What is it?
Eczema is a condition in which patches of skin become dry, red and itchy. Sometimes these patches can bleed and become thickened from excessive scratching. There are several types of eczema. The most common is atopic eczema, which is very common in children.
If something is atopic, it means it’s linked to an allergy. Someone is said to have an allergy if their immune system (the parts of your body that fight infection) overreacts to certain things that don’t cause problems for other people. Common things that trigger allergic reactions in children with eczema are pollen, dust mites, animal fur, feathers, some soaps and detergents, stress and sweating.
What are the symptoms?
• Reddish skin
• Dry and flaky skin
• Broken and bleeding skin
• Thick skin
The places affected may change as one gets older. Babies often have eczema on their cheeks and chin while older children tend to get it on the inside of the elbows, behind the knees, and on the wrists, ankles and hands.
Eczema can cause the child’s skin to get infected. Features of infection include:
• Bumps filled with pus
• Crusty yellow blisters
• Wet and oozing areas of skin where the blisters have burst.
If any of these are noticed on a child, a doctor should be seen right away. They’ll prescribe appropriate antibiotics to treat the infection.
What treatments work?
Moisturisers are very helpful when rubbed into the child’s skin regularly. This helps the child’s skin feel less dry and itchy, and may also prevent flare-ups (periods when the child’s symptoms suddenly get worse).
Moisturisers come as lotions, ointments, creams and bath oils. The skin doctor will prescribe the most suitable ones for a particular case.
Corticosteroid creams and lotions are often prescribed for use alongside moisturisers to help treat eczema and stop it flaring up. Corticosteroids are similar to chemicals your body makes to fight inflammation. They reduce itching and inflammation caused by eczema, and are quite effective.
Eczema tends to come back. So it may be helpful to use the steroid cream two days a week to prevent symptoms returning.
If the eczema doesn’t clear up after using these, the doctor may prescribe some drugs to reduce the child’s immune system’s response to the things triggering their eczema. A common example of such drugs is tacrolimus. These drugs however can only be used in children over 2 years old.
Antihistamine tablets may be prescribed for the itching. They can make children sleepy and less likely to scratch themselves.
Ultraviolet light can be used on its own or with a drug called psoralen as PUVA (Psoralen-Ultraviolet A). This drug makes skin more sensitive to ultraviolet light, so the light treatment is more likely to work. Psoralen comes as tablets or as a solution added to the bath.
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What will happen?
Most children grow out of their eczema or have milder symptoms as they grow older. But sometimes eczema can come back when they are an adult, often on their hands.