Tips for keeping a toddler from scratching?

March 15, 2011 6:07 AM

I need a physical method of preventing my toddler from scratching her lower arm/wrist while she's in bed.

My kid is 28 months old and inherited my sensitive skin. She has a fairly chronic rash on her lower arms and wrists that we're treating under medical supervision. It's better for the most part, but one obstacle has been that she'll absolutely tear at the affected area while asleep or in her bed unsupervised, pushing up the sleeves of her pjs and scratching until she bleeds onto her sheets. We're between cycles of prescription-strength cortisone lotion, so the problem is worse right now.

So we need to physically prevent her from attacking the affected area, but I'm sot sure how to do it, beyond binding one of her arms up at bed time, which doesn't seem realistic. Any ideas for sleepwear or techniques we can use to reduce or eliminate the scratching?

Any additions or critiques of how we're prepping her? She gets a colloidal oatmeal bath every couple of days (which seems to help greatly but we're weary of diminishing its effectiveness by doing it daily), then cortisone lotion when we're on-cycle followed by neosporin on any fresh cuts and finally a layer of Eucerin. She gets a dose of benadryl before bed as well. Her skin, except for the places where she's broken the skin, appears healthy and normal now.

posted by Mayor Curley to health & fitness (21 answers total)

When I was a kid and my siblings and I all had chicken pox, my Mom put long tube socks over my little sister's hands to keep her from scratching at the sores. She was only a couple years old, and it did a pretty good job of preventing her from making the sores any worse.
posted by AzraelBrown at 6:11 AM on March 15, 2011 [1 favorite]

Something like these?

My sympathies. We had an unrelated problem w/ ours (disrobing) but discovered that there is a small industry devoted to various forms of customized toddler sleepware to address various bedtime issues.
posted by carter at 6:12 AM on March 15, 2011 [2 favorites]

My brother had horrible eczema growing up. He would scratch himself bloody. My parents used medical tape to secure big, puffy ski mittens onto his hands each night before bed.

At first, they tried socks - but he would pull them off and scratch in his sleep. Then they taped the socks in place, but the the weave of the fabric still let him scratch just hard enough to do damage. The slick nylon outer shell of the mittens, paired with the puffy fiber fill stopped him completely.
posted by MorningPerson at 6:38 AM on March 15, 2011 [2 favorites]

I don't have a behavioural suggestion but I do have treatment suggestions -- try a 12% 'ammonium lactate' lotion, like this Dermalac lotion. It is equivalent to the expensive, prescription-only-in-the-US Lac-Hydrin 12% (which is OTC in Canada but which is right now hard to find at a decent price on-line). Very effective. Slap on right after the bath.

In the bath: oil. Alpha Keri or whatever it's called, Neutrogena Sesame Oil, any "bath oil" will disperse well; plain baby oil is a bit messier but it works. (Shampoo -- tie up hair if it's long enough --- then add the oil.) I know, I know, oil in a small kid's bath? But we haven't had any issues with slipping here, and it makes a big difference.

(Advice comes from own skin issues, mild version of same in small child; knowledge of how to cheaply get the 12% OTC in the States thanks to US friend with small child with same-y skin. IANAD ofco but get way more relief from these two things than oatmeal or Eucerin, and they are more helpful in attacking the cause of the itch than cortisone)

We did once have kids' pajamas that had a thumb hole in the sleeve; not finding anything like it on-line in a cursory Google, but not a difficult alteration if something so small would be of help?
posted by kmennie at 6:39 AM on March 15, 2011 [1 favorite]

There is self-clinging gauze called Coflex that you could wrap his arms with: it looks like an Ace bandage, but it sticks to itself so it doesn't require clips or tape to hold. (I believe that you can also go to a pet supply store and ask for "vet"wrap," which is the same stuff but sold for use on animals. :7)

Good luck. One of my sons had a lot of itchy skin when he was little, and we tried every cream under the sun. Periodic use of something with a topical steroid in it helped, and he also grew out of a lot of it.
posted by wenestvedt at 7:02 AM on March 15, 2011

I know you said binding her arms seemed unreasonable, but . . . what if you put ace bandages on her wrists (as is she had sprained her wrists) -- leaving her fingers free but the rash covered?

