Kids getting itchy rashes now and then are a common occurrence. However if they get eczema, it will be a different ball game altogether. Eczema is a chronic skin problem that flares up every now and then and sometimes won’t quite go away for years, even when there seems to be a remission for a period of time.
Eczema can be particularly stressful to deal with especially when you are the mother of a child with the condition, and trying to handle a distressed and irritable child round-the-clock for the long term.
High Stress Problem
A study was done and published in the National Center for Biotechnology Information (NCBI) to assess parental stress levels of mothers of children less than six years old with eczema. Here is their finding:
“The children with eczema had a mean age of 2.8 years. Mothers of children aged five years or less with eczema exhibited significantly higher total stress scores as compared to mothers of normal children and children with other chronic disorders such as insulin‐dependent diabetes and profound deafness.”
What is Eczema?
Eczema is a disorder that causes the skin to get inflamed, red, sore, swollen and itchy. Sometimes small yellowish-white boils with pus will erupt from the rashes and ooze, or the rashes could get very dry, crusty and flaky with the common denominator being incessant itching and constant irritation.
The condition affects both young adults and children but mostly, it affects the very young and continues to do so until they grow into adulthood. The skin condition is not contagious, however, and cannot be passed on from person to person.
Here is more of what the NCBI study says:
“Atopic eczema is a common childhood disorder. Caring for a child with moderate to severe eczema involves a rigorous skin treatment regime, adjustments to family lifestyle, and financial and social costs which all can place substantial demands on the caregivers. Mothers are usually the primary caregivers and carry the major burden in caring for a child with a chronic condition. Stress will arise if mothers perceive that they cannot adequately cope with these burdens.”
Eczema in Babies and Children
There are several types of eczema such as atopic eczema, contact dermatitis, discoid eczema, nummular eczema, seborrheic dermatitis and so on, but the most common type affecting infants and young children children is atopic dermatitis (sometimes also called infantile eczema or baby eczema for obvious reasons).
In babies, the rash often appears on the face and scalp. In younger children, the rash will often appear in the creases of the skin like the elbow and knees. It will also affect other areas such as the face, neck, wrists, chest and even eyelids.
In young adults such as teens and those older, the rash will often appear on the hands and feet. Those who have had atopic dermatitis as a child may see drier, leathery or scaly and peeling version of the rashes as adults.
The Allergy Centre Malaysia has reported that an estimated 20% of the population suffer from atopic eczema with 90% of these sufferers having developed this condition before the age of five.
“In the young, the rashes typically appear on the cheeks, forehead or scalp, on arms and trunk. Scratching causes the rash to spread. Atopic dermatitis is a relapsing-remitting condition which flares-up periodically often triggered by allergens, irritant chemicals and stress,” they say.
Allergy Centre Malaysia further says, atopic dermatitis in young children is a risk factor for the development of airways disease including asthma later in life. Thus, children five to seven years old may develop allergic rhinitis and asthma if they had food-triggered allergic dermatitis during infancy.
The Meaning of Atopic and Dermatitis
The reason this type of eczema is called atopic dermatitis is because the word “atopic” means allergy or a condition or “flare-up” that is triggered by a reaction to an allergen. Allergens in the environment include:
- The weather, humidity, pollutants in the air caused by rapid urbanisation, the haze
- Dust mites
- Detergents, soaps, perfumes and fragrances
- Animal hair and saliva
- Certain fabrics such as wool, synthetics, “scratchy” “pokey” or non-breathable materials
- Hormonal changes (for adults ─ often before periods or during pregnancy)
- Certain foods like milk, eggs, soy, seafood, certain fish
“Dermatitis” means a medical condition in which the skin becomes red, swollen, and sore, sometimes with small blisters, resulting from direct irritation of the skin by an external agent or an allergic reaction to it.
How to Prevent or Deal with Flare-Ups
Eczema can be hard to deal with especially when it occurs in a young child who is constantly irritated and distressed by the discomfort. The most helpful thing you can do is to prevent the flare-up before it happens.
1. Keep your child’s skin moisturized. Use fragrance, alcohol and colourant-free moisturisers for your child. Cream or ointment tend to be more moisturising than lotion. After a bath, gently pat the skin with a towel and then apply moisturiser to the damp skin to lock the moisture in. Apply the moisturiser at least once a day or more often if needed. The moisturiser should be applied to the face and entire body of the child.
2. Keep your child cool. Blame it on the Malaysian weather. Some mid-mornings till early evenings can be blistering hot and dry with temperatures going up to 34°C or even higher. Even in the house with windows open and the fans at full blast, the air could remain still and stuffy. Excessive heat and intense sweating can cause eczema outbreaks. You can turn on the aircon but do ensure the air doesn’t get too dry. Dry air can also trigger eczema. Use a humidifier if you have to. Also, avoid sudden changes of temperature from hot to cold and vice versa because that too can trigger an attack.
3. Avoid irritants. People who are sensitive to scratchy fabrics or chemicals in soaps and detergents should wear soft fabrics such as 100% cotton clothing. Use mild laundry detergent with no dyes or perfumes. When bathing the child, use gentle, fragrance-free body cleansers.
4. Beware of trigger foods. Being aware of any foods that may cause an outbreak is one of the first steps. Some of the foods associated with eczema flare-ups include: cow’s milk, eggs, soy products, gluten, nuts, seafood including shellfish. Other food allergens include processed, fast food that contain preservatives, artificial ingredients, trans fats and high sugar foods like candies, cakes and fizzy drinks. It has been discovered that exclusively breastfed babies are less likely to develop eczema. Also, an infant is less likely to develop eczema if the mother had been taking probiotics and did not drink cow’s milk during the pregnancy.
5. Remind your child not to scratch. Scratching can make the rash worse and lead to secondary infections on top of the eczema. The wet sores invite more bacteria or fungi in and the domino effect can be nasty. Also, the more your child scratches, the more itchy the area will get. Apply the necessary creams or medication. Keep your child’s fingernails short and smooth and try to distract your child from scratching. Also keep his hands clean.
6. Seek your child’s doctor’s advice. Is it caused by the food, pet, or dust mites in the bedding? Or is it caused by certain foods? Perhaps it is the heat or sweating? Try to work out with your doctor the means to avoid all these triggers, if possible.
Your child’s doctor may recommend medicines to help your child feel better and to keep the symptoms of eczema under control. He may prescribe topical creams and oral antihistamines and a variety of other treatments.
Depending on the severity of the eczema, there are also natural remedies and over-the-counter medication such as steroid-free topical eczema cream that you could apply on your child’s eczema. Fortunately in Malaysia, there are a few of these brands which you can get in our local pharmacies or even at Chinese pharmacies. But do check with your doctor first if these medicines are alright to use.
Eczema is a chronic skin problem, it can come, it can go or it might stay for over the long term. The trick is to prevent attacks and will require vigilance, ongoing management by you, your child, and your child’s doctor.
For more smart child care tips, be sure to visit Motherhood.com.my.