Managing childhood eczema

First Look Asia looks at childhood eczema — at least 20 per cent of schoolkids suffer from it…

Kids-Managing-childhood-eczema Guest Dr Teo Wan Lin from Raffles Skin & Aesthetics

Q:  What should parents of baby look for when trying to detect the onset of eczema?
A:
 Eczema typically starts as an itchy, dry skin condition in the first year of life or later. Parents may notice red, scaly patches occurring on areas such as scalp, face, chin, body, arms, legs or knees. Children may rub themselves against bedding to relieve themselves of the itch. This could be severe because it will interrupt children’s sleep at night.

Q:  Is eczema similar to nappy rash?
A:
 Nappy rash is different because it is caused by an onset of certain factors such as the soiled diaper coming in contact with the skin.

Q:  Is eczema hereditary?
A:
 If one or more parents suffer from eczema, the child is also more likely to develop the condition.

Q:  What usually causes eczema in children?
A:
 Eczema is primarily due to a defect in the skin barrier, which is genetically determined. It can be made worse by skin irritants, allergies, environment and stress. 

Q:  Are food and allergies always linked?
A:  
Food does not cause eczema. However, some studies show that children below the age of 4 may find that certain foods worsen the condition of eczema. It is important to consult with your child’s dermatologist before excluding food from your child’s diet as children need a balanced diet . Only children with established food allergies will find that certain food can aggravate their eczema condition. Common foods that can worsen the condition include peanuts and soy milk. 

Q: What should children with eczema not do?
A:
 Instead of scratching, I tell my patients to pat their skin, keep the skin properly moisturised, use wet wipes to sooth itchy skin, keep fingernails clipped and wear cotton gloves to bed. Wear clothing [of] light, breathable material such as cotton to sleep.

Q: How should parents shower their child with eczema?
A:
 It’s best to use soap-free cleansers or bath oils. Try to avoid sodium lauren sulphate as it contains a lathering agent that can irritate and dry the skin even more. Avoid abrasive materials such as loofahs or wash clothes. Keep the shower short. Use luke-warm rather than hot water. Pat the skin dry with a towel and use moisturiser liberally when the skin is slightly damp. Go for a gentle shampoo. 

Q:  When do parents need to bring their child to a dermatologist?
A:
 I recommend that when the itch gets severe enough to interrupt daily activities. If the skin is infected — red with pus oozing out or if the child is unwell — then it will be necessary to seek medical attention.

Q: What are the side effects of steroid treatments?
A:
Topical steroids are important to reduce inflammation in eczema. However, if they are used inappropriately, they can cause skin thinning, which is cosmetically disfiguring. There is also a phenomenon called tachyphylaxis, which is when steroids lose their effects and you have to use stronger steroids instead. However, if you are getting your eczema treated by a qualified medical professional, the correct dose, potency, duration and class of steroid will be given — appropriate to your child’s eczema depending on the location, age group and severity of eczema. 

Photo: INGimage

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