Eczema is a chronic disorder of the skin that results in an itchy and dry rash. It is also known as atopic dermatitis. It is the most common chronic skin disease in children and often improves with age. Eczema affects 20% of school-going children in Singapore1.
There are many factors that may contribute to or cause eczema. There is usually a genetic element, meaning that either parent has a history of eczema or other allergies.
The skin condition is worsened by a variety of factors that vary from person to person. These factors include a change of environmental temperature, synthetic or woollen clothes, soaps, dog and cat fur and emotional stress. Skin affected by eczema, especially if frequently scratched and broken, is more prone to developing secondary bacterial and viral infections.
The skin affected by eczema is usually itchy. It may be dry, red or both and usually lasts for months or longer. The front of the elbows, the back of the knees, the neck and the face are the areas that are most often affected.
Eczema cannot be cured, though it may slowly get better over time. The control of the itch is important, as it improves the child's quality of life and sleep and helps prevent complications. Complications of uncontrolled eczema include frequent skin infections and lichenification (a thickening of the skin, making it look like tree bark, and is difficult to reverse).
Five main areas of therapy are:
When the skin is dry, it is prone to itching and cracking which allows allergens to enter the skin and worsen the eczema. Moisturisers can be applied to all parts of the body including the face. You can use the moisturiser recommended by your doctor or any brands available in the market that do not contain alcohol or scents.
As woollen and synthetic clothing may irritate the skin, cotton clothing is more suitable. Detergents and harsh soaps are irritants and so is a child's saliva. If house dust mites are an aggravating factor, your doctor may recommend methods to reduce the house dust mites in your home. When eczema begins at 1 to 2 years of life, food allergy may be involved. Please consult your doctor for a thorough evaluation.
Your doctor may prescribe other medications to reduce inflammation on the skin. Steroid creams are generally safe and very effective in clearing eczema. They should only be used as prescribed by your doctor.
Doctors may also prescribe topical or anti-itch medications to decrease the itch and help your child sleep at night. These supplement moisturisers and topical steroids.
Some bacteria may aggravate the eczema. Antiseptic washes may be of help. For acute skin infections, your doctor may prescribe topical or oral antibiotics.