Is this your child’s symptom?

• Cracked skin or dry, rough skin
• Cracked skin on hands, feet and lips
• Dry, rough skin of entire body surface

Causes of Cracks in the Skin

• Most cracked skin is found on the feet, hands or lips.
• Feet. The soles of the feet are most commonly involved. Most often, cracks occur on the heels and big toes. This is called tennis shoe dermatitis. Deep cracks are very painful and can bleed. The main cause is wearing wet or sweaty socks or swimming a lot.
• Hands. Cracks can develop on the hands in children. The main cause is washing the hands too much or washing dishes. Can also occur from working outside in winter weather. The worse cracks of the fingers occur with thumb sucking.
• Lips. The lips can become chapped in children from the sun or wind. If the lips become cracked, it’s usually from a “lip-licking” habit. The skin around the lips can also become pink and dry. This occurs especially in children who suck on their lips.

Causes of Dry Skin

• Dry skin is a common condition.
• Soap. Dry skin is mainly caused by too much bathing and soap (soap dermatitis). Soap removes the skin’s natural protective oils. Once they are gone, the skin can’t hold moisture.
• Climate. Dry climates make dry skin worse, as does winter weather (called winter itch).
• Genetics also plays a role in dry skin.
• Dry skin is less common in teenagers than younger children. This is because the oil glands are more active.
• Keratosis Pilaris – dry, rough, bumpy skin on the back of the upper arms. It’s made worse by soaps. Treat with moisturizing creams.
• Pityriasis Alba – dry pale spots on the face. These are more prevalent in the winter time and are also made worse by soaps. Treat with moisturizing creams.
• Eczema. Children with eczema have very dry itchy skin.

Liquid Skin Bandage For Deep, Chronic Cracks

• Liquid plastic skin bandage is a new product that seals wounds. It is a plastic coating that lasts up to 1 week.
• It is the best way to relieve pain and promote healing. As the crack heals from the bottom upward, it pushes the plastic seal up.
• After the wound is washed and dried, put the liquid on. It comes with a small brush or with a swab. It dries in less than a minute. Then apply a second coat. It’s waterproof and may last a week.
• You can buy this at any drug store. Many brands of liquid bandage are available. No prescription is needed.

When to Call Us for Dry Skin

Call Doctor or Seek Care NowFever and looks infected (spreading redness)Cracked red lips and fever lasts 5 days or moreYour child looks or acts very sickYou think your child needs to be seen, and the problem is urgent

Contact Doctor Within 24 HoursLooks infected (pus or spreading redness)Bleeding from cracked lipsCracks on feet that make it hard to walkYou think your child needs to be seen, but the problem is not urgentContact Doctor During Office HoursCracks from thumb-sucking or finger-suckingPeeling skin and cause is not clearAfter 2 weeks of treatment, cracked lips are not healedAfter 2 weeks of treatment, cracked skin is not healedAfter 2 weeks of treatment, dry skin is still itchyYou have other questions or concerns

Self Care at HomeCracked skin on the feetCracked skin on the handsChapped lipsDry, itchy skin caused by soap or cold/dry weather

Care Advice

Treatment for Cracked Skin on the Feet

1. What You Should Know About Cracks on Feet:
   • Most often, cracked skin of the feet is caused by repeated contact with moisture.
   • The main cause is often wearing wet (or sweaty) socks. Swimmers also have this problem.
   • The soles of the feet are most often involved. Usually, you see cracks on the heels and big toes.
   • This is called tennis shoe or sneaker dermatitis.
   • Cracked, dry feet usually can be treated at home.
   • Here is some care advice that should help.
2. Shallow Cracks – Use Ointment:
   • Cracks heal faster if protected from air exposure and drying.
   • Keep the cracks constantly covered with petroleum jelly (such as Vaseline). Put it on the cracks 3 times a day.
   • If the crack seems mildly infected, use an antibiotic ointment instead (such as Polysporin). No prescription is needed. Put it on the cracks 3 times a day.
   • Covering the ointment with a bandage (such as Band-Aid) speeds recovery. You can also cover it with a sock.
   • Option: If you have it, a liquid skin bandage works even better. Don’t use liquid bandage and ointment together.
3. Deep Cracks – Use Liquid Skin Bandage:
   • Deep cracks of the feet or toes usually do not heal with ointments.
   • Use a liquid skin bandage that will completely seal the crack. Many brands of liquid bandage are available. No prescription is needed.
   • Start with 2 layers. Put on another layer as often as needed.
   • As the crack heals, the plastic layer will be pushed up.
4. Prevention of Cracks on Feet:
   • Change socks whenever they are wet or sweaty.
   • Take an extra pair of socks to school.
   • When practical, do not wear shoes. Go barefoot or wear socks only.
   • Do not use bubble bath or other soaps in the bath water. Soaps take the natural oils out of the skin.
   • Use a moisturizing cream on the feet after baths or showers.
   • Wear shoes that allow the skin to “breathe.”
5. What to Expect:
   • Most cracks heal over in 1 week with treatment.
   • Deep cracks heal if you keep them covered all the time with crack sealer. Deep cracks will heal in about 2 weeks with crack sealer.
6. Call Your Doctor If:
   • Starts to look infected (redness, red streak, pus)
   • Cracks last more than 2 weeks on treatment
   • You think your child needs to be seen
   • Your child becomes worse

