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Ask the doctor: How can I get my son’s acne and itchy skin under control?

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Sometimes there is no obvious cause for itchy skin, but allergies can be to blame

Sometimes there is no obvious cause for itchy skin, but allergies can be to blame

Sometimes there is no obvious cause for itchy skin, but allergies can be to blame

Q: My son complains he has itchy skin — right down to the soles of his feet. I only use skin-friendly products in the house and bought him paraben and sulphate-free shower gel and natural soaps, but he’s still complaining. I recently noticed his scalp looks red and irritated and wonder if he could have eczema. He also has awful acne but maybe this is unrelated?

Dr Grant replies:  Dealing with itchy skin can be difficult because often there is no obvious evidence other than some scratch marks. When scratch marks are noted, it is far from an ideal scenario, as persistent scratching can break down the skin’s natural barrier and lead to infection, inflammation and recurrent itch. You are probably right in assuming it is eczema, especially if your son suffered with it as an infant or there is a family history of eczema, asthma or allergy. The rash with eczema is typically dry, itchy, red, cracked and sore.

The mainstay of treatment involves applying lots of moisturiser several times per day. One of the best which is affordable and available is Aveeno. It’s formulated from oatmeal and even works well with sensitive skin. Sometimes mixing a cream moisturiser with an ointment or gel provides extra skin hydration. By cooling the cream/gel in the fridge it can provide additional relief and reduce the skin irritation. The three magic words are moisturise, moisturise, moisturise. After you shower, instead of drying your whole body with a towel, try to trap the water molecules on your skin with your favourite moisturiser.

Secondly, consider if your son has any allergy symptoms such as hay fever. Adding oral antihistamine medication can help block the itch sensation when there is an allergic component causing histamine release. Thirdly, you may need to attend your GP who can prescribe topical anti-inflammatory medication, either steroid or non-steroids to help reduce the inflammation in the skin and ease itching. One last thing to note is that you mentioned using paraben and sulphate-free shower gel. I suggest using a soap-substitute and wash with aqueous cream which can be found in any pharmacy.

When it comes to the scalp, a particular subtype of eczema known as seborrheic eczema is the most likely cause of your son’s irritated scalp. It can also affect the sides of the nose, eyebrows and ears. Look for shampoo containing one of the following ingredients; salicylic acid, coal tar, ketoconazole, zinc pyrithione or selenium. Try to vary the type of shampoo every few weeks and apply melted coconut oil or eucerin with urea scalp application regularly in between washes.

As for the acne affecting your son, it is a very common condition in adolescence and young adulthood with a significant negative psychological impact. Yes, I do think these are unrelated skin conditions but can often co-exist.

Topical combination products usually have various combinations of benzoyl peroxide, salicylic acid, clindamycin, adapalene or topical retinoids. These products need to be applied to clean skin at the same time every day for 6-12 weeks before significant improvement to be seen. Males tend to have more severe disease and are at higher risk of scarring.

Dr Jennifer Grant is a GP with Beacon HealthCheck

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