What is eczema?
2 Jan 2021
Eczema is the name for a group of conditions that cause the skin to become red, itchy, and inflamed.
It can look and behave very differently depending on your child’s age. It’s important to understand which type of eczema your child may have and also their symptoms and triggers so that you can better treat and manage it as they grow and change. The only way to be sure what type of eczema your child has is to make an appointment with a dermatologist.
Causes in children
The exact cause is unknown. It’s a multifactorial condition and genetic predisposition and environmental triggers play major roles. If you, your child, or any of their siblings have asthma, hayfever, or eczema (known as the ‘Atopic March’) then your child is more likely to develop eczema.
Although some children with eczema also have a food allergy, less than 2 out of 10 children with eczema develop a food allergy. Our current understanding is that eczema comes before the food allergy. The more severe it is, the higher the risk for developing an allergy.
Eczema looks like red, dry patches that can be itchy. Babies rub their feet and scratch as soon as they are undressed and sleeping can be unsettled.
Infected eczema can be weepy, sore and the skin looks swollen. Some children can become unwell if the eczema is very widespread or infected with bacteria or viruses.
Treatment for eczema
There is no eczema that doesn’t improve with topical steroids. When someone tells me that topical steroids don’t work it’s because a) the child doesn’t have eczema, b) they are not using the right topical steroid strength, and c) the eczema is infected.
Emollients are the mainstay for eczema in children and a regular application is needed. Soap-free washes are much more hydrating than bath oils.
It’s important to use the topical steroid appropriate at the correct strength, the correct amount, and the right duration.
Follow up is needed to ensure that eczema doesn’t flare and trigger factors have been identified.
Emollients that are liked by parents and children are the QV cream and ointment,cerave cream and ointment, cetraben cream and ointment, hydromol ointment, and Epaderm ointment. If too greasy you can substitute them with creams but bear in mind these are less hydrating and may need more regular application.
Soap-free washes are part of the treatment. QV gentle wash is an excellent wash and if there are frequent bacterial skin infections a very good alternative is Octenisan antibacterial wash. Topical steroids such as clobetasone ointment, Betnovate ointment, or combination creams such as betamethasone with fusidic acid or betamethasone with clioquinol can be very effective when used correctly in the correct amount, location, and duration. A dermatologist confident in treating children with eczema can advise you and prescribe these for your child.
Eczema in children affects 1 in 5 in the Western world. It’s a common and treatable condition, which once identified early and correctly managed can change your child’s and family’s life.
If your kid has eczema or any other rash, don’t despair, book an appointment with the leading Consultant Paediatric Dermatologist Dr. Gabriela Petrof on +44(0)2034684884.