How to get a handle on childhood eczema – Stuff.co.nz

DR CATHY STEPHENSON

Last updated05:00, February 16 2017

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The common symptoms of eczema include red, dry, itchy, weepy or cracked skin.

Eczema is one of the most common health problems in childhood more than1 in 10 kids will have eczema at some point, and that rate is almost doubled for Maori and Pacific Island children.

Although not life-threatening, the effects of eczema can be devastating and wide-reaching: time off school, sleepless nights, and frequent medical appointments can all place immeasurable pressures on families and caregivers.

However, the good news is that often eczema can be controlled, if not cured, so here are some facts and tips that might be of use if you or your child are suffering:

*Eczema is a recurring, non-infectious, inflammatory skin condition; it is closely linked to other "atopic" conditions such as asthma and hayfever, and can often run in families.

*Eczema can appear in babies as early as a few weeks of age; many children will grow out of it by adulthood, but around 50 per centwill still have some symptoms by 20 years of age.

READ MORE: *Eczema can blight a childhood *How to manage eczema *Itching for a solution for eczema

* Eczema is characterised by dry skin, inflammationand a breakdown of the skin's "barrier" function this leads to an increased risk of infection with staphylococcus bacteria, as well as a heightened response to irritants.

* The common symptoms of eczema include red, dry, itchy, weepy or cracked skin; the areas typically affected include face, neck, chest, behind the knees, inside the elbows and ankles, although any part of the body may be involved.

*Complications of eczema include skin infections, which can become very serious if left untreated, poor sleep which in turn can affect school performance, low self-esteem and anxiety.

* "Flare ups" of eczema can be caused by all sorts of things, including temperature changes, stress, illnessor exposure to "irritants" such as chemicals, soaps, water, pollens, moulds, dust and pet hair; for some children, diet may be a trigger too, especially foods containing dairy, wheat, eggs, nuts, seafood, preservatives and additives. Working out what particular triggers your child is susceptible to by keeping a diary of their symptoms is one of the most effective things you can do to help.

* Treatment should be aimed at minimising both the frequency and severity of flare-ups, rather than getting rid of symptoms completely. For treatment to be successful, parents and children need not only good, timely education about eczema and how to manage it, but ongoing support as well your doctor should be able to help, and can refer you to a local eczema nurse if required.

* Other than identifying and avoiding triggers, the mainstay of treatment for eczema is emollients (or special moisturisers) applied to the skin as frequently as is feasible. These moisturisers restore the skins barrier function as well as rehydrating it. Inadequate emollient use is the most likely reason for a flare-up or deterioration in symptoms.

*There are lots of emollients available on prescription, many of which are fully subsidised. It's important to find the one that works best for you and your child creams or ointments that are too hard or time-consuming to put on will probably sit in the cupboard unused, so I always advise patients to try a few and let me know which one they prefer. They should be applied at least three times a day if possible, in generous quantities on average, a young child should use about 250g of emollient per week, while an older child should get through around 500g, or one big container. One way to help your child as they get older is to "decant" some of the cream or ointment into a smaller, clean container and encourage them to apply it during lunchtime at school, thus avoiding the skin getting too dried out. To avoid getting dangerous bugs into the cream, use a clean spoon to scoop it out, rather than your fingers.

* Some emollients specifically aqueous cream and emulsifying ointmentcan be used instead of soap; they should be mixed with warm water in a bath or shower, and applied to skin to both clean and hydrate it.

* Topically applied corticosteroids are used to treat "flares" in more severe eczema. Ideally, your doctor should help you work out the lowest-potency steroid cream or ointment needed to manage your symptoms it is important to use it as directed until the symptoms settle, and then stop use to give your skin "a break". For some children with very severe eczema, treating with steroids for two days every week can prevent flare-ups occurring.

Oral antihistamines (to stop the itch-scratch cycle), oral antibiotics, oral steroidsor theapplication of creams using a method called "wet-wrapping" can all be helpful for children whose eczema is hard to control.

For more information visit allergy.org.nz

Dr Cathy Stephenson is a GP and forensic medical examiner.

-Stuff

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