Managing Eczema

CaptureEczema has got to be one of the most common skin condition we see in children. If you have children there is a very good chance that your child has had a bit of eczema growing up.

Eczema also known as “atopic dermatitis” is a condition that usually begins in the 1st year of life and is associated with dry and inflamed skin. There is no known cure for eczema but a majority of children will grow out of it by the time they reach school.

Put simply the problem with eczema is that skin is not able to maintain an appropriate moisture level. For reasons yet unknown moisture just keeps seeping through the skin, leading to dry skin, which then becomes inflamed and itchy. Children will then scratch their skin and if left unattended it is not uncommon for skin to become infected which further worsens symptoms. It’s a DAMN VICIOUS circle!

I often tell parents that there are two parts to dealing with eczema.

The first part is just the day-to-day things we can do as parents to help our kids manage their eczema.

These include the following

  • Daily use of a moisturiser to skin whether inflamed or not(cheap is best, nothing is better than plain sorbolene in my opinion).
  • Avoiding heat ( e.g. hot showers/baths)
  • Avoiding irritant clothe (especially wool and harsh prickly fabrics)
  • Trial of soap free shampoos

The second part is the treatment phase. What to do when things flare up.

While this is not the forum to give specific advice there are some general principles we use in treating eczema that has flared up.

  • Moisturiser, Moisturiser, Moisturiser…. Sorbolene, Sorbolene, Sorbolene and truckloads of it, lacquer skin with the stuff.
  • Your GP may give you a cortisone based cream, don’t be afraid to use it, use appropriate quantities. One finger tip covers roughly an area the size of your hands.
  • Wet Wraps – your clinician may ask you to wrap your child’s skin in a wet wrap, these come in a variety of forms. Cheap crepe that is wet works well. Wrap the area that’s affected, this not only helps with pain and itch but helps with moisture retention.
  • Itching will settle once the moisture is restored to the skin, but sometimes we do trial an antihistamine to help alleviate the itch.
  • It is not uncommon for eczema to become infected, if infected your GP may prescribe a course of antibiotics to help.
  • Adding a cup of salt, a small cup of bleach 4% and some baby bath oil to a bath may help with infected eczema.

With our patients we often will sit with the parents and have an eczema plan drawn up. This plan lists what to do and when to do it. What signs to look for and when to see your doctor. Preschools are catching on to this idea and I feel it’s actually a fantastic way to help manage this common condition.

Allergy testing is often on the minds of parents and rightly so. We often reassure parents that allergy testing is often only required for a select few patients. These are patients who are not responding to treatment or those with a very good history of allergy that predisposes them to eczema flare ups (e.g when my child has milk he flares up, when they don’t his eczema is well controlled). When it comes to allergies I often tell parents the history is way more important than the testing. A thorough history for allergies should be taken if suspicion is there by your GP.

Eczema is challenging for everyone involved, never feel like there is nothing you can do, there is always something you can do. A good relationship with your family doctor is paramount in dealing with this condition as you will see them over and over again as your child’s eczema waxes and wanes.

The advice provided on healthykid.com.au is of a general nature and in no way should replace your therapeutic relationship with your doctor

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