comments!

Eczema Tips

How to Support your Spouse be a Better Parent

How to Support Spouse Parenting Eczema Blues
Tweet Wisdom from Around the World

Last month, I’ve interviewed Bruce Sallan, founder of #DadChat, and one of the question was “What do you suppose a wife can help her Spouse to Be a Better Dad?”

Bruce’s reply was: This question made me smile. I will first answer simply of my wife and myself. Personally, I need validation. When my wife praises me, it reinforces my good behavior. When I’m doing a good job, I want to know that those around me – especially my wife – not only notice, but appreciate it. So, verbal affirmation is very important for me.

That said, just as we often say that what we parents “model” is what our kids will learn, I think a wife modeling good parenting will rub off on her husband. But, men tend to be dense and sometimes we men need to be hit over the head to get a point. So, this is where communication comes to bear. Sit down with your husband and talk. Never assume he will simply know what to do – or what YOU want him to do.

And I’ve got hooked on finding out from more Dads what they think, because frankly, parents with eczema child (“ME”) do need help and reminders, esp. when sometimes eczema consume my mind, instead of supporting my spouse or parenting.

So here are some tweet wisdom from Dads:

Mocha Dad: The main thing spouses can do is understand that dads do things differently and accept that his way is okay.

Harley Rotbart MDTake over your partner’s chores a couple times a week so he or she can spend more time with kids.

Scott Wild: Coaching legend John Wooden once said the most important thing a Dad can do for his kids is LOVE their mother!

Jim Martin: It’s also important to provide a safe space for dads to discuss approaches that are different from the moms.

GeekDad248: Always take time to listen

Tony Leachon MD: We fail to be better dads if there’s no clarity of thoughts to motivate them. Wives should remind busy dads. A good chat before bedtime and periodic trips together can be bonding time to discuss steps to enhance role as dad.

I then decided to ask the ladies, and here are their tweet wisdom:

Marion Ross PhDLead by example, communicate better, drop judgment and be compassionate

Dr Vicki PanaccioneGive positive reinforcement to anything he does that makes him a good parent ie “I love it when you _______ with the kids!”

Crystal Marcos: Reinforcing what the other says. Making sure that one parent isn’t contradicting the other.

Emily KnightLove it when my hubby takes the time to tell me I’m a good parent. It makes me feel noticed and appreciated.

Heidi Murkoff: The way I see it, there is nothing that a mom can do that a dad can’t do just as well if not better given the chance. The problem is, often moms (&media) don’t give dads a chance – there are too many expectations that moms do a better job, but not so.

Deborah Gilboa, MD: Explore common goals (for the child’s life and parenting outcome)

Naomi Richards: My thing is you need to parent together and use same rules etc.. Get some time just the 2 of you to discuss how to parent. Be difficult to support spouse if don’t agree with parenting skills. Be collaborative and discuss first.

I think many men and women are different when parenting – depends on who has children – if separate or together. I think back him up if you think he is doing the right thing. If not – discuss away from the children how you see things differently

Anne Parris: I try not to contradict him when he’s parenting the children. It’s hard!

Christy GarrettAgree to disagree when comes to compromising on a disciplining solution. And plan parent kid date nights.

RaiseSavvyKidsEmpathy, even if it means one partner taking a back seat, goes a long way. It’s like leading from behind. And there are many smart women who know how to adapt depending on the situation.

Lisa Sunbury: My best advice is to model, resist criticizing & allow spouse to develop their own relationship with child.

Alicia Gonzalez: We have to stop thinking “our” way is the only right way. When spouse wants to engage in it, don’t criticize it.

Mary Jo Rapini: Extract from her post:

When your husband does a loving act for your child say aloud, “Did daddy do that for you?” Follow that with, “You have a great dad.”

Respect your husband as your child’s father. Never cut your husband down in front of the kids. Eye rolling, or shushing your husband are passive aggressive forms of disrespect. Kids know what they mean.

Understand time pressures and give him a break. Helping him make one day of the week his with the kids is good for everyone.

Dawn LanteroRead a parenting book together and discuss it. Set a calendar with couple time, family time and individual time.

Kelli Smithgall: My thoughts on this are to not criticize, extend grace, and prayer.

