Sun Screen for Sensitive Skin

Q: My son has eczema and sensitive skin. I’m worried that sunscreen may cause him to break out. Are there certain ingredients I should avoid?

A: Dr Jain- People with eczema are apt to have problems with virtually any chemical that’s applied to their skin but a few ingredients in sunscreens are particularly troublesome.  Watch out for para-amino benzoic acid (PABA, used less commonly today than in the past, padimate A and O, and benzophenones (such as oxybenzone and any other chemical ending with –benzophenone). In addition, avoid dibenzolymethanes, such as abovenzone. Other active ingredients, such as titanium dioxide, zinc oxide, alumina and triglycerides, are more benign and most people can tolerate them. The perfumes in sunscreen products can also be irritating to those with sensitive skin. To see whether or not the product is well tolerated, try the sunscreen on a small patch of your child’s skin a few days before using it. Many sunscreens that are for babies or are labeled “sensitive skin” are better tolerated. If you’re still unsure, ask you allergist or dermatologist for product recommendations.


The Water’s Fine

Q: Is swimming in a chlorinated pool bad for my child’s eczema?

A: Dr Jain- Not necessarily. Many people affected by eczema notice that their skin actually improves after spending time in a swimming pool. There’s mounting evidence that people with eczema are colonized by Staphylococcus aureus, a bacteria that contributes to the skin inflammation seen in eczema. Swimming in chlorinated water may reduce the amounts of staph growing on the skin, thereby helping quell the eczema. I recommend that patient’s shower off after swimming and immediately apply a thick moisturizer to their skin while it’s still damp so that it doesn’t dry out from the chlorinated water.


Hard to Breathe

Q: My little boy’s asthma is getting worse. The doctor wants to start him on daily medicine to control the symptoms but I’m reluctant because I’m worried that the drugs may have side effects. What should I do?

A: Dr Jain- This is probably the most frequently asked question I hear in my practice- and the most important. Before starting long-term daily medications to control asthma, you and your doctor should identify potential triggers and clear them from your child’s environment. This may include investing in dust mite control or making hard choices about moving pets from your home. You and your doctor can also look at alternative therapies that may help symptoms, such as deep breathing and relaxation exercises, yoga or acupuncture. If these measures don’t help, allergen immunotherapy (allergy shots) can be effective if administered properly. Allergists generally don’t start this treatment until children are at least 10 years old.

There are two main classes of preventative medicine commonly prescribed for people who have persistent asthma, defined as someone who has symptoms during the day more than twice a week or symptoms at night more than twice a month. One class of medication is the inhaled corticosteroid (ICS), the first line of treatment for patients with mild persistent asthma; these drugs have been FDA-approved for asthma treatment for two decades. The other medication type is leukotriene inhibitors, a newer treatment option. Generally speaking, the risk of side effects related to either of these classes of medications is low. And multiple long-term studies have demonstrated that, when used appropriately, ICS do not cause growth delay, a parental concern I commonly hear.

Frankly, this is an emotionally charged topic. I see a lot of asthmatic kids who are untreated (of treatment is delayed) because parents have concerns about using medications. The risks of uncontrolled asthma are many, including growth problems, increased rate of obesity-and even death.

Fortunately, the death rate related to asthma has decreased steadily over the last decade, in large part due to the increased use of these long-term controller medications. Asthma, like food allergies, can be deadly. Appropriate treatment is very important.


“Pediatric Allergies Q & A- Sun Screen, Meat Allergy, More!” Living Without’s Gluten Free & More. N.p., June 2010. Web. June 2015.