Why is my child scratching?

Is your child complaining of feeling itchy, or do you find them scratching a lot? Here are several common conditions that can cause itchiness and irritated skin in kids.

Eczema

Eczema, also called atopic dermatitis, is a common childhood skin condition caused by increased sensitivity to common allergens in the child’s environment, including airborne allergens, ingredients in soaps and detergents, and certain foods.

Atopy (which is where the term atopic dermatitis comes from) is caused by a genetic defect that causes a child’s immune system to be hypersensitive to common allergic triggers. Children with eczema are also more prone to asthma and seasonal allergies.

Eczema often occurs in infancy, causing a red, scaly, itchy rash on the infant’s scalp, face, hands, and feet. In childhood, the rash usually appears in the antecubital fossa (the crease of the elbow), and the backs of the knees. Often the condition improves as the child matures and disappears by adolescence.

A variety of treatments can improve eczema, including topical moisturizers, hypoallergenic skin products, topical steroid creams and medications that reduce the immune system’s hypersensitivity.

Head lice

Lice are wingless insects that feed on human blood. While there are three main types of lice -- head lice, body lice and pubic lice (also called “crabs”) -- head lice are by far the most common type in children. In fact, each year in the U.S. there are as many as 12 million cases of head lice in children ages 3-11.

Because lice don’t have wings, they’re unable to fly. Instead, they move by crawling. They can be transmitted by close contact, infected furniture or shared belongings.

Head lice can cause intense scalp itching as well as a crawling sensation. They can also cause small sores to appear, most commonly behind the ears and along the nape of the neck. On close examination of the scalp, lice and lice eggs (“nits”) are often visible.

Over-the-counter shampoos that contain either pyrethrin or permethrin are usually effective. Prescription topical and oral treatments are also available if over-the-counter treatments don’t work.

Pinworms

Pinworms are a common human parasite that infects up to 40 million people in the U.S. each year. Pinworms are most commonly found in school-age children, their caregivers, and people who live in institutions.

Pinworms live in the large intestine and rectum. Female pinworms lay their eggs around the anus, which causes intense anal itching that’s often worse at night.

Pinworms are spread via fecal-oral transmission, which is why young children who haven’t yet learned proper handwashing techniques are at a higher risk of becoming infected.

An easy way to diagnose pinworms is called the “tape test,” where a piece of tape is placed over the anus and inspected in the morning to look for pinworms or their eggs that may have been deposited on the tape overnight.

The most common treatment for pinworms is a prescription oral medication that’s administered to the child, as well as their caregivers and any other household contacts. 

Scabies

Scabies is a skin condition caused by Sarcoptes scabiei, a mite that burrows under the skin, where it lives and lays eggs.

Scabies causes intense skin itching that’s often worse at night. Scabies causes small red bumps and small red patches to appear on the skin. It can also cause thin gray or white lines in the skin where a female mite has burrowed into the skin to lay its eggs. 

While scabies can cause diffuse itching, the rash is most commonly visible in the web spaces between the fingers and toes, along the inner aspect of the wrists, along the waist and in the groin.

The treatment for scabies is a topical treatment that’s applied from the neck down, left in place for 8-12 hours, and then rinsed off. To eradicate scabies, it’s also important to sanitize common surfaces and wash all clothing, bedding and other fiber-containing objects (called fomites), to make sure the mites are completely gone.

If a patient’s case of scabies doesn’t resolve with topical treatment, they can be treated with a course of oral medication.

 Visit an urgent care for pediatric care

If your child is feeling any itchiness, come see the experts at one of our urgent care locations. You can walk in without an appointment, or save your spot online. We’ll have you back to feeling better in no time.

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Sources:

https://www.mayoclinic.org/diseases-conditions/atopic-dermatitis-eczema/symptoms-causes/syc-20353273

​​https://www.mayoclinic.org/diseases-conditions/lice/symptoms-causes/syc-20374399

https://www.cdc.gov/parasites/pinworm/gen_info/faqs.html

https://www.cdc.gov/parasites/pinworm/gen_info/faqs.html

https://www.mayoclinic.org/diseases-conditions/scabies/symptoms-causes/syc-20377378

Written by Sarah Thebarge, Physician Assistant