A Unique Child - Health: A guide to ... Eczema

- What is eczema?

Eczema is a condition that affects the skin, causing it to become irritated and inflamed. It is also known as dermatitis. Eczema can occur anywhere on the body and can affect anyone of any age, although it is primarily seen in children. In the UK one in five children and one in 12 adults have eczema. It is not a contagious and cannot be passed from person to person.

- What causes eczema?

There are a number of different types of eczema, but the two main types are called atopic and contact. Atopic eczema is the more common. It is a genetic condition and tends to be seen in children who have a family history of eczema or conditions such as asthma or hay fever. Atopic eczema usually develops when a child is young - about 80 per cent of cases occur before a child reaches five. Many children grow out of it, but it can 'flare up' and come back during adulthood.

Contact eczema is more commonly seen in adults. It is caused when the skin comes into contact with an 'allergen' (a substance that causes an allergic reaction). Allergens that causes contact eczema include things such as toiletries, perfumes and cleaning products.

- What are the signs and symptoms of eczema?

The symptoms of eczema vary depending on the type of eczema. The symptoms will also differ between people and vary in severity. Eczema often affects the skin in areas around joints such as the elbow, behind the knees, and on the chest, face and neck.

The typical symptoms of atopic eczema include:

- red, dry and itchy skin

- small blisters on the skin, particularly on hands and feet

- scaly and thickened areas of skin in places that have been scratched frequently

- swollen, wet and weepy skin.

Bacteria called Staphylococcus aureus which lives on the skin can often make eczema worse. As the skin is often very itchy, constant scratching can cause it to break open and bleed. Bacteria can then get into the skin and cause an infection.

- What are the triggers?

In most people who have atopic eczema there is no apparent reason why the eczema 'flares up'. However, some flare-ups may be caused by triggers such as:

- emotional or physical stress
- changes in temperature
- illness
- sensitivity to foods
- house dust mites
- pets
- clothing

- How is eczema treated?

Eczema cannot be cured, but there are a number of effective treatments that can control the symptoms. Being able to identify and avoid triggers is also an important part of any treatment plan.

Even when eczema is under control, it is important that the skin is moisturised daily - this prevents it from becoming too dry (which may cause the eczema to flare up). Creams, ointments and oils suitable for the bath and shower help replenish the skin's natural oils. Creams or ointments containing steroids are effective in treating flare-ups, as they help to reduce the itching and inflammation. If the skin becomes infected, antibiotic creams may be combined with the steroid. Should these treatments not be effective, there are a number of other approaches that can be taken, including bandages and wet skin wraps, and skin ointments containing drugs called immunomodulators.

Oils such as evening primrose and fish oils are safe treatments and can help in some cases. Wearing cotton clothes instead of man-made fibres is also less irritating to the skin.

- Caring for a child with eczema in a childcare setting

Parents/carers often spend a lot of time deciding on the right childcare for their child. For those who have a child with eczema, it is important that they feel safe in the knowledge that their chosen provider has a good basic knowledge of eczema. It is important to talk to parents/carers to find as much information as possible about their child's condition and learn about what things can be done to manage it.

For example, emollient cream may need to be regularly applied to the child's skin, especially before their skin is exposed to things that might dry or irritate it, like messy play and extremes of temperature. Children may need to exclude certain foods from their diets, so it is important that this restriction is adhered to.

FURTHER INFORMATION

- WellChild Helpline on 0808 801 0330, e-mail helpline@wellchild.org.uk or text 0778 1472599

- National Eczema Society, 0800 089 1122 (open Monday to Friday, 8am-8pm) www.eczema.org