My assumption is that the benedryl is working, but wears off during the night, and it's after it wears off that she itches? So, depending on when you give her the first dose, you could give her a second dose before you go to bed (providing that's 6 hours after the first dose). Or, ask the doc if there's a 12-hr version of benedryl-type medicine?

Poor thing. Sometimes I think itching is the worst thing ever. So minor and yet so consuming.
posted by MeiraV at 7:03 AM on March 15, 2011

My brother also had terrible eczema as a toddler. My grandmother sewed gloves and socks into one-piece pajamas to keep him from scratching himself in the night. He learned to use the zipper fairly quickly and then would undress himself to scratch, so they secured the zipper with a giant safety pin that he couldn't undo himself. I believe they were all-cotton garments, but MorningPerson might be on to something with the nylon instead. I think mittens would allow him to pull his hand back inside the sleeve to scratch himself, so gloves are the way to go there.
posted by aabbbiee at 7:05 AM on March 15, 2011

What about finding a rigid tube - cardboard shipping tube - to put over the arm with something that goes over the hand making it bigger than the opening of the tube.

(I had a rather itchy allergic reaction to something over the summer in the same area and, even as an adult, had great difficulty keeping myself from scratching it. Much sympathy to your kiddo, and I hope the itching stops soon.)
posted by sciencegeek at 7:25 AM on March 15, 2011

I've got two kids who had really bad eczema when they were little so I really sympathise with you and your daughter.

My wife and I used a colloidal oatmeal bath nightly on both of our kids, and I don't think it reduced its effectiveness. The bath really settled them as it became their bedtime routine and of course it helped to take a lot of the itching away.

With the cortisone creams - are you doing a wet wrap after the application? We gave our kids the oatmeal bath, then applied the creams, then wrapped them in a warm, soaking wet Bonds wondersuit (hopefully you will have a local equivalent), then wrapped a towel over the top to keep them warm, then sat and held the kid for 15 - 20 minutes after the application. The damp environment really helps with the absorption of the cortisone into the skin. It was almost miraculous how well it worked with my kids. We also applied Dermeze after the wet wrap to keep the skin moisturised.

We were also really lucky to get a fantastic paediatric dermatologist who was one of the best in Australia at the time - it may help to shop around to get the best advice re. medication. We were advised to just keep applying the cortisone creams (with wet wraps) every night until we could see visual improvement - usually 4 or 5 days, then stop. When the rash recurred, we just started the process over again. But, that was my kids, you'll have to seek your dermatologist's advice.

I think others have it with their suggestions for gloves, mittens etc. - we used Bonds Suits which have fold-back sleeves that become mittens. Anything constrictive isn't going to go down well with a two year old.
posted by KirkpatrickMac at 7:43 AM on March 15, 2011

Is it important to keep the skin exposed? Or will it be worsened if you cover her arm with something? I knew a kid with this same problem, and her parents eventually had success by wrapping the sensitive area with a bit of gauze, and covering it with the sticky, stretchy ace medical tape, like this. Sometimes they would moisten the cloth before wrapping it.

They also used an inner wet cloth, like described in this two-pajama guide.

Finally - if you're willing to consider another treatment to add into the rotation, I've had great success with the ShiKai borage oil lotion, and they now make a product for kids. I babysat some kids with eczema last year, and they had good success (not perfect, but it was useful) with the ShiKai borage lotion too.
posted by barnone at 7:49 AM on March 15, 2011

I'm really sorry you're having this problem. I don't have any personal experience with it but maybe one additional idea is a wrist brace.
posted by lakeroon at 8:30 AM on March 15, 2011

I have sensitive skin and a penchant for getting bug bites and chicken pox. The only thing that ever worked to get me to stop scratching and picking was really smooth fabrics. My dad got me footie pajamas with long, clingy sleeves, and I had smooth gloves - I think maybe a fake silk? It didn't solve it completely, but I rarely bled.
posted by SMPA at 8:32 AM on March 15, 2011

You need long pretty princess gloves! Make a huge gigantic deal over some Disney princess movie (ugh, I know) and buy the slippers and nightie and gloves - possibly the tiara too, and make it part of your night time ritual. She's got to want to keep them on or she will find a way to scratch through anything you try. Good Luck - toddlers are HARD!
posted by PorcineWithMe at 9:06 AM on March 15, 2011

I have dermographia, which means I sometimes get hives all over my entire body in response to touch stimulus. It sucks, because scratching makes it exponentially worse. The things that I've had good results with are 1) Zyrtec and Allegra, double-teamed if necessary, and 2) lidocaine gel to anaesthetize the area. It seems like lidocaine might wear off, but I would ask your doctor about children's doses of Zyrtec (cetirizine) and Allegra (fexofenadine), both of which are now OTC. In particular, I find that 10mg of Zyrtec controls my itching extremely effectively, far more than Benadryl.
posted by KathrynT at 10:40 AM on March 15, 2011

I haven't seen anyone mention diet, yet.

