Eczema: Listen for the sound of silence

I find that most parents who bring their children in for atopic eczema have woefully underlubricated the child's skin. To make my point in the exam room, I tell the parents "If you can hear your child's skin, it's too dry." Then I rub my fingers over a patch of the child's dry skin and watch the parents' expressions of amazement as they hear the rough, sandy sound. For contrast, I rub a finger over the top of my hand, which is usually well lubricated with lotion. The silence is instructive and evokes smiles all around.

Wanda Lo, MD
San Luis Obispo, Calif.