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Skin Care

Whether your child has a mysterious rash or is battling eczema, it’s helpful to have a pediatric dermatologist as part of your medical team because they are uniquely trained to diagnose and treat children’s skin.

“Childhood is full of ongoing physical and emotional changes, and a child’s skin changes a lot over the years,” said Craig Burkhart, MD, Burkhart Pediatric & Adolescent Dermatology.

Education is a big part of skin care. Dr. Burkhart recommends starting the conversation with children while they’re young using fun facts and tips that kids can grab onto and carry forward to develop lifelong healthy habits.

“If we teach children about how cool and important their skin is, they’re much more likely to be curious, aware and engaged in proper care,” said Dr. Burkhart.

We asked Dr. Burkhart to share some helpful insight and tips for parents and kids. Follow along for the skinny on common concerns and irritating skin issues!

Eczema Explained

Children with eczema (commonly referred to as atopic dermatitis) often struggle with repeated, annoying skin flare-ups. The most common symptom is a rash on arms or legs. Eczema is an inflammatory condition that is caused by an immune system reaction, which can be commonly triggered by allergens. Typically eczema begins in childhood, and one or more parent has likely experienced similar irritations at some point because it is often inherited. However, the different triggers are not always understood so the cause might be a bit of a mystery without expert guidance.

“Childhood is full of ongoing changes, and a child’s skin goes through a lot of change over the years,” – Dr. Craig Burkhart, Burkhart Pediatric & Adolescent Dermatology

Easing Eczema

A pediatric dermatologist can help provide some relief and management tips for children while working with a family to narrow in on likely triggers for a child’s flare-ups.

“It’s important for families to work with their doctor to determine the root cause of skin irritations so they can avoid it or eliminate the use of triggers and ease any suffering caused by eczema,” said Dr. Burhkhart. “It’s not uncommon for more than one thing to be part of the problem.”


When a child has an eczema flare-up, it is helpful for parents to try to track any possible irritants, including food, over the past few hours or even over the past day. “A rash, dryness or other
skin reaction could be caused by irritants, allergens, weather, or a combination of things,” said Dr. Burkhart. Working with your child’s pediatrician and a dermatologist can help you identify the causes. Keep in mind that removing a trigger can help control eczema, but it doesn’t cure it.

Picking Products

Parents can start troubleshooting skin flare-ups by avoiding the use of products with any of the following top allergens for children. When selecting baby products, the list below is a good reference for parents who have battled eczema and want to proactively prevent potential baby skin irritation.

  • Fragrances
  • Betaines
  • Propylene Glycol
  • MCI/MI*
  • Formaldehyde
  • Lanolin
  • Neomycin

*Methylchloroisothiazolinone and methylisothiazolinone

“Many sensitive skin products are priced much higher so parents wonder if it is necessary to use them for all children,” said Dr. Burkhart. “If your child doesn’t have eczema or the eczema is mild and easily controlled by other changes, you might not need to worry about picking special products.”

However, he does advise anyone with severe eczema, sudden flare-ups or ongoing concerns to shop wisely and proactively avoid top allergens. Otherwise, you might find yourself regretfully tossing out half-used soaps, shampoos, moisturizers and more when you realize they’re a problem for your family.


Washing and disinfecting your hands is a top recommendation for preventing the spread of germs, but all that scrubbing and soap can disrupt the top, protective layer of skin. Frequent hand washing with harsh products can lead to dry, irritated skin, inflammation and dermatitis, which is a reaction due to exposure to certain substances. Dr. Burkhart says it’s common to see young patients with very dry, irritated skin or frequent eczema flare-ups that cause a lot of concern for both children and parents.

“If a child has eczema, the risk and frequency of dermatitis increases,” said Dr. Burkhart.

Irritant contact dermatitis can be a big problem for adults or children whose hands are frequently wet. Repeated exposure to substances such as soaps, detergents, alcohol, and irritating chemicals can trigger a response and result in red, scaly skin and more severe concerns such as blisters and splitting.