My toddler had terrible eczema, and your question describes our struggles quite accurately. All the things mentioned so far are potentially just treating the symptoms, not the cause. What finally got us past it was a visit to an allergist where the kid got both blood and skin testing and we cut out the positives from his diet. Eczema was completely gone within maybe two weeks.

Best of luck.
posted by NoRelationToLea at 11:17 AM on March 15, 2011

I have a dry skin condition that I passed onto my kids, and both I and my kids had nighttime itching issues very similar to what you describe.

Before you try anything fancier, try a sock on her hands at night. It may not matter that the sock doesn't cover the part she's scratching, the first goal is to make it so that casual scratching doesn't break the skin or irritate the affected area unacceptably. The sock over her hands may be enough to take the edge off of the scratching. (Obsessive nail grooming is also helpful!)

Since your kid is too young to understand, you may have trouble with her trying to yank off the sock (intentionally). You don't really want to make things too tight, lest you hamper circulation at night. You can experiment with tucking the sock/mitt over the pj's, which might provide enough additional resistance to prevent the little fingers from getting loose.

When I was a little kid, my mom sewed some mitts (they didn't even have a thumb in them) out of some really soft material, but with slightly tighter elastic by the cuff than you'd normally have on tube socks.

Sounds like you've found a good mix of creams that works for you / are derm approved. Just to cover all the bases, have you tried Aquaphor? It is goopier than Eucerin but a layer applied immediately before going to bed really does wonders for my boys when they are in an itchy mood. (For them, the extra goopiness seems to help more, and the socks on their hands prevents them from leaving a trail of Aquaphor slime.)
posted by QuantumMeruit at 11:22 AM on March 15, 2011

There is self-clinging gauze called Coflex that you could wrap his arms with: it looks like an Ace bandage, but it sticks to itself so it doesn't require clips or tape to hold. (I believe that you can also go to a pet supply store and ask for "vet"wrap," which is the same stuff but sold for use on animals. :7)

I was going to suggest this. It comes in hot pink, which a girl toddler might really like. It's comfortable. The vet wrap is about $2/roll at a farm supply store, which will last you awhile. It will be difficult for her to get off on her own. You should buy a safety scissors (also called bandage scissors or EMT shears - get these for $5 at Walgreens). Of course, if she has latex allergies, then never mind.
posted by desjardins at 11:25 AM on March 15, 2011

There are a lot of excellent suggestions here and I'm going to review them with my wife tonight and see what we think we can/should try first.
posted by Mayor Curley at 11:29 AM on March 15, 2011

If you're going to be using a lot of Vetrap or generic knockoffs, it's much cheaper from equine/pet supply places online. Also, the last time I went to buy an Ace bandage at a pharmacy, I couldn't find a normal one, but I found one that was like extra-thick Vetrap (self stick) and says it can be washed and reused. I don't know how accurate that claim is, but I know the product exists.
posted by galadriel at 11:51 AM on March 15, 2011

I admittedly have not read through all the responses.
I have eczema and have a friend with a small child that has the same as well.
The miracle thing that has worked for me.... coconut oil. just from he grocery store.
Though i am now seemingly becoming immune to its affects. I has worked for well over a year now.

As far as scratching. I'd say consider getting footy PJs and stitching mittens to them. I think altering what they sleep in and keeping it comfortable would help. If you have to strap stuff to them or have a whole ritual of things that go on at bedtime they might start to dread sleeping.

You could even make it fun.. make their mittens into sharks or other animal mouths!
posted by misformiche at 9:06 AM on August 28, 2011

and im not the only one with that idea. :)

http://thegiggleguide.com/launch/2010-11/new-jammies-llc/pajamas-offer-child-excema-sufferers-nightime-relief-0
posted by misformiche at 9:28 AM on August 28, 2011