Eczema

If your child suffers from eczema, like many other people across the globe, then they may be looking forward to summer more than most. It is reported that most people with atopic eczema find that their symptoms improve during the summer and get worse in winter. The dry, red and usually intolerably itchy patches often recede when the air is warm and damp and skin is exposed more often to sunlight.  Cold weather and rough clothing, on the other hand, are two of the many things that bring out eczema.

Eczema is a red rash that can be dry and itchy and that can appear anywhere on the body. It happens because the skin’s barrier is not working properly and can therefore make your child’s skin more susceptible to allergies. It is suggested that 20 per cent of children are affected by eczema at some time.

If a child is going to suffer with eczema, they are most likely to develop the first signs of the condition before the age of 2. Approximately 4 out of 5 cases happen before a child is 5 years old. Unfortunately, there is nothing that can cure eczema although it is possible to control the condition. Some outgrow the condition but it can persist throughout childhood and beyond. It is not uncommon for symptoms to continue into sufferers’ 20s, and even crop up unexpectedly in adults for the first time.

Atopic Eczema
The main type of eczema to affect children is called atopic dermatitis or atopic eczema. Although atopic dermatitis or eczema can occur anywhere on the body, it normally appears in small patches. In babies, it is more common on the face and scalp and on the outside of the arms and legs. In children, it is most common around the arm and leg creases and joints including behind the knees and around elbows.

The symptoms are usually always present and they include making the skin dry, red, itchy, broken or cracked. Sometimes your child may not be affected by these symptoms, however, it is possible that they can ‘flare-up’ and get worse. This may be for a number of different reasons including an allergy, the weather or the environment. A flare-up may cause the skin to become very itchy, red, hot dry and scaly, it may cause the skin to become wet or swollen, and may cause it to crack and bleed, it is also possible for the area to become infected.

What should I do?
If you are concerned about your child arrange to take your child to see your doctor.  The doctor will then be able to diagnose atopic eczema by looking at the skin and asking questions including whether the rash is itchy, whether it flares-up, when the symptoms first appeared, what parts of the body are affected and whether there any family members have the condition.

Your doctor may try to find a cause of the eczema. They will ask you questions about your child’s lifestyle and diet or whether you have recently changed a shampoo or washing tablets.  If the cause can be found, it may be possible to reverse the condition by not coming into contact with the cause.

Your doctor will then prescribe medication to be used on your child’s skin.There are many different creams and emollients that are used to treat eczema and your doctor will prescribe the one he thinks is most suited to your child. However, if there is no improvement in your child’s condition, you will need to re-visit the doctor and try something else.

Causes of Eczema
Adding to the causes of eczema is the long list of things that can trigger the condition. Stress has been known to be associated with atopic eczema, vigorous exercise causing sweating may result in symptoms becoming worse, and tobacco smoke, perfume, latex, living near a busy road and even having hard water can trigger the condition.

Unfortunately, it is not known exactly what causes eczema. It is a mixture of many things including genetic and environmental factors. A child is more likely to have eczema if the parents suffer from the condition. It has been said that a child who has one parent with eczema has a 60% chance of developing the condition themselves. However, a child may still get the condition if neither parent suffers themselves.

A child could get eczema as a reaction to an allergy to something in the environment, such as allergens.  The most common allergens are house dust mites, pollen and pet fur. Food allergens – such as to cow’s milk, eggs, nuts, soya and wheat – can also encourage eczema.  You may wish to keep a food diary to see if you can associate any foods with triggering the eczema. However, it is important to never cut anything out of your child’s diet before discussing with your doctor.

Other things that can cause eczema or make atopic eczema worse (flare-up) include:

  • Cold weather
  • Change in weather
  • Dry weather
  • Dampness
  • Over-heating
  • Soaps/perfumes
  • Rough clothing against the skin
  • Washing too much
  • Cigarette smoke/pollution
  • Stress
  • Hard water

Treatment of Eczema
If your child suffers from atopic eczema it may seem as if they are left with nothing to eat, touch or even come into contact with, and this can cause some parents to protect their child in a bubble away from the allergens and triggers of the outside world…
Hold that thought! Although there is no cure for atopic eczema, there are treatments that can ease the symptoms.

If you are concerned with your child’s eczema, you will be pleased to hear that usually the symptoms naturally improve over time. That being said, there are various medications that can be used to treat the condition. These include the following:

  • Emollients: moisturising treatments applied directly to the skin to ease dryness
  • Topical corticosteroid, aka steroid creams: any sort of cream gel or ointment containing corticosteroids, used to reduce swelling and redness during flare-ups
  • Antihistamines: used to ease the symptoms of severe itching
  • Oral corticosteroids: used for severe symptoms; in the case of severe flare-ups a GP may prescribe corticosteroid tablets.
  • In addition to the above, if eczema becomes infected it may be necessary to take antibiotics to treat and prevent bacterial infections.

Medication is not the only route to help ease eczema symptoms. Sufferers should avoid scratching as this can aggravate the skin, eventually causing it to thicken and increasing the risk of infection. Tapping or pinching the skin until the itch has gone may offer relief. If you have established what might trigger the flare-ups, you can try to avoid them, i.e. certain soaps or detergents.

Although there is no evidence to suggest that it is effective, some parents use homeopathic and complimentary medicines and therapies. Some parents also use Chinese herbs but it is vital that if you wish to take this route, you MUST seek advice through a qualified and registered practitioner.

With so many different treatments available it can be overwhelming and difficult to pin point the most appropriate one to ease the symptoms. It can therefore help to speak to an expert. A dermatologist can examine the skin, discuss the symptoms and family history with you, together with assessing any allergies and offer your child the best treatment.

by Jenny, mum to William and James

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