My daughter who is 22 months old recently had a bout of eczema but it cleared pretty quickly with some medication. How can I prevent it from happening again? And if it does, what are some natural treatments I can try before heading to the doctor?
Eczema or dermatitis is one of the commonest skin conditions affecting young children. Many cases start before the age of two. The terms ‘eczema’ and ‘dermatitis’ are used interchangeably and refer to inflammation in the skin. Eczema is always itchy and causes red, rough patches to appear on the skin. It is also usually associated with dry skin. The child would tend to scratch the affected areas, and this can sometimes result in broken skin.
Atopic eczema is the commonest skin condition affecting children. This is a chronic condition, and there will be episodes of flares, due to a variety of reasons—including weather changes or environmental factors such as exposure to heat and dust. The important thing to note is that it can be managed effectively with medications and both the parents and the child can learn to cope with the condition.
Atopic eczema does tend to improve as the child grows, in the majority of cases. Usually by the time the child is about 12 years old. This does not mean that the child no longer has eczema, however. There are also cases where eczema continues to remain active well into adult years.
In terms of prevention, you can try to minimise the known triggers for your child’s eczema. However, this is not always easy. Dust and house dust mite allergy is a common trigger, and one can reduce exposure to this by having less soft toys and buying washable stuffed toys instead. Wash bedding weekly and cut down on carpeting in the home, and vacuum the home regularly. Some patients find having a humidifier useful.
Avoid harsh soaps and cleansers, and use soap free cleansers. Do not subject your child to long baths and after a shower, gently pat dry the skin with a towel instead of rubbing.
Moisturise the skin regularly—even when eczema has cleared. Moisturisers are important in reducing the potential for eczema flares.
Food allergy is not a common cause of eczema, although certain foods can be an aggravating factor in some children with severe eczema. Keeping a food journal is a useful tool for parents and may help the doctor in assessing a child with suspected allergies. Skin prick tests can be used in certain situations, but generally, are not used by dermatologists in every case.
In terms of nutritional supplements, there are advocates for taking Omega -3 and -6 essential fatty acids, which are incorporated into chemicals and transmitters in the body which affect immune responses, as well as regulating inflammation and allergic responses. Oily fishes such as tuna, salmon and sardines, are a good source of omega-3 fatty acids. Cod liver oil is a good source for children. There are also advocates for probiotics, and although some patients appear to benefit from them in terms of reducing eczema severity and flares, the current evidence is not sufficient to recommend this for everyone. If you are thinking of incorporating any of these into your child’s diet, discuss it with your family doctor first.
Question answered by:
Dr Tan Hiok Hee
Senior Consultant Dermatologist
Thomson Specialist Skin Centre