Treatment for Cracked Skin on the Hands

1. What You Should Know About Cracks on Hands:
   • Cracked skin of the hands is usually caused by repeated contact with moisture.
   • Examples are washing dishes or washing the hands often.
   • Soap removes the natural protective oils from the skin.
   • Cracked, dry hands usually can be treated at home.
   • Here is some care advice that should help.
2. Shallow Cracks – Use Ointment:
   • Cracks heal faster if protected from air exposure and drying.
   • Keep the cracks constantly covered with petroleum jelly (such as Vaseline). Put it on the cracks 3 times a day.
   • If the crack seems mildly infected, use an antibiotic ointment instead (such as Polysporin). No prescription is needed. Put it on the cracks 3 times a day.
   • Covering the ointment with a bandage (such as Band-Aid) speeds recovery. You can also cover it with a glove.
   • Option: If you have it, a liquid skin bandage works even better. Don’t use liquid bandage and ointment together.
3. Deep Cracks – Use Liquid Skin Bandage:
   • Deep cracks of the fingers usually do not heal with ointments.
   • Use a liquid skin bandage that will completely seal the crack. Many brands of liquid bandage are available. No prescription is needed.
   • Start with 2 layers. Put on another layer as often as needed.
   • As the crack heals, the plastic layer will be pushed up.
4. Prevention of Cracks on Hands:
   • Wash the hands with warm water.
   • Use soap only if the hands are very dirty. Also, use soap for anything that won’t come off with water.
   • Wear gloves when washing dishes.
   • During cold weather, wear gloves outside.
   • Use a moisturizing cream on the hands after anytime they have been in water.
5. What to Expect:
   • Most cracks heal over in 1 week with treatment.
   • Deep cracks heal if you keep them covered all the time with crack sealer. Deep cracks will heal in about 2 weeks with crack sealer.
6. Call Your Doctor If:
   • Starts to look infected (redness, red streak, pus)
   • Cracks last more than 2 weeks on treatment
   • You think your child needs to be seen
   • Your child becomes worse

Treatment for Chapped Lips

1. What You Should Know About Chapped Lips:
   • The lips can become chapped in children from too much sun or wind.
   • If the lips become cracked, it’s usually from a “lip-licking” habit.
   • The skin around the lips can also become pink and dry. This occurs especially when children suck on their lips.
   • Here is some care advice that should help.
2. Lip Balm:
   • A lip balm should be used often, even hourly.
   • Be sure to put it on after eating or drinking.
3. Avoid “Lip-Licking”:
   • Help your child give up the habit of lip-licking or sucking.
   • This habit usually is not seen before age 6.
   • This habit will only change if you can gain your child’s active participation.
   • Appeal to your child’s pride. Show your child in a mirror how lip-sucking has affected their appearance.
   • Give them a lip lubricant to put on their lips. Tell them to use it when they feel the urge to suck on them. Another option is to replace lip-sucking with chewing gum.
   • Offer an incentive for going an entire day without lip-sucking. Examples of rewards are money or points towards a prize.
   • Avoid any pressure or punishment. It will backfire, cause a power struggle and make the habit last longer.
4. Call Your Doctor If:
   • Starts to look infected (redness, red streak, pus)
   • Cracks last more than 2 weeks on treatment
   • You think your child needs to be seen
   • Your child becomes worse

Treatment for Dry or Itchy Skin

1. What You Should Know About Dry Skin:
   • Dry skin is a common condition.
   • Mainly caused by too much bathing and soap (soap dermatitis).
   • Soap removes the skin’s natural protective oils. Once they are gone, the skin can’t hold moisture.
   • Dry climates make it worse, as does winter weather (called winter itch).
   • Genetics also plays a role in dry skin.
   • Dry skin is less common in teenagers than younger children. This is because the oil glands are more active in teens.
   • Here is some care advice that should help.
2. Bathing – Avoid Soap:
   • Young children with dry skin should avoid all soaps. Soaps take the natural protective oils out of the skin. Bubble bath does the most damage.
   • For young children, the skin can be cleansed with warm water alone. Keep bathing to 10 minutes or less.
   • Most young children only need to bathe twice a week.
   • Teenagers can get by with using soap only for the armpits, genitals, and feet. Also, use a mild soap (such as Dove).
   • Do not use any soap on itchy areas or rashes.
3. Moisturizing Cream:
   • Buy a large bottle of moisturizing cream (such as Eucerin). Avoid those with fragrances.
   • Put the cream on any dry or itchy area 3 times per day.
   • After warm water baths or showers, trap the moisture in the skin. Do this by putting on the cream everywhere after bathing. Use the cream within 3 minutes of completing the bath.
   • During the winter, apply the cream every day to prevent dry skin.
4. Steroid Cream:
   • For very itchy spots, use 1% hydrocortisone cream (such as Cortaid). No prescription is needed.
   • Use up to 3 times per day as needed until the itching is better.
   • Eventually, the moisturizing cream will be all that you need for treating dry skin.
5. Humidifier:
   • If your winters are dry, protect your child’s skin from the constant drying effect.
   • Do this by running a room humidifier full time.
6. Preventing Dry Skin:
   • Don’t use soaps or bubble bath.
   • Wash the hands with warm water. Use soap only if the hands are very dirty. Also, use soap for anything that won’t come off with water.
   • Don’t use swimming pools or hot tubs. Reason: Pool chemicals are very drying.
   • Run a humidifier in the winter if the air is dry.
   • During cold weather, wear gloves outside. This helps prevent drying of the skin.
   • Drink lots of fluids.
7. Call Your Doctor If:
   • Dry skin lasts more than 2 weeks on treatment
   • You think your child needs to be seen
   • Your child becomes worse

And remember, contact your doctor if your child develops any of the ‘Call Your Doctor’ symptoms.

Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.

Copyright 2000-2022. Schmitt Pediatric Guidelines LLC.