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Eczema in children
Tips for protecting Eczema prone skin
Healthy skin contains fats and oils which help to maintain moisture by creating a protective layer. In eczema prone skin, the cells don’t produce as many fats and oils and so retain less water. This leads to the protective layer being weaker, allowing irritants and allergens to enter the skin leading to irritation. Eczema is an extremely common condition affecting around one in five children in Ireland. 8 out of 10 cases occur before the child turns 5 years of age. Eczema can cause the skin to become itchy, red, dry and cracked. In severe cases there may be weeping, crusting and bleeding.
Recognising Eczema
Eczema usually occurs in areas where the skin folds, such as: Behind the knees, inside the elbows, the sides of the neck and also around the eyes and ears. The major symptom of atopic eczema is an intense itch. Scratching only provides temporary relief, and leads to more itching and scratching. This is often referred to as the itch scratch cycle, where itch leads to scratching and scratching makes the skin itchy. Scratching worsens eczema, and can make the skin more vulnerable to infection.
During a ‘flare up’, when eczema is very active, symptoms such as redness, dryness and itch worsen, while at other times, symptoms settle. A flare may be triggered by environmental irritants such as soap or detergents, changes in temperature, or allergens like animal dander, but sometimes no cause can be identified. Although there is no cure yet, treatments are available to manage the condition.
Treatments
The most common method of treatment is the use of emollients. Emollients are an essential treatment in eczema and dry skin conditions to moisturise the skin by soothing and softening. Emollients are moisturisers which are used in two ways - applied directly to the skin as a leave-on moisturiser, and as a soap substitute instead of soap and shower gel.
Emollient Wash Products
Emollient wash products work as soap substitutes. Ordinary soaps and bubble baths dry out the skin by stripping away its natural oils. Emollient wash products should be used when hand washing, bathing or showering to leave the skin coated with a protective film afterwards. These products cleanse but do not lather like ordinary soap. Parents of children with eczema should try to bathe their child in an emollient wash product once a day. Emollient creams should also be used frequently; the weekly recommended amount for children is 250 g per week. On a day to day basis, it is recommended to apply an emollient cream at least 3 to 4 times a day. Bath emollients which come in tubs need to be diluted before use. Two tablespoons of emollient should be taken out of the container using a clean spoon, NOT fingers (to prevent contamination), and transferred into a jug. Hot water should be added and the solution whisked with a fork for five minutes before adding to the bath. A bath additive solution can simply be poured into the bath.
Applying Emollients to the Skin
Emollients should be applied several times every day and are an essential part of a longterm skincare regime, even when the skin is clear.
• Emollients should be applied in a smooth, downward motion, in the direction of hair growth, after a bath and before going to bed. • Emollients come as lotions, creams and ointments. However, ointments work better when the skin is very dry. Sometimes, more than one product may need to be used, for example an ointment at night and cream or lotion during the day. • Make sure the skin is moisturised using an oil-based moisturiser.
• Protect children from the harsh winter weather, by wrapping up in warm clothes. • Use a gentle bath wash such as a bath additive. After washing use an emollient cream.
• Changes in temperature can aggravate the skin.
• When drying after a bath, pat the skin gently instead of rubbing the skin dry. • Soak the child in the bath water for 10-20 minutes - keeping them in bath longer may dry out the skin. • Use cotton sheets that have been washed with a sensitive skin detergent. • Apply an emollient cream about 20 minutes before bedtime to allow it to soak in to the skin.
• Try to keep the child’s nails short so any scratching that does occur does minimal damage.
WWho? It can start at any time of life but is most common in childhood,
affecting approximately one in five children. It affects males and females equally
WWhat are the symptoms? Eczema is almost always itchy. The rash
most commonly appears on the face, back of the knees, wrists, hands, or feet
HHow long has the patient had the symptoms? 8 out of 10 cases occur
before the child turns 5 years of age
AAction already taken? Finding the right emollient may be a matter of
