Eczema is a common skin problem that can start in infancy and become a lifelong issue. According to the Dermatological Society of Malaysia, over 20% of children in the country are affected by eczema, also known as atopic dermatitis.
Dr Melanie Majaham, consultant paediatrician from a medical centre in Sunway Velocity, Kuala Lumpur, shares that eczema usually happens in a child who already has a tendency for dry skin.
And while it is not an allergic disease, allergens such as dust mites and pet dander can exacerbate the condition.
“When exposed to triggers such as chemicals, sweat and heat, the skin becomes inflamed and very itchy,” she explained. “This results in the child constantly scratching, which further damages the skin.”
Frequent scratching can cause blisters, oozing, crusting or sores from infection. “As a result, the child may be in discomfort or even pain. He or she could develop a fever, and may even require hospital admission to get intravenous antibiotics and antiviral drugs.”
Treatment options depend on the phase of the eczema. “In active flare-ups, the child may need steroid-based creams that reduce the inflammation and break the ‘itch cycle’.
“If the skin is infected, antibiotics and antiviral medications may be needed,” Melanie said, adding that short-term use of steroid creams are safe and will not lead to complications.
In the subacute or chronic phase where the skin is dry but not actively inflamed, maintenance is important to prevent flare-ups. This includes use of moisturising creams that are free from fragrance and certain chemicals.
“The child will also need to bathe with soap-free solutions to prevent excessive drying of the skin. Make sure the water is not too hot, as that, too, can dry out the skin. After their bath, pat your child dry gently with a towel,” she advised.
Eczema in adulthood?
While not a rare occurrence, children with eczema can develop food allergies, allergic rhinitis, and asthma. These are known as an “atopic march” – a natural progression of allergic diseases from infancy into adulthood.
More than 50% of children with eczema develop asthma later in life, and a further 33% develop food allergies with an increased risk of allergic rhinitis.
Dr Juani Hayyan Abdul Karaf, consultant ear, nose and throat (ENT) and head and neck surgeon, shares that the atopic march starts with a skin condition as it’s the first body barrier that can be breached.
The body then reacts with an excessive immune response, which can continue and manifest later in the form of the three allergic diseases.
According to research, eczema can be caused by a combination of environmental and genetic triggers, and tends to be more common if there is a family history of the condition, or other forms of allergic manifestation like asthma or allergic rhinitis. Environment triggers may include foods, soaps, creams, or chemicals.
That said, for most patients with eczema, there is no identifiable source.
Dos and don’ts
Studies suggest that women who eat more poultry while pregnant may contribute to the odds of their child having eczema, while a diet high in dairy, eggs and vegetables may help to protect against the condition.
As there is currently no cure for the skin condition or other allergies, Melanie has one word of advice for parents of children with skin conditions: moisturise!
“Constant round-the-clock moisturising does wonders,” she said. “Parents should also ensure their child is kept cool, as heat can aggravate eczema.”
She cautions, however, against using antiseptic soaps, which are harsh and can worsen skin conditions. “A more appropriate bathing solution would be using something soap- and fragrance-free, and rich in emollients.”
But organic soaps, she added, may not necessarily be suitable as they might not be moisturising enough.
In addition, eating healthy and staying active can help. “Exercise regularly, spend time outdoors, and soak up vitamin D, which is beneficial for your child’s overall wellbeing,” Juani advised.
“Maintaining a healthy weight and getting plenty of sleep will also help your child build up a stronger immune system.”