On the Coast – Families Issue 97 I December/January 2019 | Page 26

Eczema in children
By Dr Georgia Page
What is Eczema?
Eczema is a common skin condition in
which the skin becomes dry, itchy and
red. It can make the skin crack, weep
and bleed and more prone to bacterial
infection, especially if a lot of scratching
occurs. Approximately 30% of children
in Australia are affected by eczema but
a large proportion of these children will
grow out of it by the time they are a
teenager. It can have a large impact on
families with sleepless nights, irritability
and frequent visits to the doctor or
chemist.
What causes Eczema
It is unknown what causes eczema
but it seems to run in families and
is associated with other allergy type
conditions such as asthma and hayfever.
It is essentially an issue with the skin’s
protective barrier so it isn’t very good at
maintaining moisture, is prone to drying
out and is sensitive to various triggers.
These triggers can include overheating,
infection, irritants such as soap and
detergents, dry skin and allergens in the
environment such as animal fur, dust
mites and pollen.
Symptoms of Eczema
Eczema is characterised by a red, dry
and itchy rash on the skin. The locations
of the rash usually varies depending on
the age of the child. Infants less than 6
months usually get eczema on the face,
cheeks, chin, forehead, scalp and nappy
region. Crawlers between 6–12 months
tend to get eczema on the outside of
their elbows and knees. Toddlers and
older children are usually affected in the
creases of their elbows and knees, wrists,
mouth and eye lids. In some children
the whole body can be affected. Due to
the loss of the skin’s protective barrier
the skin can get infected and becomes
weepy and crusty (especially with lots
of scratching!). The severity of eczema
can vary for each child – sometimes it
can be quite mild and other times it can
get very severe and distressing for the
child which is why it is so important to
manage it well.
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KIDZ O N T H E C OA ST
How to treat eczema
The aim of eczema management is to try
and maintain the moisture of the skin,
avoid triggers that can flare up eczema
and stop the itch scratch cycle. A large
proportion of children with eczema
can be managed with the below simple
measures.
1. Avoid Triggers
• Minimise the things that irritate
the skin such as grass, sand, carpet,
chlorine and salt water (e.g. by
rinsing off after swimming),
synthetic clothing, baby wipes,
overheating, fragrances,
bubbles baths and soaps.
Saliva and and some foods
can also be very irritating
around the mouth area.
2. Moisturise
• Use soap free washes (there
is a large range found in the
eczema section of the chemist)
Avoid bubble baths and fragrant
washes as they dry out the skin.
Bath oils are very moisturising.
• Short baths – we recommend less
than 5 minutes and make sure it isn’t
too hot. The aim is to preserve natural
skin oils and long showers or baths
can dry out the skin.
• Moisturisers – when treating
childhood eczema it is important to
know the difference between lotions,
creams and ointment.
Lotions – contains more water
in it and less oil, so they are less
moisturising for kids with eczema. It
contains more preservatives so more
likely to sting
Creams – contain 50% oil and are
white. They are thicker than lotions
but more moisturising so good for
maintenance treatment for eczema.
They can sting if the skin has active
eczema so ointment better for flare ups
Ointments – contains 80% oil, they
are clear and more greasy. They are
better for flare ups and doesn’t sting
as much
3. Treat Flare ups
Sometimes eczema does not respond to
the simple measures as above and your
doctor may recommend the following.
• Steroid creams – help reduce the itch
and the redness and are very effective
at treating eczema flare ups. They
are very safe when used correctly so
please discuss with your doctor which
steroid cream or ointment is better for
your child.
• Wet dressings can be soothing for
children with flare ups especially
before bed. They can increase the
absorption of topical steroids three
times and are usually only needed
for a few nights. The Royal Childrens
Hospital Melbourne has some good