Eczema Tips

What Foods for Eczema Kid – Tips from Nutritionists, Dietitians and Experts

This blog has featured many experts and there are still many more who are working on bringing you a themed series to help your eczema child. There are yet many many more who are helpful over social media, and so for the past weeks, I took to Twitter and Google Plus to ask nutritionists ‘What Foods do you recommend for Eczema Child?’. Many nutritionists and dietitians kindly offered their take, so much that pediatrician and skin experts also chipped in!

Foods for Eczema Kids Nutrition

Nutritionist PhiVan Ha at Nutrition4Women

My theory for eczema is caused by high acidity in the body. Recommendation: eat more alkaline foods & try magnesium  supplement (65mg is the safe dosage for kids). Green vegetables, beans, peas, seeds, nuts and unrefined grains such as brown rice and whole-wheat products are high in magnesium. Some people also swear by magnesium oil as a topical treatment. My problem is acne and magnesium has helped a lot.

I’ve found an article on magnesium on Livestrong here.

Dietitian Judy Converse MPH RD at NutritionCare RDs often don’t realize dairy proteins frequently cause eczema, how to test, & that soy is not always ok as a substitute.

Judy has previously helped with Eczema Kids Nutrition Series, and a relevant extract below:

Anti-inflammatory, probiotic foods are good for everyone. Though there is plenty of debate on this topic, this generally means eating a plant strong diet: Lots of fresh raw organic vegetables, greens, and fruits, along with traditional fats like those from organic meats or dairy products, butter, whole unprocessed, unsweetened organic coconut milk, olive oil, and oils from organic raw nuts and seeds. Humans have always made and eaten fermented foods. If you don’t like or can’t eat yogurt, kombucha, kim chee or sauerkraut, naturally cured meats, poi, or other fermented foods, or if you don’t have access to safe raw dairy products (which contain healthful fats and enzymes that are altered or lost when pasteurized), you can supplement with probiotics. There are now hundreds of probiotics products available. Look for diverse strains and high potency, over 15 billion colony forming units (CFUs) per dose. I often use much higher doses than that in my practice.

Dietitian Maryann Jacobsen at RaiseHealthyEaters Eczema is usually not related to diet but one study showed organic milk may help prevent it

Nutritionist Mary Hartley at AskMaryRD  It’s an individual thing. Know which foods bother you, don’t mistake a diet cause for stress.

Dietitian Kelly Jones MS, RD at EatRealLiveWell

Try eliminating dairy & increase intake of omega 3 and water. Any food intolerance could possibly be related though can have reactions to dairy that don’t seem like true allergies. Water intake can relate to inflammation and the immune system.

Nutritionist Jan Katzen CN at NutritionforLearning High vitamin or DHA cod liver oil & other anti-inflammatory essential fatty acids (EFAs) (with supplementing nutrients for utilizing from whole foods) helps eczema. 

Dermatologist Cynthia Bailey MD at DrBaileySkincare Vegetables, carrots, no cow dairy, watch the gluten, minimize refined sugar. This is my opinion and not based on science.

Pediatrician Cigal MD at MomMedicine Foods should be individualized by an allergist.

Laura VR Bertotto at VMVHypoallergenics I know nutritionists live the Mediterranean diet for kids, too. My mom’s very big on healthy oils for eczema for sure! 🙂 (side note: Laura’s mom is Dr Verallo-Rowell, dermatologist who on worked on Sensitive Skin Product series with me here)

Nutritionist at FitnessRepublic

Although most foods and supplements have not shown promise in eczema research, research is ongoing. For example, some studies suggest that probiotics may help relieve the symptoms of eczema in children. Probiotics are a type of live bacteria. They can be found in foods like yogurt and in some supplements. Most of these studies were done in other countries and tested different kinds of probiotics. So it is not clear what type of probiotics are most useful. “More research in this area is surely needed before we can make a definite recommendation,” says Cambio.

Another food being studied as a benefit for eczema is tea. Although there is no definitive evidence, a few studies suggest that drinking black, green, or oolong tea may help relieve eczema symptoms. Omega-3 fatty acids found in fish and fish oil, which help fight inflammation, are also being studied for eczema.

Note: above tips may not have been conclusively proven in studies but are friendly suggestions given over social media. For eczema and diet studies, see here.

Eczema Tips

My Food Grading System for Eczema Child’s Diet

ood Grading for Eczema Child
What do you think of my food grading system?

