If your doctor has told you that your child has Atopic Eczema (AE), you are not alone. More than 10 per cent of infants and toddlers are diagnosed with AE, also known as Atopic Dermatitis. The good news is, for many of these children, the symptoms will become less bothersome as they get older.

Atopic Eczema is a chronic skin condition that occurs primarily in infants and children but can also present at any age. It is characterised by red or pale rashes with dry and extremely itchy skin. In fact, itching is a hallmark of this common condition. Controlling and preventing the itch is your first line of defence against eczema flare-ups. During infancy, from birth to about age two, eczema is manifested by red, weeping, crusted rashes (lesions) on the face, back, arms, and legs. In long-standing cases the rashes may appear dark (hyperpigmented) and thickened (lichenified), making the skin appear rough.

In childhood, from age two through 12, eczema appears in the skin-fold areas, especially the front of the elbow, back of the knee, inside the wrist, and in depressions of the ankle and neck, and often appears pale in a dark-skinned person. In puberty, eczema may clear up entirely, or may flare-up occasionally when the person is under stress. An itchy rash as described above, along with a family history of hay fever, asthma, sinusitis and migraine, may indicate a diagnosis of atopic eczema.

IT’S ECZEMA SEASON

During the months of November to February when the cold fronts from North America touch down in Jamaica, the air is typically cold and dry with low humidity. For a child with eczema, that means ashylooking, dry skin and frequent flareups during this time. For some children, humid weather, hot summer sun and exercise with excessive sweating can also pose challenges. Pay attention to your child’s eczema season and be prepared with the right preventive action and treatment options.

TRIGGER FACTORS

For many children, flare-ups can be caused by skin irritants such as soaps, solvents (such as bleach), chlorinated water/salt water, wool clothing, or sudden changes in temperature or humidity. A common problem for infants with eczema is that their saliva is often an irritant, which is why cheeks and mouths are often affected. For a child with eczema, typical childhood feelings such as anger and frustration, can contribute to an eczema flare-up.

MANAGEMENT:

• Keeping skin moist is the first line of defence against AE. Dry skin is more likely to crack, making it open to germs and irritants that may bring on an eczema flare-up. Make moisturising a part of your child’s daily routine and get him or her involved in moisturising as often as possible. If skin is dry, you can moisturise hourly.

• Bathe your child in lukewarm water, never in hot water, and with a mild soap (eg Oilatum, Cetaphil, Dove soap). At the end of the bath, rinse, and pat dry. Apply creams or emollients (eg Kare cream/ lotion, Cetaphil) when the skin is damp to lock in the moisture. Moisturising creams may be fine for moderately dry skin. If eczema is severe, use pure petrolatum jelly which does not irritate the inflamed skin.

• Dress your child in clothes that breathe. Cotton is best for all seasons, especially in Jamaica where the weather is warm all year round. Tight elastic areas and waistbands are often trouble spots for children with eczema.

• Avoid fabrics like wool, nylon and stiff or scratchy materials.

• Make sure your child gets the right kind of exercise. Exercise is a great stress reliever and just plain good for kids. But if your child reacts to sweat, bathe as soon as possible after exercise and stay cool.

• Keep the house cool, especially your child’s bedroom. Always use cotton lightweight bedclothes and be aware of which stuffed animals and toys that may trigger a flare-up.

• Children with eczema are often prone to other allergies. Keep family pets outdoors or at least off beds, sofas, or areas where your child plays.

• Control mosquito breeding grounds around the house. Scratching of the bites will introduce bacteria to the skin and result in an infection.

• Consult a dermatologist/doctor for confirmation of this condition. A combination of external medications such as cortisone creams, moisturising ointments/lotions and tar ointment may be prescribed. Internal medications such as oral antihistamines can help to ease the itching. Oral antibiotics may be prescribed if there is also a secondary infection. For severe cases, your dermatologist may recommend oral steroids.

Dr Patricia Yap is a dermatologist at Apex Skin Care and Laser Center. E-mail: apexskinclub@gmail.com