Eczema in children – add

Eczema are chronic skin conditions accompanied by itching, redness and dry skin.

They occur in 10% of children and in the first 5 years of their life. A child can develop the first signs of the condition in the first 6 months of life, with a tendency of symptoms to subside in the third and seventh year of life. Until puberty, 50% of children lose susceptibility to eczema but if they still develop, the condition can be detected only on the palms and soles. Some children have very mild eczema and others have severe type that disturbs their daily activities and sleep. A small percentage of people retain the severe form of eczema during their entire life. A very severe type of eczema which spreads on almost all surfaces of the body is called atopic dermatitis.

It is not known why eczema develop in children, but it is generally considered that it is always a combination of genetic tendencies and environmental factors. They are significantly more common in families where there are chronic bronchitis, asthma, tendency toward high temperatures and allergies. Inheritance is not due to dominant genes but as a result of their combination. Since there is a genetic predisposition, development of eczema cannot be stopped.

The appearance and position of eczema changes as the child grows. In newborns commonly affected parts of the skin are the face and scalp. This condition can affect the whole body but the area covered with diapers is very often spared. In children older than twelve months, eczema are more frequently observed on the elbows, knees, neck, and in the region around the mouth. After the second year of life a typical localization is in the folds of the skin.

In infants, the main indication is the bright red rash. In the later period of life, it is expressed as dryness, redness, peeling and cracking of the skin. In adolescents the most common manifestation is the emergence of bubbles and peeling on the palms and soles.

Eczema occurs on a part of dry skin that is in contact with an irritating substance. In order for dryness to be reduced, skin moisturizers in form of creams and milks are recommended. Skin lotions should be avoided because they have a higher percentage of the aqueous component. Care must be intensified when eczema are visible and when they are in a healing phase. If saliva in babies causes redness it is possible to apply substances such as petroleum jelly in order to isolate skin. Baths should be warm, not hot, and up to 10 minutes long. Substances from the external environment such as air fresheners, perfumes and cigarette smoke may additionally worsen eczema in babies.

The clinical picture is always worse in winter than in summer because of cold air, wind, central heating. Children with atopic dermatitis are overly sensitive to pollen, dust, animal hair, wool, certain foods, detergents and excessive sweating.

Parents often look for a cause of eczema in child’s diet. Unfortunately the answer is not so simple. Most eczema are not caused by food and parents who put their children on strict diets can often contribute to worsening of symptoms. If a child is overly sensitive to certain foods, the rash will appear 1 to 2 hours after ingestion of novel foods. This type of rash often looks quite different from chronic eczema. Only if a child with eczema does not respond to therapy one need to think about the tests to food allergens.

There is no drug that can be given to a child and lead to healing, but it is possible to control the disease so that the changes on the skin are not visible. In order to reduce eczema it is necessary to simultaneously treat dry skin and inflammation of the skin. The first treatment is always corticosteroid therapy. With a proper application of corticosteroids it is possible to very quickly calm the skin. If long term therapy is necessary, immunomodulators and antihistamines can be included.

In addition, in between treatments a proper skin care should be conducted. Failure to implement adequate therapy will worsen the situation. Children often damage the skin with uncontrollable scratching, which in turn creates conditions for secondary bacterial infections. Very often the reason to avoid the therapy is parents’ fear of corticosteroid creams. It should be noted that if properly used, these creams cannot cause the damage.

Read more about eczema in children here…

Spec. Dr. Svetlana Djurisic, dermatologist
Dermatological clinic DERMATIM, Belgrade – Serbia