This is a post to share my food grading system that I use with Marcie (my eczema toddler). Now that she’s older (3+), she certainly knows what’s good and what’s not good. We play a simple game with her, especially during buffet, by going through the dishes and saying, this is GOOD! (THUMB UP ACTION) or this is NO GOOD< THUMB DOWN! Those on the good list, such as broccoli and shiitake are also anti-inflammatory foods, which though no study confirmed benefits for eczema, certain compounds of the food are anti-inflammatory, read more here and here (from Julie Daniluk, TV nutritionist’s recommendation).


Eczema Tips

Parenting Tips for Eczema Children – Distracting from Scratching

Tips Scratching Eczema Distraction

For the past week, I took to Twitter to ask parenting experts their tips to distract eczema children from scratching. Why?

Because I realized that close to 2 years after this post – Saying (or Shouting) Stop Scratching to your Eczema Child, communicating effectively (other than shouting stop scratching) remains a difficult task for many families with eczema children, including myself!

So here are the responses, and many other friends around the world on Twitter also chipped in their tips! Add yours to the comment, and also let me know which one works best for you!

Tips from Parenting Experts & Expert Moms

Shara Lawrence-Weis, mother of 4  with background in education, early childhood & nanny work.

“Scratching might hurt your skin. Let’s think of other things you can do to help the itching.”

Dr Lynne Kenney, mom, mother of two, a practicing pediatric psychologist and author of The Family Coach Method.

“Did u know scratching is self-reinforcing cause it can release dopamine? Distraction from scratching is about finding other ways to use ones hands and still release dopamine (link)”

Erika Brodnock, mum of 5 & CEO of Karisma Kids that helps raise happy, confident & creative children.

“Gently patting the itchy areas while singing a song distracts in very itchy moments!!”

Dr Melissa Arca, Pediatrician, mom of two, writer, and blogger at Confessions of a Dr Mom.

“Empathize: “Ooh, I know you’re itchy”. Action: “Let’s put some lotion on instead of scratching.”

Shadra Bruce, creator of and also an author.

“Keep their hands and minds off the itch by keeping then focused on being creative! Arts, crafts, and hands-on helping moms.”

Mary Hartley, RD, Nutritionist, with her own practice

“Time to get moisturized!”

Shonette Bason, mom of 4 children and works full time as an outstanding primary teacher, author and consultant trainer for Early Years Education.

Dough Disco (practising finger muscle control with dough and music!) is good for hands distraction!”

Ann Wu, MD, MPH, mom to eczema kids, Pediatrician and asthma researcher at Harvard medical school

“I usually say, “I know–it feels so good to itch! But I don’t want you to look like a red bean popsicle.”

Tips from Tweeps (friends who tweet):

I admit I do say Stop Scratching! followed by Put on some lotion! – Maria Wen Adcock, BiculturalMama

Today I fashioned some footed pajamas…using Egyptian magic cream and seeing what happens and it worked great. For the first time in almost a year, he slept without one scratch…I stayed up all night watching tho – Veena Goel Crownholm, Tiarastobabies

Perhaps – “It’ll hurt” – Harleenas

Sitting in a bath with some baking soda – MVOrganics

Depends on itch. if unthinking idle itch can simply put something in child’s hands, or distract non verbally. also need to accept that true burn of ezcema canNOT be ignored. so it depends on the habits and state of eczema flare – SarahJChapman

Depending on age, u could discuss beforehand and have a keyword that u both decide on that you say to remind them to stop. – Michelle Winters, Pediatric Sleep Consultant VASleepCoach

Make it a game: ‘I bet you can’t leave your arm alone’ – Ali_Nguyen

If you reduce the itch then hopefully they will stop scratching! – Dermasilk

Eczema Tips

Best of 2012 MarcieMom Eczema Twitter Tips – On Hygiene, Nutrition & Lifestyle

Last but not least, the Best of 2012 MarcieMom Eczema Twitter Tips would also include tweets on hygiene, nutrition and lifestyle! I’m passionate about these – prevention of staph infection through good hygiene and prevention of diseases and obesity through healthy eating and living! Also tons of gratitude to world renowned experts who help me in these topics!

110 of 366 MarcieMom Eczema Tip – Apply chlorhexidine to clean staph bacteria before applying steroid and moisturizer

Marcie’s doctor, Prof Hugo van Bever, told me about staph bacteria and advised using chlorhexidine. And I’m much honored to have Dr Clay Cockerell, board-certified dermatologist and dermatopathologist in U.S and ex-president of American Academy of Dermatology in this Staph Bacteria Series.

