Mom! This thing itches!

Published: September 29, 2023

Caring for your child’s cast requires extra steps and patience. If your child has broken a bone, you’re already familiar with the stress of the initial injury and getting them the help they need. Cast care during the weeks it takes to heal an injury can be time consuming and require extra caution, on top of dealing with an unhappy child whose life has been altered for the next several weeks.

An arm cast or leg cast is made of a combination of materials. Most casts today are fiberglass on the outside — that’s the same stuff they use to make Corvettes! The inside is lined and has padding. You and your child might not be in love with dealing with their new cast, but you still want to take good care of it. Otherwise, you might keep the injury from healing, cause other injuries or require an entirely new cast.

“The inside of a cast is lined with a stocking and then padded so bony joints don’t rub against the hard fiberglass,” said Laura K. Jacks, M.D., pediatric orthopedic surgeon with Norton Children’s Orthopedics of Louisville, affiliated with the UofL School of Medicine. “The stocking and padding can absorb water and other liquids, so they should be kept as dry as possible.”

Keeping the cast dry and clean

The best way to keep the cast from getting wet is to avoid water altogether, but since you don’t want a smelly child for the foreseeable future, Dr. Jacks offers some tips:

• Cover the cast with two plastic bags. Check each bag first to be sure it doesn’t leak. Seal the top of each bag to the skin with tape.
• Even with the cast covered, never dunk the cast in water. The bag will repel a splash but usually won’t survive a dunking. Commercial cast covers are available at medical supply retailers or online.
• If the cast does get wet, blot it dry as best you can. Let the water run out first, then blow cool air from a hair dryer in the ends.
• Be sure the air is cool. A warm blow dryer can burn skin. If the cast is too wet, even after drying, it may cause the skin under the cast to break down. The only way to fix this is to change the whole cast.
• If you are allowed to walk on a leg cast, make sure you cover the foot of the cast with a shoe or something else. The cast bottom is slick, and without something between it and the ground, you could fall and break something else.

The good news is, it’s still OK to turn your child’s cast into a work of art.

“We strongly encourage your child to have fun and decorate the cast,” Dr. Jacks said. “We would love to see the artwork when you return!”

How to care for an itchy cast

• Itching under the cast is very common. Tapping the outside of the cast can satisfy some itches. Don’t use a pen to scratch inside — the top may come off inside the cast and leave a nasty bruise on the skin where it is stuck. Benadryl or Zyrtec can help the itch feel better, especially if it is keeping your child up at night. These medications may cause sleepiness.

Care after cast removal

• Wash the skin with soap and water when you get home from getting the cast off. This will help it smell better! After that, wash the area normally, just like you wash the rest of your body.
• Do not pick at any scabs from the injury. Doing so can lead to infection. Scabs will heal and fall off on their own.
• If your skin is dry from the cast, use a fragrance-free moisturizer or lotion after bathing.
• Wait several days before shaving the area, as your skin is still sensitive immediately after removing the cast.
• The area may feel kind of stiff or weak. Follow your doctor’s instructions for any at-home stretching, exercises or physical therapy.
• Check with your doctor before resuming regular activities or sports.