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Ask all of your pediatric questions to our local Guru, Dr.Bill: Comments
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Signs of Childhood Leukemia
written by Erin Jones , October 15, 2008
Re: Dry red skin patch
written by Dr. Bill , September 29, 2008
Dear Karina,
What you describe could be eczema. The eczema rash usually is a dry scaley rash mostly found on skin surfaces that are rubbed a lot. The most common areas are around the elbows, knees, neck and waist area, but it can occur anywhere. The rash tends to be itchy. There are many causes of eczema, usually some sort of allergic reaction (food, meds, soaps, etc). Other irritants can also bring it on. The key to succesful management of eczema is to find out what the cause is and avoid it if possible. I generally recommend daily use of a moisturizer lotion, wearing clothes with soft fibers (not wool), and using mild soaps and detergents to wash body and clothes. Scratching itchy skin will make the rash come out. For flare ups I'll have parents apply over the counter hydrocortisone twice a day for five days. The degree and amount of eczema can vary widely. Also, parents need to be aware of conditions which may look like eczema. If you use a steroid cream and the rash gets worse, seek medical attention immediately. Sometimes ringworm (skin fungal infection) can look like eczema. The best course of action is to use moisturizers regularly and an anthistamine like Benadryl or Claritin for itchiness. For more serious flare ups we tend to use some form of steroid cream for several days. The most serious cases require presciption steroid creams and/or immunomodulater creams. On occasion, prescription oral medications are needed. The thing to remember about eczema is that you are able to control it, but not cure it. No matter what you do, once you stop treatment, the rash can come back at any time. The good news is that most children will outgrown their eczema at some time. We tend to see more eczema cases in the winter when the weather is cool and dry. If the rash doesn't respond to treatment, or gets worse, then a visit to your pediatrician will help. Good luck with that rash, Dr. Bill
Dry red skin patch
written by karina , September 27, 2008
Dr. Bill, my daughter gets at least one or two red dry patches of skin every year. They seem to come and go on their own but last several weeks. Does this sound like excema? If so, what is the best remedy?
Re: What medicine is safe to give a 3 year old for a cold?
written by Dr. Bill , September 26, 2008
Dear Confused About Medicine ,
You're absolutely right. Since the recall of cold meds for small children and the new FDA recommendations, parents have very little recourse to treat their sick children. Most of the problems occured in very small children who were overdosed with various cold meds. The problem we face is that the available over the counter cough/cold meds work minimally at best. Many of them may even create unwanted side effects. When looking at the many cogh/cold remedies you will see that there are four main types of ingredients (decongestant, antihistamine, antitussive, and expectorant). You will find a large variety with every possible combination. In the "old" days I would suggest that parents buy single ingredient meds and treat that specific symptom. But nowadays, a cold med with a decongestant and antihistamine is your best bet. Benadryl ,also know as diphenhydramine, is a very good antihistamine, it's main drawback is that it will cause drowsiness. I currently use this type of med for my daughter when she gets cold symptoms. Supportive care in the form of taking plenty of fluids, vaporizer, and proper positioning help a little. For very bad cold symptoms, there are a few prescription cold medications which I have found to be pretty effective in controlling symptoms. The best way to treat colds is to prevent them. Steps like encouraging good handwashing, using disposable tissues, cover our coughs, and avoiding contact with sick persons help. I'm a big proponent of taking vitamin C for the prevention of colds. Some studies have also shown that certain forms of zinc (zinc gluconate) might also reduce the duration of colds. If you find that your child's symptoms last for two weeks or more or that they are getting worse, then a visit to your pediatrician is warranted to rule out any other illness. Hope this helps.
What medicine is safe to give a 3 year old for a cold?
written by Confused About Medicine , September 23, 2008
Dr. Bill,
I am so confused about the types medicine I am no longer allowed to give my children. Is Benadryl safe? What do I give my children without worrying about hurting them? Are there natural alternatives? Thank you very much. I read your advice column religiously and love this set up.
Re: Is there a cold strand out there?
written by Dr. Bill , September 21, 2008
Dear Jill S,
The symptoms you are describing do suggest allergies. The only sympton you didn't mention was itchiness in your eyes or nose, that would be even more suggestive of allergies. Ragweed is still in full bloom. Kids can and do inherit their parents propensity towards having allergies. So it isn't a far-fetched idea that everyone in the house has allergies. But you all can also be a part of what I call the "Sickness Tsunami". Usually about 1-2 weeks after school starts, everyone comes down with cold symptoms which can last several weeks. Typically infections give you fevers and more generalized symptoms. But I have seen many patients have severe ear or sinus infections and not show any fever or pain. You could consider using one of the over the counter anti-allergy meds like: Benadryl, Claritin, Zrytec, or their generic equivalents. If these help, it's most likely you're dealing with allergies. The problem with these symptoms lasting this long is that they can cause secondary problems, like sinus and ear infections. It's never a bad idea to consult with you pediatrician and have him or her check things out. There are some other things that can be checked or examined to determine the difference between allergies and infections. I hope this helps. Remember, no question is to silly to ask. Dr. Bill
Is there a cold strand out there?
written by Jill S. , September 19, 2008
I have had a cold for two weeks, my nose, sneezing, the post nasal drip and the soreness it creates in my throat... the kids, the same. Is this something you are seeing out there? No fever, no body aches. Just nasal misery?... Could it be allergies? I am so lost and embarrassed to call the peds for a silly cold. But 2 weeks???
Re: check up for school every year
written by Dr. Bill , August 28, 2008
Dear Hulya,
Since your son just had his check up recently, all you need is for your pediatrician's office to fill out the form. If he's playing sports, the schools require that the physical be done after May 1st. Since he had it done in June you shouldn't have any problem. The month of August we're packed with back to school/sports physicals. School starts next week, so you'll need that form filled out ASAP. Some offices take a few days to fill out the forms. Dr. Bill
Check up for school every year?
written by hulya , August 26, 2008
Hi Dr. Bill,
I have a quick question. I wanted to clarify what is necessary for back to school paperwork. My son had a check up this June. What do I do with the paper sent home from school for his physical and immunization? Do I call the peds office or do I have to go in? What does your practice require? Thanks, Hulya
Re: Chicken Pox
written by Dr. Bill , August 23, 2008
Dear HCM,
Your dilemma about this possible chicken pox situation is quite interesting. The timing for the exposure does fit the typical incubation period (7-14 days) for Chicken Pox transmission. What is not typical is that so many children with the same exposure are all coming up with "Chicken Pox". The vaccine is very protective and only about 1% of vaccinated children will still get it. Kids with Chicken Pox who were vaccinated tend to only get a few spots and are less sick. Typical symptoms begin as a cold-like illness and then several days later, the rash devolops. The spots, or rather vessicles (they are little water blisters) can be very itchy. You can also look in your child's mouth and look for red spots. Some other things that could give similar rashes are related viruses to Chicken Pox, bug bites, and contact with plant sap. The distribution of the rash can be helpful. If it's only on "exposed" surfaces (ie areas of skin not covered by clothing, then insect bites and contact derm are possibilities. Also check the scalp. Since all the children were at the same place at the same time, all the above possiblities can apply. I would make sure each parent contacts their pediatrician and lets them know the situation. If we're having this many break-through infections. then the health department and even CDC need to know. I hope this info helps, Let me know if you have more specific questions. (also sorry for the late response). Good luck, Dr. Bill You can add your comment here
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