Dr. Clay Cockerell – Board-certified Dermatologist and Dermatopathologist

136 of 366 MarcieMom Eczema Tip – Swimming is part of healthy lifestyle for kids and can help to remove harmful bacteria on eczema skin

Another health authority that has helped in this blog is Dr Sears Lean team. Dr Sears is possibly the most well-known pediatric doctor in the US and I’m honored that his team helped out in this Dr Sears L.E.A.N series.

108 of 366 MarcieMom Eczema Tip – Avoid obesity in kids as this is associated with eczema

201 of 366 MarcieMom Eczema Tip – Sugar is inflammatory, avoid inflammatory foods

I’m honored to have registered dietitian, Toby Amidor, to help out in this Eczema Kids’ Nutrition Series.

Toby Amidor, MS, RD, CDN (picture credit:

242 of 366 MarcieMom Eczema Tip – Kaempferol, phytonutrient can reduce allergic reactions

Another nutritionist I’m very honored to work with is Julie Daniluk. Julie is passionate about meals that heal inflammation, and shares much on nutrition on her numerous TV and radio shows. Read here for her healthy recipes.

Julie Daniluk – TV Host & Nutritionist (picture credit –

265 of 366 MarcieMom Eczema Tip – Don’t limit choice of sports for kids, of greater importance is skin care and applying creams correctly 

Another doctor I had the chance to work with is Dr Lynn Chiam, a consultant dermatologist who is very willing to share her insights with parents of eczema children. Read her Teen Eczema series and Facial Eczema series.

Dr Lynn Chiam, a consultant dermatologist who subspecializes in paediatric skin conditions

286 of 366 MarcieMom Eczema Tip – Your jewelry & cosmetics may be causing facial eczema 

AAhhh… a wonderful year of 2012 and blessings to all eczema families!

Doctor Q&A Eczema Tips

Reinforcing Amount to Moisturize Eczema Child

Dr Benabio (DermDoc) is board certified in dermatology and is a fellow of the American Academy of Dermatology. He is also the author of numerous scientific articles, a book and quoted in notable publications such as O, The Oprah Magazine, Dermatology News, Dermatology World, CNN and WebMD.  He is the chief of dermatology at Kaiser Permanente, San Diego.

Moisturizing Amount and Childhood Eczema with Dr Jeff Benabio

This is a combination of two previous posts – the first one was an explanation of Dr Benabio’s ‘Great hack to help your kid with eczema’ video that he tweeted me and the second a short Q&A with him. The videos are no longer available which is why I’ve combined the two posts into one to be more informative.

DermDoc Video on moisturizer use

The simple message is to moisturize your child enough.

How much is enough? It’s about half ounce a day, equivalent to about 12 pumps. Dr Jeff Benabio has an insanely simple way to hold your kid responsible for moisturizing enough, i.e. by marking the bottle. Also, parents tend to underestimate the amount of moisturizer to put on our child.

I’ve blogged about this before, as I also have wondered how much is enough. Here’s the link to my post How Much Moisturizing is Enough? I mentioned 400-500ml/week!

Causes of Childhood Eczema

DermDocchildhood eczema causes

Marcie Mom: In the video, Dr Jeff explained that eczema is mainly due to an overactive immune system and damaged skin, where the damaged skin allows bacteria to penetrate, resulting in a vicious cycle of inflammation, itching, scratching and more damage to skin (more on causes of eczema here).

Here’s a question – For parents whose children are more likely to have eczema due to family history of eczema in parents or siblings, what would you recommend the parents to do before pregnancy, during pregnancy, after birth to reduce the likelihood of eczemaand/or the severity of eczema in the child? 

Dr Jeff: Great questions here. Unfortunately, there’s little that parents can do to prevent it. There is some evidence that taking probiotics during pregnancy and up to 6 months post pregnancy if breast-feeding can reduce the risk of eczema in the child. There is some evidence that some foods can make atopic dermatitis more severe if the child is allergic to that food. Common suspects include: cow’s milk, soy, nuts, eggs, and wheat. There’s some evidence that living on a farm can help — I’m not kidding. Here are a couple of links to studies:

Eczema Tips Guest Interview

Reducing Stress for Children

Reducing Stress for Eczema Children

Eczema families face higher stress due to the constant attention required to manage our child’s skin, including the itch and the scratching. Marcie Mom interviews Lori Lite, founder of Stress Free Kids®, who has a line of books and CDs to help children reduce stress, anxiety and anger.

