Eczema is a chronic skin disorder that begins primarily in infants and children but can also present at ANY age. It’s characterized by red and Dark, dry, and extremely ashy itchy skin. In fact, itching is a hallmark of this common condition.

Dr. Patricia Yap
patsyapja@me.com

“DOES YOUR CHILD HAS ECZEMA?”

If your doctor has told you that your child has eczema, you’re not alone. More than ten

percent of infants and toddlers are diagnosed with eczema, also known as atopic dermatitis. Of those, 60% continue to have some symptoms like dry skin into adulthood. For many, the symptoms will become less bothersome as childhood progresses. Whatever your child’s prognosis, you can learn how to manage eczema and teach your little boy or girl how to manage this condition.

WHAT IS ECZEMA?

Eczema is a chronic skin disorder that begins primarily in infants and children but can also present at ANY age. It’s characterized by red and Dark, dry, and extremely ashy itchy skin. In fact, itching is a hallmark of this common condition. Controlling and preventing the itch is your first line of defense against eczema flare-ups. In layman term, your skin is  like the wall around the house, once it is breached by intruders( internal or external)   the wall start to burn/ inflame (  inflammation eczema).

 

WHAT ECZEMA LOOKS LIKE

In infancy, from birth to about age 2, eczema is manifested by red, dark weeping, crusted rashes (lesions) on the face, scalp, arms, and legs. In long standing cases the rashes may appear black (hyper-pigmented) and thickened (lichenified) making the skin appeared rough.

In childhood, from age 2 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.

In puberty, eczema may clear up entirely or flare-up repeatedly with occasional periods of relapses when the person is under stress from exams.

 

RECOGNIZING ATOPIC DERMATITIS

An itchy rash as described above, along with a family history of atopic problems( Hay fever, Asthma, Sinusitis, Migraine ), may indicate atopic dermatitis. Proper, early, and regular treatment can bring relief and may also reduce the severity and duration of the disease.

The disease does not always follow the usual pattern. It can appear on the palms, backs of the hands and fingers, or on the feet, where crusting, oozing, black and thickened areas may occur on and off for years.

 

A SIMPLE EXPLANATION FOR ATOPIC ECZEMA

Your child was born with certain over reactive cells. When something triggers these cells, such as an irritant, allergy or an infection  the cells migrate towards the skin’s surface and cause it to burn ( inflame ) ; resulting in itching, redness, and swelling.

Managing eczema involves preventing the triggering factors, treating the inflammation and promote healing and restoring the skin barrier function

 

TRIGGER FACTORS

For many children, flare-ups can be caused by skin irritants such as soaps, solvents (e.g. bleach), and other drying compounds (e.g. acetone); chlorinated water and 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 around the  mouths are often affected.

One of the most difficult trigger factors to predict in infants and young children is emotional stress. Children with eczema often react to stress by experiencing red flushing and itching. For the child with eczema, typical childhood feelings such as anger, frustration, and tear can contribute to an eczema flare-up.

 

“MOISTURIZE, MOISTURIZE, MOISTURIZE”

Dry skin is more likely to crack and flake, making it open to irritants, pollutants, and germs that may bring on an eczema flare-up. Keeping skin moist is the first line of defense against eczema. Make bathing and moisturizing a part of your child’s daily routine and get him or her involved in moisturizing as early as possible.

  • Bathe your child in lukewarm water, never in hot water as hot water strip the natural moisturizer made by skin. Allowing him or her to play in the tub can be a relaxing and enjoyable time, but don’t allow your child to sit in soapy water for too long. At the end of the bath, rinse, and moisturize.
  • Moisturize while the skin is still damp. When water evaporates from the skin surface, it causes drying and chapping, so apply moisturizer as soon as possible after your child’s bath locks in moisture.
  • Ointments containing pure petroleum jelly without preservatives are the best, as they are non-irritating and promote healing. Creams have preservative which may be fine for moderately dry skin but can be irritating if the skin is already inflamed. Lotions containing alcohol should be avoided as they can actually increase dryness.

 

KEEP YOUR CHILD COMFORTABLE

  • 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 or bathing suits and waistbands are often trouble spots for children with eczema.
  • Avoid fabrics like wool, nylon, or 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 getting sweaty and overheated, monitor exercise and bathe as soon as possible after vigorous activity.
  • Keep the house cool, especially your child’s bedroom. Always use lightweight, soft bedclothes and be aware of which stuffed animals and toys might trigger a flare-up.
  • Because children with eczema are often prone to other allergies, keep family pets outdoors or at least off beds, sofas, or other areas where your child plays.

 

TREATMENT

AVOID precipitating factors!

Moisturize , moisturize , moisturize  to reinforce the integrity of the skin so the barrier function is optimized and not easily breached!

Your dermatologist/doctor can prescribe external medications such as cortisone creams.Internal medications such as antihistamines can help to deal with the itch. Oral antibiotics may be prescribed if there is also a secondary infection. For severe cases, your dermatologist may recommend oral steroids. There are newer types of internal and external medications that may be helpful for patients when standard treatment doesn’t work.