What are the treatment guidelines for pediatric dermatitis caused by soap?

From the Guidelines

Treatment for pediatric dermatitis caused by soap should primarily involve stopping the irritating soap, using gentle cleansers, and applying moisturizers, as recommended by the most recent guidelines 1. The key to managing pediatric dermatitis is to restore the skin's barrier function, which is disrupted by soap stripping natural oils, leading to moisture loss, inflammation, and irritation.

Key Recommendations

• Switch to mild, fragrance-free, hypoallergenic cleansers specifically formulated for sensitive skin, such as Cetaphil, Dove Sensitive, or CeraVe.
• Apply moisturizers like petroleum jelly, Eucerin, or Aquaphor at least twice daily, especially after bathing while the skin is still damp to lock in moisture.
• For inflamed areas, low-potency topical corticosteroids such as hydrocortisone 1% cream can be applied sparingly twice daily for 3-7 days, as suggested by older guidelines 1, but with caution and under supervision due to potential side effects. Some important considerations include:
• Avoiding medium or high-potency steroids on children's skin, particularly on the face, as they can cause skin thinning.
• For severe cases with significant inflammation, a healthcare provider might prescribe a non-steroidal anti-inflammatory like tacrolimus (Protopic) or pimecrolimus (Elidel), based on the latest treatment algorithms 1.

Prevention Measures

• Use lukewarm water for bathing.
• Limit bath time to 5-10 minutes.
• Pat skin dry rather than rubbing.
• Dress children in soft, cotton clothing. These measures, guided by the most recent and highest quality evidence 1, are crucial for effectively managing pediatric dermatitis caused by soap and improving the child's quality of life by reducing morbidity and preventing potential complications.

From the FDA Drug Label

Uses temporarily relieves itching associated with minor skin irritations, inflammation, and rashes due to: ... soaps Directions for itching of skin irritation, inflammation, and rashes: adults and children 2 years of age and older: apply to affected area not more than 3 to 4 times daily children under 2 years of age: ask a doctor children under 12 years of age: ask a doctor

For pediatric dermatitis caused by soap, the treatment guidelines are to:

• Apply hydrocortisone to the affected area not more than 3 to 4 times daily for children 2 years of age and older.
• For children under 2 years of age, consult a doctor.
• For children under 12 years of age, consult a doctor before using the product 2, 2.

From the Research

Treatment Guidelines for Pediatric Dermatitis due to Soap

• The treatment of pediatric dermatitis caused by soap involves a comprehensive approach that includes routine general skin care, medical management of symptoms, identification and avoidance of aggravating factors, and attention to quality-of-life issues 3.
• Emollients, moisturizing agents that inhibit water loss and provide a protective coating, are recommended in all patients with atopic dermatitis, as they may reduce the need to use topical corticosteroids 4.
• Topical corticosteroids are the first line of treatment for patients with atopic dermatitis, and are available in several formulations and strengths 5, 4.
• The use of topical calcineurin inhibitors may be considered in children above 2 years of age who fail to respond to topical corticosteroids 4.
• A lipid-rich, moisturizing formulation of hydrocortisone butyrate 0.1% has been shown to be a well-tolerated and beneficial treatment for atopic dermatitis in children, with no evidence of adrenal suppression 5.
• Systemic therapy may be necessary for children with severe atopic dermatitis, and may include ultraviolet light exposure, systemic corticosteroids, and cyclosporine 3, 6.

Avoiding Aggravating Factors

• Identifying and avoiding aggravating factors, such as soap and detergents, is an important part of managing pediatric dermatitis 3, 4.
• Patients and their caregivers should be advised to avoid triggers that can exacerbate the condition, and to use gentle skin care products that are fragrance-free and hypoallergenic 3.

Medical Management of Symptoms

• Topical corticosteroids can be used to reduce inflammation and pruritus associated with atopic dermatitis 5, 4.
• Systemic agents, such as ultraviolet light exposure, systemic corticosteroids, and cyclosporine, may be necessary for children with severe atopic dermatitis 3, 6.
• Emollients and moisturizers can be used to provide a protective coating and inhibit water loss, reducing the need for topical corticosteroids 4.