Lori started her business when trying to settle her young son to sleep and reduce night terrors of her daughter. Her Indigo Dreams® audio book/CD series has been awarded the CNE Award of Excellence. Lori has been interviewed and/or featured in NY Times, MSNBC, ABC Radio, CBS News, USA Today, Web MD and Prevention Magazine. She is a certified children’s meditation facilitator and parenting stress expert and gained national attention when she appeared on Shark Tank.

What is Stress?

Stress is a reaction that affects our mind and/or body when we are confronted by a ‘stressor’ – something that angers, scares or worries us. For the child, stress can trigger or worsen the eczema – Dr Christopher Bridgett and Dr Claudia Aguirre shared about stress brain and skin connection.

Apart from impact on skin, stress can affect a child’s learning, sleep, emotions and ability to handle stressful situations. Not all stress is bad, as some normal stress encountered prior to a test may help the child to prepare for it. Unfortunately, with eczema, the stress can be chronic (just like eczema) as persistent eczema flares, scratching, lack of sleep and self-esteem can build up in a child.

How to Know if Your Child is Stressed?

MarcieMom: Lori, can you share with parents how we can identify that our child is stressed, in particular, for an infant or toddler? Can a new-born be stressed? (I’m thinking of all the writhing and fidgeting of my baby when her eczema already affected her at two weeks old!)

Lori:  Recognizing stress in new-borns and toddlers is difficult. As you noted, you felt your baby’s body language was telling you something was out of balance at only two weeks old. Babies that stiffen their bodies, arch their backs, grimace, and cry frequently can be exhibiting signs of stress. I always tell parents to trust their instincts. Parents, especially moms, know when something is wrong with their children. Keep an eye out for a change in your child’s behavior.  For example: clingy behavior is a sign of stress in toddlers. However, some toddlers are clingy. So if your child is usually not the clingy type and they are suddenly attached to your leg, then that would be a change in behavior.

Babies that stiffen their bodies, arch their backs, grimace, and cry frequently can be exhibiting signs of stress.

Some of the signs in children also include: no longer wanting to go to school, an increase in nightmares or night terrors, difficulty falling and staying asleep. Physical symptoms can present themselves as unexplained stomachaches, headaches, or other ailments. Sometimes the child will withdraw from friends and family members, or have frequent meltdowns, which is a common sign of stress for toddlers. It is important for moms or parents dealing with the additional challenges of eczema to be aware of and manage their own stress. Babies, children, and teens pick up on our stress. It is contagious and we must find healthy ways to manage stress and anxiety. We can set a great example to our family and send  a ripple of calm throughout the house.

Causes and How to Cope with Stress

In a survey of 1,206 young people, 44% are stressed over performance in school and 30% are stressed over family’s finances. In an article on, it is mentioned by David Code, author of “Kids Pick Up on Everything” that “Parental stress can weaken the development of a child’s brain or immune system, increasing the risk of allergies, obesity, or mental disorders.”

In other words, “Stress is highly contagious between parent and child, even if the parent is unaware of his or her own anxiety.”

Children cope with the stress they face, usually by doing activities that relax them, such as exercise, music, TV or talking to a friend. As a parent, we can try to help our child cope in a healthy manner, ways that help their mind and body and won’t cause harm such as hitting themselves or others.

Reduce Stress Techniques for Kids

MarcieMom: Lori, your books and CDs focus on a few techniques, namely breathing, muscle relaxation, affirmative statements and visualization. For breathing, you mentioned

(i)         Have your child lie on their back and put their hand on their belly.

(ii)        Take a slow deep breath in through their nose and let it out through their mouth with a gentle ah-h-h-h-h-h-h sound. (They should feel their belly rise and fall).

(iii)       Breathe in slowly through their nose and out through their mouth like they are trying to move a feather up in the air.

(iv)       Breathe in slowly to the count 2, 3, 4 and out 2, 3, 4.

(v)        In 2, 3, 4 and out 2, 3, 4.

For breathing and muscle relaxation exercises, which age is appropriate to start?

