What it is and how to manage it

Childhood eczema is the bane of many parents existence, especially in the first few years of a child’s life. Seeing the rash, or worse, the discomfort it brings to your child can at times be very confronting, especially if you are unsure of what it is or how to manage it.

But fear not! Childhood Eczema can be managed relatively easily if you have the right approach.

Childhood Eczema

What Exactly is Eczema and How Does It Affect My Child?

First, some background. Eczema is also known as ‘atopic eczema’ or ‘atopic dermatitis’, and is a chronic skin condition that affects around 15-20% of children, and is most common between the ages of 2 and 4 years. It often disappears with time, but for some people, it can persist into adulthood.

Whilst the exact causes of childhood eczema are unknown, there is a strong genetic factor, and eczema often occurs together with asthma and hayfever. This is called ‘atopic tendency’. While eczema can’t be cured, it can be effectively managed in most children.

Childhood Eczema commonly appears first on the face of younger children, but as children grow older, it’s the skin around the joints that can become the most problematic.

Symptoms of Childhood Eczema

The main symptoms of Childhood Eczema include redness, inflammation and intense itching. In severe cases, the skin may begin crusting or weeping, which could be signs of a bacterial infection. Whether the symptoms are mild or severe, Childhood Eczema needs to be diagnosed by a medical professional to ensure you’re getting the right treatment for your child.

Discuss the problem first with your GP or Paediatrician. If the condition doesn’t respond to the initial management strategy, they may refer you to a dermatologist.

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Managing Childhood Eczema

Even before thinking about treatment, there are two key strategies that should form the basis of every eczema management routine:

  • Identifying and avoiding triggers
  • Regular use of moisturisers

Eczema Triggers:

Just as things like dust and pollen can aggravate hayfever, some irritants are known to trigger or even worsen eczema. These aren’t the same for everyone, but often include:

  • Heat
  • Animal Dander
  • Dust
  • Sweat
  • Food allergens like egg
  • Fragrances
  • Wool Clothing & Carpets
  • Soap
  • Stress

It’s important to be aware of these triggers and watch for any others that might be affecting your child. One way to do this is to use a symptom diary where you can record when and where symptoms occur. This can make it easier to spot patterns or triggers in your child’s diet or environment.

The Role of Moisturisers

Even when the skin appears normal (not red or inflamed), people with eczema have a weakened skin barrier – the part of the skin responsible for keeping water in, and irritants out. Just like a bucket with holes in the bottom, eczema-prone skin will lose water more quickly than normal skin and is often bordering dryness and irritation. Similarly, the incessant itch associated with eczema can be made worse by dry skin.

To work effectively, the skin barrier needs to be hydrated all the time, so regular use of moisturisers should form the foundation of any eczema management strategy. This is why all expert guidelines for eczema management recommend regular, liberal use of moisturisers.

Top Tips for Home and School

Management Childhood Eczema at Home:

  • Keep fingernails trimmed short – this helps reduce skin damage caused by scratching.
  • Develop an eczema management routine with the help of your doctor. Know how much and how often to use moisturisers and establish a soothing bedtime routine.
  • Look for moisturisers that are specifically designed for use with eczema. Examples include QV Dermcare which is designed to relieve the symptoms of mild to moderate eczema. Look for these types of products in your local pharmacy.
  • Encourage kids to take an active role in management their eczema – for younger children, use sticker charts or other forms of positive reinforcement; for older children, help them write down or draw the steps in their moisturising routine for them to follow.
  • Keep a symptom diary to look for new triggers and patterns. Dedicated apps are also available.
  • Make time for self-care. Schedule breaks for yourself where a trusted friend or family member can step in.

Management for Childhood Eczema at School:

  • Discuss your child’s eczema needs with their teacher.
  • Ensure your child has moisturisers in their school bag and the classroom if they need to apply them throughout the day.
  • Be aware that some children with eczema may experience bullying or embarassment because of thier condition. Talk to their teacher about ways to help ensure your child is comfortable and supported at school.

References

1. Stanway A. Atopic dermatitis | DermNet NZ [Internet]. DermNet NZ2004 [cited 2021 Dec 16];Available from: https://www.dermnetnz.org/topics/atopic-dermatitis/

2. Eczema and Dermatitis. In: Clinical Dermatology. Chichester, UK: John Wiley & Sons, Ltd; 2014. page 76–98.

3. Atopic dermatitis [Internet]. National Eczema Association [cited 2020 Sep 24];Available from: https://nationaleczema.org/eczema/types-of-eczema/atopic-dermatitis/

4. World Allergy Organization. Atopic dermatitis [Internet]. 2018 [cited 2021 Dec 16];Available from: https://www.worldallergy.org/UserFiles/file/WAOAtopicDermatitisInfographic2018.pdf

5. Eczema – British Skin Foundation [Internet]. [cited 2021 Dec 16];Available from: https://knowyourskin.britishskinfoundation.org.uk/condition/eczema/

6. Agrawal R, Woodfolk JA. Skin Barrier Defects in Atopic Dermatitis. Curr Allergy Asthma Rep 2014;14(5):433. 

7. Homey B, Steinhoff M, Ruzicka T, Leung DYM. Cytokines and chemokines orchestrate atopic skin inflammation. Journal of Allergy and Clinical Immunology 2006;118(1):178–89. 

8. National Institute for Health and Care Excellence. Atopic eczema in under 12s: diagnosis and management [Internet]. 2007 [cited 2021 Dec 16]. Available from: https://www.nice.org.uk/guidance/cg57/resources/atopic-eczema-in-under-12s-diagnosis-and-management-pdf-975512529349

9. Bourke J, Coulson, I, English, J. Guidelines for the management of contact dermatitis: an update. British Journal of Dermatology 2009;160:946–954. 

10. Holden C, English J, Hoare C, Jordan A, Kownacki S, Turnbull R, et al. Advised best practice for the use of emollients in eczema and other dry skin conditions. J Dermatolog Treat 2002;13(3):103–6.