Eczema

Your child of two years always tells you to scratch her back, hands and other areas of the body, which really gets you worried. You find that the more she scratches herself, the more severe are the rashes that develop. A visit to the doctor confirms the diagnosis as eczema, a kind of dermatitis that results in red, swollen, and itchy skin.

More about eczema

The most common kind of eczema is atopic eczema, seen in both children and adults. Atopic dermatitis is most common in babies and children, known to affect around 1 in every 10 kids (15 to 20%) but only1 to 2 % of adults. ‘Atopic’ refers to being overly sensitive to allergens in the environment like pollen, mold, dust, animal waste and certain food items.

Dermatitis refers to the inflammatory condition of the skin. This is known as skin eczema. Most children develop this condition before the age of five, and in most cases, it resolves by adolescence. However, some people do continue to suffer throughout their lives.

The exact cause of eczema is still unknown, but a complex interaction of genetic and environmental factors may be a cause. Families with allergic tendencies may be at a higher risk and other triggering factors include skin irritants, the weather, and temperature. However, eczema is not contagious, and though there is no definite cure, it can be managed by avoiding the causes that trigger it.

To keep eczema under control, the following practices may help on a routine basis. When the eczema is under control, then maintaining and protecting the skin is important.

  • Use emollient therapy, where washing with oil is recommended, and avoid using anything soapy.
  • Commercial soaps that bubble and dry the skin should be avoided.
  • After oiling, use moisturizers, to keep skin soft and supple. When there is eczema flare, the skin is red, itchy, dry and flaking. So, use emollient therapy and thicker moisturizers.
  • Corticosteroid creams can be used to reduce inflammatory signs.
  • Keep an eye on bacterial or fungal infection setting in the cases of lesions oozing, crusting or when there is a fever.

In moderate to severe eczema flare, intensive treatment for eczema is required,

  • A greasy cream should be applied several times during the day, along with prescribed topical corticosteroids.
  • Wet wraps in the form of wet bandages can be wrapped over emollients or steroidal creams, over the irritated areas to ease the itchiness and relieve the inflammation.

During eczema, there is reduced production of fats and oil in the skin, and lesser water retaining properties. Due to moisture evaporation, skin cells shrink; causing cracks, through which irritants can enter, resulting in more itchiness.

Such flare-ups of eczema can be prevented by avoiding triggering factors such as:

  • Dry skin
  • Scratching
  • Swimming in chlorinated pools
  • Playing in sand
  • Sitting on carpets at school
  • Perfumes, soaps and cleaners
  • Temperature changes (more heat)
  • Wool or man-made fibers
  • Cigarette smoke

Allergy causing substances (allergens) from food, plants, animals or the environment includes:

  • Eggs, peanuts, milk, fish, soya and wheat products
  • Pollen
  • Mold
  • Dust mites
  • Animal dander

Other factors that can make eczema worse are:

  • Stress, anger, frustration
  • Long and hot baths
  • Not moisturizing skin properly
  • Dry climate year-round
  • Sweating
  • Bacterial infections

Tendency to scratch due to the itchiness makes it worse, so curb this ‘scratch and itch’ cycle, which can be very distressing by implementing the above practices in everyday life.

Eczema in children can annoy them and make them feel uncomfortable. It sometimes can have an emotional impact as they become older.

As parents, try to establish a skincare routine, ensuring bathing is with only with lukewarm water and applying moisturizers on a regular basis.

Try to prevent the child from encountering a stressful situation, like extra competitions at school. Help the child to de-stress and focus on other activities that bring enjoyment.

Both adults and children may benefit from taking an oatmeal bath, on consulting the doctor. Always pat the skin dry gently with a soft towel after bath, instead of rubbing vigorously.

Take any prescribed medicine correctly, especially after bathing, as topical applications get absorbed faster after a shower or bath.

A humidifier may also help when air inside the house is hot and dry. This helps to keep the skin moist.

During summer wear appropriate clothing so that there is minimum contact of sweat with the skin.

Alternative medicine is also an option, where different kinds of oils like chamomile or evening primrose and other such oils can help bring relief along with a change in diet.

Some changes to the extent of even changing one’s career, might be required as occupations like farming, hairdressing, industrial and domestic cleaning cause exposure to chemicals and other irritants.

It is always wise to continue taking care of the skin even after outgrowing eczema, as the skin may still be vulnerable to any kind of irritation.

Though it is impossible for any healthcare practitioner to predict whether the condition in an individual will improve or not, taking the necessary precautions, keeping your doctor informed and avoiding the triggering factors can help people affected with eczema to still live a satisfying life.

There is no specific way to prevent dermatomyositis, but one can develop strong and flexible muscles by exercising regularly. An exercise program must be made after consulting the physical therapist. The skin should be protected from sunlight by wearing protective clothing and applying a sunscreen lotion.