Lori: It is never too soon for a child to reap the benefits of relaxation and meditation. There are reports that state that stress levels during pregnancy can affect an unborn child. I used deep breathing throughout my last pregnancy and I believe that because of this my newborn was easier to soothe when I focused on my breathing. In general the age of 4 is when a child can start to participate in relaxation exercises, but I have seen children as young as 18 months copy breathing and positive statements. Self-care, relaxation and stress management can begin at any age and should be part of daily living. When you feel stressed, tell your children that you are takeing a minute to focus on your breathing. Add visualizing breathing in happy, calm air…Throw an affirmation in like, “I am calm.” Children will copy what they see. Don’t be surprised if they climb up on you lap and breathe with you.

MarcieMom: You also recommended using affirmative statements, and also asking ‘What-If’ positive scenario questions. What age is suitable for this, and can you recommend a few ‘what-if’ questions and affirmative statements that parents with eczema children can use? (I was thinking ‘What if you don’t feel itchy?’ but then I’m WORRIED that will get the child to think about the itch!)

Lori: As soon as children start asking “what-if” and inserting their own fear-filled or negative outcomes, this is the time to implement repeating their “what-if” question and finishing with a positive outcome. For example, the child says, “What if my eczema gets worse?” and the parent says, “What if your eczema gets better?” Another example would be if the child asks, “What if the kids laugh at me?” In turn, the parent should suggest, “What if you find friends that accept you?”  Many children with eczema have food based allergies and might say, “What if I can’t eat anything yummy ever again?” We can empower children by answering, “What if we find new foods together that we can have a picnic with?”

The important aspect in affirmative statements is helping the child see a positive side, and have them focus on a positive outcome that rather than negative. You intuitively knew not to use the word itch in an effort to avoid bringing attention to it. We also want to avoid saying “not.”

MarcieMom: Thank you Lori so much for giving us a few techniques to relieve the daily stress. p.s. to readers of, I did not receive any money from Lori or StressFreeKids for this interview

Eczema Tips

Is IPad a Good Diversion from Scratching?

Free IPad Apps Marcie Loves!

My hubby got me an IPad recently, so that I can tweet at night while still making sure that Marcie doesn’t scratch in bed (I’m @MarcieMom!). As expected (going by how the kids are hoarding the display Ipad in stores), Marcie loves the IPad and intuitively can swipe, squeeze (to zoom out) and stretch (to zoom out) her fingers! As all parents of eczema child know, scratching is bad but seems to feel good for the child, and we’re always looking for a way to keep them off scratching.

So, we’ve let Marcie play with the IPad, but only for no more than 30 minutes and only when she catches me tweeting on it (I don’t play any game, not yet anyway). I find that it’s effective when it comes to occupying her fingers, and the apps are so interesting! In the picture are Marcie’s favorite free apps – ABFree, Music Sparkle, Doodle Buddy and Coloring Book. Her fingers can be occupied with tapping the ABC, flicking the circle up and down the screen, tapping on crayon and drawing on the IPad! But as with all things, I googled to find out the impact of IPad on kids and I’m amazed that it helps special kids. Here’s a quick pros and cons list.


1. Catches the attention of the child – It’s better than scratching till blood and reinforces learning; you can always go for apps by trustworthy developers, see recommendations from Mums with Apps and here.

2. Helps special needs children such as those with speech or language delays or with cortical visual impairment or autism kids

3. Helps with motor skills, see this inspiring story on how it has helped a boy with debilitating motor-neuron disease


1. Makes the child become used to being distracted and switching tasks, instead of focusing (see here for NYT article)

2. The intense visual/mental interaction deprives the child’s brain from needed rest (another great NYT article)

3. Causes temporary deafness disorder as the ears tune out because the mind is tuning in so much (so kids really can’t hear what you’re telling them to do while they’re on IPad)

4. Not a replacement for human interaction and guidance which can build social skills and critical thinking skills

5. Rewards the child for short attention span and insignificant acts (think of games that give you a goodie/point when you just point here, go there)

6. Exposing your child to more advertising (as if TV is not enough!)

7. Lack of regulations on privacy and on tracking use of your child’s behavior when he/she is on the app

Lastly, we as parents can’t be hooked on the IPad ourselves (“Plugged-in Parents“) and deprive our children of needed attention! What’s your take on this?

p.s. See updated policy statement from Amercian Academy of Pediatrics