The Basics of Managing Your Child’s Eczema
The article below appeared in the Feb 17th issue of Health with Perdana, a regular column in The Star by Perdana University faculty members. This week’s article is contributed by Dr. Razia Latif, Associate Professor of Paediatrics at the Perdana University Graduate School of Medicine.
Eczema is a condition in which patches of skin become red, cracked, itchy and inflamed. In medical terminology, it is called atopic dermatitis.
The rash can easily get infected, but is not contagious. It can occur at any age, but is commonly seen in children between the ages of six months and five years.
Signs and symptoms
Eczema can affect any part of the body. However, manifestations of eczema vary in different age groups. Eczema looks different in infants than in older children. In infants, the red, inflamed rash is commonly seen on the face, cheeks, chin, forehead and scalp.
In older children, the affected skin appears thickened and brownish, commonly involving the creases of the elbows and the knees, while sometimes also involving the wrists, ankles and hands. The hallmark of the rash in all age groups is itching, which in turn makes the rash worse.
What causes it?
We do not exactly know what causes eczema. Perhaps a combination of genetic and environmental factors are involved.
Approximately half the children who develop eczema will also develop hay fever or asthma. Generally, a history of eczema, hay fever, asthma or other allergies is also present in other family members.
The good news about eczema is that more than half the children who develop eczema will outgrow it by the time they become teenagers.
Common triggers that cause flare-ups of eczema include dryness of the skin, hot weather, sweating, infection, pollen, dust, harsh soaps and detergents, and some allergy-provoking foods.
If your child has eczema, don’t despair! There is a lot that you can do to help your child with eczema.
Bathe the child daily in warm water (not hot water), using a moisturising body wash. After the bath, pat the skin dry and apply unscented moisturising cream or ointment all over the body. Evidence suggests that creams and ointments are more effective than lotions and oils.
Keep the skin moist and lubricated at all times. You may need to apply the moisturiser several times a day, especially in dry weather. Make sure you wash your hands before and after applying the cream.
Make sure that your child’s fingernails and toenails are kept clean and short, so that they do not scratch themselves, which can make the condition worse. Putting mittens and socks on an infant at night and at nap times will help in this respect and will enable baby to sleep better.
Their room should be cool and comfortable, as heat makes the condition worse. Your doctor may prescribe an oral medicine (antihistamine) to control the itching. Your child’s clothes should be soft, cottony and not very warm.
Wash the clothing and bedsheets in a mild, unscented detergent. Vacuum the house regularly as dust can trigger or worsen the rashes. Try to identify and avoid any triggers or allergies that might be making the condition worse.
If the above steps do not help or the rash seems to be getting worse, consult a physician who might prescribe a steroid cream to clear the rash. Use the cream during acute flare-ups as per your doctor’s instructions.
Another reason for consulting your doctor would be infection. This may be the case if the eczema rashes appear bright red, crusty and angry looking, or is oozing yellowish discharge. Your doctor may prescribe an antibiotic to clear up the infection.
The eczema will only respond to the usual treatment once the infection is under control and cleared up. Remember, controlling the dryness of the skin and itching, and avoiding your child’s triggers, is of paramount importance, and may be all that is needed in milder cases of eczema.
There is no cure for eczema, but the symptoms can be controlled by the measures outlined above. This condition often waxes and wanes, so the rash may appear and disappear from time to time.
The rash generally starts to improve around five years of age and the majority of children outgrow the condition by the time they reach adolescence.