Managing eczema

MOST children will, at some point, experience itchy, scratchy rashes. While most of these are one-off cases of allergy or are triggered by an irritant, paediatrician Dr Anona Griffith said that the culprit might be eczema, one of the most common skin conditions seen and treated in children.

“Atopic eczema, dermatitis, more commonly known as eczema, is an itchy skin condition that affects all ages. It can be quite worrying for parents and patients, especially because of the intense itching, which can make children quite fussy, as well as because of the appearance of the skin,” Dr Griffith explained.

She pointed out that even though the condition can affect just about anyone, it may be found in families and may be associated with conditions such as asthma. It often appears as early as the first few weeks after being born or within the first year of life.

“Its first appearance may differ according to the age group affected. In young babies, it usually appears first on the cheeks, scalp, and forehead as dry, scaly patches. Another presentation, however, is that of bumps which may resemble small fluid-filled blisters, which may ooze. These are at risk of becoming infected,” Dr Griffith explained.

In older children, however, she said that the itchy, scaly rashes become more localised to the skin folds or creases of the elbows and knees, neck, ankles, and wrists.

While some children might outgrow the condition, it can, unfortunately, plague others throughout childhood and even into adulthood, because of its chronic nature. As such, it will require a consistent system of care and maintenance to prevent or reduce the possibility of flare-ups.

“To reduce the possibility of flare-ups, you want to identify what the trigger for your child’s eczema is, since this differs in babies. If identifying a trigger proves challenging, then what you want to do is avoid possible triggers such as extreme temperatures, perfumes and soaps commonly present in laundry detergents, soaps, and skincare products. Stress is also notorious for triggering flares and should be limited as much as possible,” Dr Griffith advised.

Even while you might work to reduce exposure to triggers, Dr Griffith said that to improve the quality of life of your child, it is important that you devise a consistent skincare strategy to manage eczema in your child or children. Below, she shares a list of practical steps that you should include in your child’s daily care routine:

• Moisturise, moisturise and moisturise some more. However, it is important that you don’t just use any moisturiser. Choose moisturisers that are oilier, for sensitive skin and, importantly, choose those that are unscented.

• Use warm water to bathe and only for brief periods, because prolonged soaks in hot water are drying to the skin.

• Use mild moisturising skin cleansers, preferably unscented and with limited sodding properties such as bubble baths which should be avoided altogether.

• Immediately after bathing, the skin should be lightly dried leaving some moisture before applying an effective moisturiser, preferably thick in consistency. It, too, should be unscented or lightly scented.

• For children who can understand, teach them not to scratch or to avoid doing it as best as they possibly can. This can be particularly difficult since eczema can be so itchy. In any event, try to always trim your child’s fingernails to reduce the chances of infection, just in case they do scratch.

• Creams directed at reducing itching may be prescribed. These are usually steroid creams, the potency of which is prescribed based on the severity of the condition. There are newer non-steroidal options which have to be used cautiously.

• Antihistamines may be prescribed to help with itching.

• Choose clothing made of breathable fabric such as cotton. Fabrics such as nylon, spandex, which may be itchy, could irritate the skin causing children to scratch.

• Newly bought clothing must be washed prior to wearing.

• Keep or encourage your child to stay hydrated. This will add needed moisture to the skin.

• Detergents, including fabric softeners used for laundering clothing, should be mild and rinsed well (double rinsing is recommended).

• As best as possible, keep your child away from allergens such as pollens and dust, as well as second-hand smoke.

In the case of children with severe forms of the condition, Dr Griffith said this may have leather-like thickening of the skin in the areas affected, as well as the appearance of pimples. The skin may crack and bleed and as such will require more intensive treatment.