Eczema is a very common condition, particularly in children, affecting up to 20% of kids globally. The condition affects the skin, causing a red, itchy, flaky rash that can occur on any part of the body. In children, it commonly appears on the face, arms and legs.
The rashes are not necessarily always present; often they come and go. These are often referred to as “flare-ups”.
When eczema occurs, the very outer layer of the skin called the stratum corneum of the epidermis or the skin barrier, doesn’t function properly in keeping moisture in, and irritants out.
In eczema skin, this barrier is porous or not tightly sealed, allowing irritants in and provoking a reaction from those with an “over-sensitive” immune system. Common symptoms include itch—which in kids may be extremely difficult because it means scratching away at night with some leading to skin bleeding which eventually disrupts sleep and negatively affects both the child’s and the parents’ quality of life.
Eczema tends to run in families so if one or both parents have it, there is a good chance their child will have it.
Eczema may develop at any age, but typically in babies from 3-4 months old onwards; some children will “grow out” of the condition as they get older. However, for others, it is not the same—for reasons yet to be defined by science.
So, what should you do if your child develops a rash that doesn’t go away, or is itchy and irritating? You should first bring your child to a doctor who can help identify the nature of the rash. If it is diagnosed as eczema, the treatment will involve a two-step process:
1. Eczema in kids: The acute phase
In this phase, the condition usually flares up and the focus is on trying to get the symptoms under control:
- There is an immune system reaction in eczema, which results in inflammation of the skin. As such, steroid creams which are anti-inflammatory are often used to control the inflammation. Many parents are afraid of the long-term effects of steroids, but when used right, the risk of side effects can be minimised.
- To help soothe the dryness of the skin, you need to moisturise your child’s skin regularly, as often as five times a day!
- To stop the itch, creams that combine cooling menthol with a moisturiser, help to relieve the itch and break the itch-scratch cycle. This not only prevents physical damage to the skin from excessive scratching but also means your child will sleep better and suffer less stress.
- If there is a skin infection, then an antibiotic may be required.
- If the flare-up is severe, then more intense therapy may be required and your child may have to be referred to a dermatologist for specialist care.
2. Eczema in kids: The chronic phase
In this phase, we try to reduce or prevent flare-ups from occurring. While no cure has yet been found for eczema, there are strategies (other than any prescription medicines that your doctor might prescribe) that minimise the frequency of flare-ups, such as:
In between flare-ups, the skin barrier is still defective and vulnerable to irritants, thus using a moisturiser daily (at least twice a day) is advised. Moisturisers containing ceramides are particularly effective, because eczema skin is lacking in ceramides (ceramides are substances normally present in the skin, are key to the normal functioning of the skin barrier). As such, applying ceramide to the skin helps to restore the barrier to its healthy state, where it can resist irritants and retain moisture.
Use a gentle body wash or cleanser
Harsh soap is not recommended for eczema skin as it tends to have alkaline, which can promote the growth of bacteria on the skin. As such, when choosing a body wash or cleanser, check that the product has a slightly acidic pH of between 5 and 6.5. Note that many body washes contain ingredients—such as sodium lauryl sulfate, perfumes/fragrance and parabens—that are potentially irritating to eczema skin.
Choose body washes that are free of irritants that are gentler on the skin such as Suu Balm Kids Body Wash.
Minimise exposure to triggers of your child’s eczema
This is important, but very hard to do! In general, reducing stress is important (try to create a happy, positive environment for your child), but also identifying any potential food triggers and avoiding these foods, using gentle detergents, reducing dust in the home, keeping a stable temperature in the home, and reducing exposure to pollution are all positive steps you can take to reduce exposure to triggers.
Finally, be reassured that you are not alone. Eczema is a common condition and there are many parents out there who are also dealing with it. There are various patient support groups that have the necessary tools and resources for optimising your child’s care, and also provide emotional support.
This article was contributed by Dr John O’Shea, Co-Founder of Good Pharma Dermatology. Good Pharma Dermatology produces a brand of consumer healthcare products, including Suu Balm.
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