Jun 02, 2016

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Treating your child’s eczema- how to control the itch

By Dr Maria Boulton

Eczema affects 20% of children under the age of 5. Eczema is a skin rash that looks pink, scaly and is itchy. Sometimes it becomes infected and can look moist and yellow. It is most common around flexures such as elbows or behind the knees but it can affect any part of the body. It is important to manage your child’s eczema as well as possible to reduce their discomfort and itch but also to reduce the risk of infection and scarring. Some children will outgrow their eczema, others will go on to have it into their adult years. Eczema flares up from time to time and unfortunately there is no cure. However there is a lot that can be done to reduce the risk of infection and the number of flare-ups.
1-Accurate diagnosis.
An accurate diagnosis is essential so that your child receives the right treatment. Consulting a GP with experience in the diagnosis and treatment of eczema in children is a good place to start as there are other rashes that can look similar. General Practice is a broad field and finding someone with the right experience is the key.
2-Looking after your child’s skin.
Eczema flare ups can be reduced by maintaining the skin in good condition and well moisturised. This involves:

      • avoiding soap containing products in the bath
      • adding moisturising oil to the bath- to increase skin moisture
      • avoiding harsh detergents or soap based laundry detergents. Running a clean cycle on your washing machine to clean the detergent residue. Making sure clothes are well rinsed to remove traces of detergent.
      • avoiding harsh cleaning chemicals around the house
      • moisturising your child’s skin 2-3 times a day. The best time to apply moisturiser is after the bath to lock the moisture in. Your GP can recommend a good quality moisturiser that can do the job and doesn’t contain additives that can harm your child’s skin.
      • using a sunscreen for sensitive skin
      • eating a healthy diet to power your child’s immune system
      • probiotics. Studies have shown that some probiotics may reduce eczema in babies. Our skin is full of probiotics or “good bacteria”. However, more research is needed in this area to confirm this, establish what probiotics actually work and at what doses are needed.

3-Avoiding triggers
You may be able to pin point triggers that cause your child’s eczema to flare-up. For example, some children are allergic to some types of grasses so it may be a good idea to avoid going on the grass after it is freshly mowed. Sometimes pet fur can be a trigger, even pets that are sold as ‘non-allergenic’. Other triggers include-skin products and dust mites.
Sometimes eczema can be triggered by food allergies, for example an allergy to cow’s milk protein. Once again, discussing this with your child’s GP, paediatrician, immunologist or dermatologist is important to confirm this and look for alternative sources of nutrients.
4-Treating flare-ups
Treatment for flare-ups vary depending on the severity of the flare-up. Treatment can involve, increasing the frequency of use of the moisturiser. There are ointments and creams (corticosteroids or calcineurin inhibitors) that your doctor may prescribe when simple measures fail.
5-Controlling itch
Scratching causes further damage to the skin so it is important to control it. Trimming your child’s nails is also important to limit the damage they can do by scratching. Cold compresses, wet wraps and antihistamines sometimes help. Although what will help the most is getting on top of the flare-up.
6-Treating superimposed infection
Infection gets in through the broken eczematous skin. Antibiotics and antibacterial/bleach baths are some treatments of infected eczema.
7-Reducing the risk that your next child will have eczema
There is a lot of exciting research taking place to see if there is something that can be done to reduce the risk that children will develop eczema. Studies are being done into probiotics and nutrition during pregnancy. As a GP and a parent I can’t wait to see what the future holds.
The most important tip in helping your child with eczema is to keep the skin healthy and moisturised.
Every child is different and I recommend you talk to your doctor for individualised advise. Your doctor can also provide you with an Action Plan for Eczema which is an individualised plan for your child. The plan and further information on eczema can be accessed on the Australasian Society of Clinical Immunology and Allergy

Website www.allergy.org.au.
Dr Maria Boulton (MBBS, FRACGP)
GP/ Director Family Doctors Plus, author ‘Dr Mum’s guide to…pregnancy’, Director Healthtalks
Ph: 33578192
A:2/178 Albion Rd, Windsor Qld 4030
www.familydoctorsplus.com

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