Seasonal Flare-Ups

Seasonal changes in temperatures from hot to cold or vice versa can cause eczema to flare-up.

“The dry air of winter and increased exposure to indoor dust can be troublesome for many people,” said Dr. Burkhart. “Regularly applying a moisturizer to your skin is extra important in the winter when it tends to be drier.”

Throughout the year, each season can bring a new concern and logical prevention step for skincare. Wind, sun and extreme hot and cold temperatures are all reasons to take extra
precautions with protective layers. Whether it’s sunscreen, hats or gloves, parents can help prevent concerning skin conditions for kids by taking a few minutes to layer on whatever is most seasonally appropriate.

Dry Skin Dilemmas

Battling dry skin can be super frustrating, but the solution might be simple. Make sure your children learn to wash, rinse, dry and moisturize. Dr. Burkhart says you can easily resolve many dry skin concerns by washing with milder soaps, rinsing thoroughly, and completely drying the skin. He encourages families to keep a fragrance-free hand moisturizer nearby and to use it after hand washing or bathing and before bedtime. Here’s some additional tips:

  • Avoid hot water! Lukewarm is best.
  • A bath or shower is not necessary every day for children. Aim for 3 to 4 times a week.
  • Wash off chlorine from pools or saltwater to prevent dry skin.
  • Teach children to gently wash with a cloth or sponge; avoid harsh scrubbing.
  • Moisturize. Dry skin is a common concern for young children.
  • Stay hydrated. Make sure kids take activity breaks and drink water throughout the day.


Parents naturally worry when they spot a rash on their child. While some rashes will come and go quickly, others can persist and become both pesky and perplexing. Dr. Burkhart explains that irritants and allergens cause rashes.

Irritants – direct skin contact causes irritation and inflammation.

Allergens – cause the body’s immune system to have a reaction.

Examples of these include soaps*, cleansers*, air fresheners, creams, dyes and coloring, elastic in socks, foods, fabric softeners, fragrances, medications, metals, poison ivy, oak or sumac, pollen & mold, rubber applicators

WARNING! Seek immediate medical attention if your child has a rash and any other signs of concern, including the following symptoms:

  • Fever
  • Pain
  • Refusing to eat
  • Swelling or tingling of mouth, tongue or throat
  • Trouble breathing
  • Trouble swallowing
  • Vomiting
  • Eye soreness

* Industrial, long-lasting soaps and extra bubbly products are more likely to irritate the skin.

Choose gentler formulas to use whenever possible.


While most kids love the joy of a bubble bath and fun with foaming soaps, the harsh reality is that sometimes too much of a fun thing can lead to irritating skin problems. Bubble bath products typically contain surfactants, which lower the surface tension in water and create foam. Additionally, many bubble bath products contain fragrances. Unfortunately, surfactants and fragrances can lead to or aggravate contact dermatitis, dry skin and eczema.

There are plenty of other ways to add an extra splash of fun to bathtime. A few waterproof toys and a child’s imagination can go a long way. Washable finger paint can add a creative twist but Dr. Burhkart cautions parents not to overdo it since they do contain soap.

“For a bathtime party without skin irritating products, add in some glowing bath buddies or an underwater disco light and turn up the music,” says Dr. Burkhart. “For the brave parent who doesn’t mind mopping up a little water, a submarine spray station or other interactive toys can add an extra dose of play at the end of the day.”

Meet the Expert – Dr. Burkhart

Craig Burkhart, MD, MS, MPH, is one of eight board-certified pediatric dermatologists in North Carolina dedicated to the care of children and teens. Prior to opening Burkhart Pediatric & Adolescent Dermatology, PLLC, in Cary, he provided pediatric dermatologic care for infants, children, and teens for 11 years as a professor at the University of North Carolina School of Medicine. Every aspect of his practice is designed so that young people feel welcomed and valued. Dr. Burkhart sees children of all ages and is a local expert on everything from vascular lesions and birthmarks to eczema and acne. He treats conditions requiring excisions or laser surgeries in his practice and at WakeMed Cary Hospital.