Living with eczema
What is eczema?
Eczema or atopic dermatitis is a very common inflammatory condition of the skin. While the causes are not well understood, eczema occurs when the skin barrier does not function properly causing the skin to dry out. Children with eczema are usually affected by dry, scaly, red and itchy skin. Ooze and skin break down may also occur which can be distressing.
In babies, eczema is most commonly found on the face, scalp and neck and may spread to other parts of the body. In older children, eczema also occurs in these upper body areas but is seen more often in the creases of elbows, knees. Eczema tends to improve significantly with age usually resolving by the age of five. Whilst some children will completely outgrow their eczema, most will continue to have a tendency for dry and sensitive skin into their adult years.
Are eczema and allergies associated?
It is common for people with eczema to have or develop other allergies. In fact, many infants with severe eczema will also have food or environmental allergies. Despite this apparent relationship, food avoidance will not cure eczema however in certain children, removal of specific food(s) may help improve more severe eczema symptoms. It is important to have your Immunologist/Allergist advise and monitor this approach as food restrictions are generally unnecessary and could impact negatively on your child’s growth and nutrition.
What about other triggers?
Because the skin barrier is damaged, this makes the skin more susceptible to irritants. Triggers such as chlorinated pools, sandpits, carpets or grass, perfumes, soap, chemicals, woollen or synthetic fabrics, temperature changes or even stress and infections are known to worsen eczema. Avoidance of these potential triggers is not routinely recommended and may only be relevant for some sufferers of the condition.
A common misconception is that highly specialised skin products are required to manage eczema yet this is generally not the case. Oral steroids can be beneficial to treat inflammation but must be used as prescribed and are not recommended for general use as they can lead to new flare ups post use.
It is recommended that sufferers avoid skin products which contain food-derived oils such as coconut or peanut or food-derived proteins such as goat or soy products, particularly if your child has allergies to these.
It is important to be aware that eczema flares can not only create discomfort, but can also lead to scarring if not treated, or trauma to the skin from associated itching and inflammation.
I recommend following three basic principles to see a marked improvement of your child’s eczema.
- Keep skin hydrated by using moisturisers 3-5 times per day. Some examples of products include Dermeze, Aveeno, QV, Epaderm, etc.
- Use oils in the bath or shower (QV, Paraffin oil, etc)
- Use ointments (a type of “oily cream”) over creams
- If available utilise baths over showers as baths allow for better moisturisation
2. Treat flares:
- Treat redness and inflammation quickly and with sufficient topical steroid
- Use steroid ointments over creams and use steroids with adequate potency. Please seek medical advice
- Apply moisturisers only after the corticosteroid has been applied to affected areas
3. Control itch & infection:
- Use cold compresses / wet wraps. Wet wraps are bandages wrapped over moisturisers and steroids and applied to affected areas. This will control the itch by cooling the skin and rehydrating the area.
- Use non-sedating antihistamines regularly to control itch. Some examples of non-sedating antihistamines include Zyrtec, Claratyne, Aerius, Telfast, etc
- If there are signs of early infection (red, hot, weeping eczema), use an antiseptic wash like Condy’s Crystals in the bath
- See your doctor as antibiotics may be required
For more information visit www.allergy.org.au or see your doctor who can refer you to a paediatric allergist.
If your child is experiencing regular symptoms or side effects from eczema, it may be time to seek paediatric specialist care. Make an appointment with Dr Pinzon Charry, call 07 3177 2000 or use the booking form to make an appointment.