Eczema of the scalp in children

In eczema of the scalp in children we frequently, and perhaps generally, find the case acute as regards its character, though it may be chronic "as regards the duration of time that it has existed. It is almost always presented to the physician in the second stage characterized by exudation and crusting, and complicated with enlarged glands at the back of the neck, small abscesses of the scalp, and may also be accompanied with pediculi. The vesicular and pustular forms are the most common, and the crusts, entangled in and retained by the hair, accumulate more thickly than elsewhere. The first thing to do is to cut the hair off as short as it is possible to do it with scissors. If pediculi are present, search through hair stumps for their ova, which should be removed. If many crusts adhere to the scalp after clipping the hair, saturate the parts with olive oil, and,  after a few hours, give the scalp a good washing with soap and warm water. After thorough drying, apply zinc or diluted white precipitate ointment. The ointment should be applied thickly, and renewed daily and even twice daily, and accumulations of old ointment be removed by gentle use of the comb as often as necessary. The scalp should not, however, be washed again for seve­ral days; in fact, the less frequently it is washed the better. If abscesses are present, they must be opened, and perhaps poulticed for a day or two. Eczema of the scalp, in many cases, seems to be called into existence as a consequence of parasitic irritation; arid when the eczema itself is of but limited extent, but the parasites are numerous, they may be made the first point of attack and cutting of the hair be avoided. I know of nothing more effective than drowning them out with ordinary kerosene. If the hair be thoroughly saturated with this for two or three days in succession, soap and water, and a fine-tooth comb and patience will do the rest. The parasites destroyed, the eczema may recover spontaneously, or more quickly if aided with a few applications of ointment.


The enlarged glands at the back of the neck require no special attention. When the eczema gets well they will subside. Eczema of the scalp often extends to the fore­head, face and cars. If fissures form behind the ears, it is well to add a little finely-powdered graphite to the ointment. As the case progresses toward recovery, and the exu­dation and crusting cease, and the third stage, characterized by dryness and scabs, is ushered in, the treatment requires a change.

A little tar, in some of its forms, should then be added to the ointment, and the proportion of tar gradually in creased as improvement occurs. If progress toward recovery should halt, a little more active stimulation may be the thing needed. If, however, the eruption should revert to the second stage, as not infrequently happens, the latter treatment will have to be resumed.