Injections may be part of diagnosis, treatment, and disease management for a child with eczema. Frequent injections and doctor's visits to treat flare-ups and complications related to eczema can be stressful for children. Finding ways to reduce pain and anxiety related to injections can help parents and children better manage eczema.

Eczema is a chronic, allergic skin condition that frequently affects children. Eczema affects 1 in 10 people in America, and atopic dermatitis (AD) is the most common form. Among people with atopic dermatitis, 80 percent developed the condition before their 6th birthday. Nearly 10 million children in America have atopic dermatitis.

Injections Related to Eczema

Children with eczema may require more injections or medical procedures involving needles than children without eczema. Below are instances when a child’s eczema may require an injection, blood draw, or skin prick.

Allergy Testing and Treatment

Many children with atopic dermatitis also have allergies, for instance to pet dander, dust mites, and pollen. The word “atopy” refers to the tendency to develop an allergic reaction. Eczema, together with seasonal allergies (also called rhinitis or hay fever) and asthma, is sometimes called the atopic triad. In other words, having eczema makes it significantly more likely that a child will also have food allergies, rhinitis, and asthma. Research has shown that allergy shots may benefit people with eczema, although the things they are allergic to may not be the cause of the eczema.

Approximately 30 percent of babies with severe eczema also have food allergies. To identify other allergic reactions that may exacerbate eczema, your child’s doctor or an allergist may recommend allergy testing, either by blood draw or allergy skin prick testing.

“Every time he eats, no matter what he eats, he breaks out in hives,” one mom on MyEczemaTeam wrote. “Finally got an appointment with his allergist and they did blood work to see what was going on.”

Treatments for Eczema

Among newer therapies for harder-to-treat eczema are anti-inflammatory medications called biologic medications. Dupixent (dupilumab) is a biologic approved by the U.S. Food and Drug Administration (FDA) to treat atopic dermatitis for people ages 6 and up whose symptoms are not well controlled by topical treatments. Dupixent is injected subcutaneously twice a month with a prefilled syringe or pen cartridge.

Around 7 percent of children in the U.S. with eczema experience severe symptoms that require a more aggressive treatment approach. Your child will have likely tried over-the-counter moisturizers, topical corticosteroids, and other first-line treatments before a dermatologist recommends biologics. One parent on MyEczemaTeam wrote, “My little boy is miserable. The topical steroid hardly works anymore, and I don't know what to do.”

Standard Childhood Vaccinations

Vaccinations do not cause eczema or trigger eczema flares. Nearly all children with eczema should follow the standard immunization schedule.

Some vaccines — including the measles, mumps, and rubella (MMR) vaccine and some flu vaccines — are produced using eggs. Eggs are a common allergen for children with eczema.

Make sure to alert your child’s pediatrician if your child has an egg allergy. Alternatives may be given to ensure your child is protected against MMR and flu.

Tips To Reduce Pain From Injections

Pain, swelling, and redness are common symptoms at the site of injection. These side effects shouldn’t last longer than 24 to 48 hours and usually rectify themselves without intervention. That said, minimizing the pain before and after the shot can be very helpful for children.

• Be honest. Remind your child that the pain is short-lived, that it's OK to be nervous, and that it’ll be over quickly.
• Tylenol (acetaminophen) can help relieve moderate pain and swelling at the injection site.
• Ice packs applied to the site of the injection before and after can help with the pain and reduce swelling and redness.
• Vibration near the injection site can minimize pain. A simple vibrating massager can help, and the doctor may have vibrating or cooling tools for this purpose.
• Extended reality programs that use virtual reality, augmented reality, and other emerging gaming technologies can help with pain and anxiety about needles.

Tips To Help Manage a Child’s Fear of Injections

Coping strategies, such as mindfulness or deep breathing exercises for stress or anticipatory anxiety, can help your child overcome their fear of shots. These skills can also come in handy in other stressful situations. These tips can help you and your child feel control over anticipatory anxiety and stress around injections and visits to the doctor.

• Focus on the health benefits. Remind your child that injections can help the symptoms of eczema improve, including itchy skin, dryness, and flakiness. Remind them how much better they will feel afterward.
• Sit up instead of lie down. Children can be more scared when they have to lie down. See if a change in position helps them better control their fears.
• Model calmness. Do your best to stay calm and maintain a positive attitude. If your child senses you’re nervous, they will be more anxious too. Practice some of the coping strategies with them while they wait for their injection.

Tips for Feeling Confident Administering Injections at Home

Many people experience anxiety whenever needles are involved. Some of the tips above can help you remain calm; practicing them with your child can help you both. These tips will help you gain confidence in administering injected treatments at home.

• Inform yourself about different methods, tactics, and firsthand advice from other people who have learned to give injections at home.
• Biologics often need to be stored at cold temperatures, but allowing them to warm up before injection can reduce pain. Talk to your doctor about the best way to store and warm these medicines.
• Practice with guidance from your child’s doctor or pharmacist. Getting comfortable with the process of giving injections will help you feel prepared.
• Make sure you’ve got all the equipment you need, like sterilizing pads and medication, laid out for use.
• Remind yourself that the reward of this momentary stress is the convenience of not having to go to a doctor's office, the comfort of being in your home, and the flexibility of being able to give medication on your watch. And it's all for the sake of your child’s health!

Connect With Other Parents

There are more than 10,600 parents on MyEczemaTeam who understand the challenges of caring for a child with eczema. Parents on MyEczemaTeam offer support during hard moments and share tips for helping their children.

How did your child overcome the fear of injections? Do you have any other tips for parents? Leave a comment below or join MyEczemaTeam.

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