Childhood Atopic Dermatitis: Unravelling the Truth - November 2024

Imagine a child grappling with ceaseless discomfort. Their innocent laughter stifled by persistent itching, their excitement dampened by rashes that never seem to go away. Frustration, irritation and despair. That’s what daily life is like for a child suffering from atopic dermatitis (AD). The emotional toll of severe atopic dermatitis extends far beyond the superficial layers of the skin. Thankfully, with early and effective treatment this scenario can be managed well. Based on the results of a recent survey, we reveal the challenges, insights and solutions that provide some much-needed relief, with some help from Dr Leong Kin Fon, consultant paediatric dermatologist based in Hospital Kuala Lumpur. The Emotional Trauma of Atopic Dermatitis It can be hard to see your kids watching from the sidelines as their peers lead normal lives, while they have to sit at home and stay indoors. That is the reality of parents who participated in the survey, where over 20% remarked that AD severely impacts their child’s ability to do normal things like playing sports, socialising with friends, going to school and even getting dressed. Moreover, 34% of parents also noted that their child demonstrated mood swings and emotional sensitivity as a result of their condition. According to Dr Leong, this does not bode well for their development. When AD starts to affect psychosocial development and sleep quality, it will also begin to affect focus and school performance. Children suffering from AD may also feel isolated or self-isolate, as they find that friends won’t play with them. They may feel further excluded if parents ask their teachers to keep them out of certain activities. “We should not stop kids from being involved in outdoor activities,” says Dr Leong. “We should tell them how to manage the outdoor activities. Allow them to play but ask the teacher to allow the child to rinse off the sweat and apply moisturiser immediately after. This is a more positive way to handle the situation.” The Challenges of Treating Atopic Dermatitis But why do these children have to suffer with atopic dermatitis at all? Aren’t we at a place in time where medical treatment is advanced enough to treat a skin condition? The survey found that the main issue that parents face when combating their child’s skin concerns starts at the doctor’s office. Over 55% of parents surveyed struggled with conflicting and unclear medical advice. Most feel as though their child’s condition is not being taken seriously by healthcare professionals, leading to unclear advice and years of ineffective treatments. Moreover, Dr. Leong explains that diagnosing AD is difficult because there are so many things that play a role in its emergence. He refers to these as a ‘rojak’ of factors that need to come together, resulting in AD among those who are susceptible to the condition. Some factors like our DNA cannot be changed, as some genes are responsible for causing itchy, dry skin. But just having the gene isn’t the whole story. As it turns out, the environment plays a big role too. The world has become an increasingly AD-friendly place, with more pollutants in our surroundings that interact with irritants in our sweat, friction from tight clothing, and allergens in the food we eat. So, in a nutshell, all these environmental factors interact with certain genes, creating a perfect storm that contributes to AD development. How to Address Atopic Dermatitis Effectively Dr Leong offers three important tips for parents to help manage atopic dermatitis. First, manage expectations. Parents often get disappointed when their child’s atopic dermatitis does not resolve in a short amount of time. Dr Leong urges parents to adopt realistic expectations. AD is not a condition that can be cured, and it takes more than just a few sessions to learn how to manage it well. Second, approach treatment as a learning experience, with the doctor playing a crucial teaching role in the early stages. For example, learning about which creams are best for different situations such as dry vs humid environments, the consistency and texture of the cream or lotion, and which ones work best for different body parts. Finally, parents need to be flexible and understand that there is no fixed regiment for AD. More often it is a combination of different medications that creates optimal results. That said, parents need to adjust their child’s regime to suit the weather, activity, temperature and other factors. Treatments Available for Atopic Dermatitis According to the survey, only 29% of parents use medications prescribed by doctors. The rest depend on alternative treatments to treat their child’s AD like traditional Chinese Medicine or TCM. However, according to Dr Leong, TCM is not effective for someone with full-blown AD. Furthermore, he explained, any TCM treatments that do work may actually contain steroids or harmful chemicals like arsenic. Parents should be careful about using traditional and natural remedies because not all of them are truly organic or free from things like steroids, parabens and alcohol. Additionally, even if they do work, it is only for a short amount of time. For example, a product would be suspect if it is marketed only using a parent’s testimonial instead of science-backed research. He says that, at the end of the day, you still need medicated cream or medicine prescribed by a licensed healthcare professional, in injection or oral form, to control AD. Recent Breakthrough in Atopic Dermatitis Treatment According to Dr Leong, the perfect treatment for moderate to severe AD does not yet exist. To fulfill this criteria you would need four 4 important parameters: speed, sustainability, efficacy and safety. First, the AD medication needs to produce fast results. Second, it needs to be sustainable, or long-lasting. Third, it needs to be very effective, offering at least 90% reduction in itch, scaling, redness and overall severity. Fourth, it needs to be safe without long-term side effects or health risks. “We now have what are called ‘injectable biologics’.” says Dr Leong. “Although it is more costly compared to other therapies, they fulfill the four parameters which makes it a good option for moderate to severe AD.” Tackling the Problem of Atopic Dermatitis The most important thing for parents to know about AD is that early diagnosis and treatment is key in helping prevent AD from getting worse, which can lead to chronic relapsing. This will lead to better outcomes in terms of life quality. Empowered with knowledge, treatment paired with a personalised management plan will allow children relief from AD symptoms that could otherwise affect many aspects of their life. As they grow older, parents will likewise need to empower their children to actively manage their condition. With better understanding and the new treatment options, there is more hope and a brighter outlook for children with moderate to severe AD to lead fuller lives. Disclaimer: The information provided in this article is for informational purposes only and should not be considered as medical advice from Motherhood. For any health-related concerns, it is advisable to consult with a qualified healthcare professional or medical practitioner. For more insightful stories and fun recipes, stay tuned to Motherhood Story!

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