Written by Dr Amjad Khan for Doctify
If it wasn’t you, it was another child at school, who always seemed to have a patch of dry skin in the crook of their elbow or was constantly itching their knees. Eczema can be a nightmare for parents with little ones who suffer from it, especially in summer.
Luckily, Doctify Paediatric Dermatologist Dr Amjad Khan has provided us with a handy guide for managing this common skin complaint in children.
So, what is eczema?
Eczema, or atopic dermatitis, is a common dry, itchy skin condition in which skin looks red and sometimes fissured. It can sometimes be associated with allergies. More than two thirds of eczema cases manifests themselves in children under five years of age. The majority of these children have spontaneous remission before adolescence, however, while the rest continue to have eczema into adulthood.
Usually a third of young children are sensitised to common allergens including food, pets or house dust mites. Up to half of moderate to severe eczema patients can end up having asthma, while two third in this category carry a risk of developing hay fever.
What causes it?
Eczema is a complex disease caused by genetic as well as environmental factors. The condition makes skin more porous so it loses water easily and becomes dry. This is the reason that skin is more prone to infections. The risk of developing eczema is much higher in those whose family members are also affected. The best known gene mutation associated with eczema is that of filaggrin gene. About 1 in 10 people in the UK carry this gene mutation. This results in poor skin barrier function hence loss of water from skin and dryness.
Is it more common in children or adults?
Eczema is more common in children. Some children grow out of their eczema, so less adults have eczema compared to kids.
What mistakes do people often make when managing it?
There is a lot of misconception about use of steroids in eczema. There are four categories of topical steroids depending on their strengths including mild, moderate, potent and very potent. The most common mild topical steroid cream used for eczema is 1% hydrocortisone. It is quite safe for use in all age groups for short durations i.e. 1-2 weeks
What is your advice to parents of children with eczema?
- Keep the skin moisturised to reduce dryness
- Use topical steroid regularly and as advised to keep redness (inflammation) in the skin under control
- Consider oral anti-itch (anti-histamine) medication, if itching is a significant issue
- Avoid things that make your child’s skin flare up, such as overheating or any chemicals like soap and detergents
- Short water contact during bathing, i.e. under 10 minutes, is better for eczema patients
- Poor response to treatment, oozing or blistering may indicate a secondary infection. Please seek urgent medical attention to avoid spread of infection
- There are non-steroidal creams called Calcineurin inhibitors, which are generally as effective as steroids for eczema. Please speak to your doctor to see if these are appropriate for your child instead of steroids
