Affecting 1 in 8 babies and young children, eczema is a common, yet often misunderstood condition. People who themselves have not suffered, or have never personally witnessed the somewhat devastating effects of eczema cannot seem to comprehend what the fuss is all about, and tend to be unsympathetic. Some people, even close family and friends, can be brutally critical and selfish in their ignorance of the condition. They don't understand why you avoid certain places, foods or other things, because they are never around to observe the after effects of that contact.
The truth is, parents of children with eczema suffer almost as much as their child, as do any siblings who are not affected. It can be an emotionally and physically draining experience for everyone involved, and the ignorance of other people, especially those you rely on for support and maybe a bit of sympathy, can make things a whole lot harder to cope with.
Through this article we hope to help you cope with your child's eczema, and in turn help their children to cope, as well as offer some insight to those who are unaware of the impact eczema can have on a family.
What Is Eczema?
Eczema is a commonly used term to describe a broad range of skin conditions, also known as dermatitis. The most common being Atopic or Allergy Eczema which is characterised by it's red, dry and scaly appearance. A rash usually forms and if this is scratched it may weep and form crusty sores, and also becomes susceptible to infection. Eczema is not contagious though, even if it does take on an unsightly appearance.
Who Is At Risk?
It has been suggested that eczema is a result of genetics, meaning that another family member either has eczema themselves or another allergy such as asthma or hay fever, and, even a food allergy – while not known to actually cause eczema – can worsen the condition. The chance of your child developing eczema is doubled just by having 1 parent who is affected, so you can imagine the increase in risk if both are. Sometimes the person themselves has another such allergy, or may develop them at a later stage. It is also believed that a person whose skin is prone to be dry and/or cracked may be more susceptible to the development of eczema as the protective layer of skin has been broken allowing allergens, bacteria and other foreign bodies to penetrate and irritate the skin.
Babies are not usually born with eczema, but about 80% of those who will develop eczema will do so within their first year.
Forms & Types Eczema
Forms Of Eczema
Your child can develop 1 of 2 forms of eczema, which are distinguishable by their appearance.
1. Mild – The skin in mild cases are usually very dry and easily irritated which in turn causes a rash to form. The skin can also become flaky, hot and itchy.
2. Severe – In it's severe form, the skin of an eczema sufferer becomes scaly, broken and raw, which often leads to bleeding and infection.
Types Of Eczema
There are in effect, 3 common types of eczema, 2 of which are less common than the other, and tend to either clear up without any assistance or are out-grown relatively fast.
1. Cradle Cap – Although not usually diagnosed by your doctor as a form of eczema, apparently it is still considered thus. It usually appears as a mass of thick, greasy scales on the top of baby's head, but doesn't cause much, if any, irritation at all. This clears up on it's own.
2. Infantile Seborrhoeic Eczema – Quite a mouthful, but a condition that again offers little or no discomfort to your child, and is quickly outgrown. It may originally appear as nappy rash or on the scalp with similarities to cradle cap. Occasionally crusty patches of skin may appear on the torso, forehead, behind the ears, on the eyebrows and under the arm.
3. Atopic Eczema – This is the most common type of eczema with around 90% of infants with eczema being diagnosed as being atopic. As stated earlier, this condition has close connections to asthma, hay fever and other allergies, and 10% of children are known to be affected by these 3 conditions. Sometimes, a rash your baby has had earlier in life - nappy rash, sweat rash or cradle cap – can eventually develop into eczema, usually around 2-3 months of age.
The 3 Stages Of Eczema
Eczema can appear at 1-3 stages of a person's life. Some people simply grow out of it, and others must carry out a strict treatment regime for the rest of their lives to help control and prevent flare-ups. This condition can be very mild (acute) or chronic, depending on the individual, but in almost all cases it is very irritating, and sometimes frustrating. Unfortunately at this stage there is no known cure for eczema sufferers, but there is a wide range of treatments available which can help ease the condition.
The 3 stages are as follows:
Infantile Eczema – Thiscan appear around the age of 4-6 months and usually on the face and on the backs of the arms and legs or in severe cases the whole body can be affected. It has been known to take on the appearance of cradle cap with heavy scaling. This stage of eczema usually disappears about the ages of 3-5.
Childhood Eczema – This stage may follow infantile eczema, or your child may develop it for the first time between the ages of 2-4. The rash seems to effect the creases in this stage; the elbows, behind the knees, the ankles, and can still be found on the face, neck and even the ears. Most children effected will grow out of it by the age of 10, but it has been known to follow them into adulthood.
Adult Eczema – The most badly effected areas are much the same as in childhood, with large areas of weeping, red and itchy skin in the creases of the elbows, behind the knees, the wrists, neck and ankles. Adults tend to grow out of the condition in the middle of their life, and there have been no known cases in the elderly.
Complications Of Eczema
Infected Eczema
Once the skin is broken, it is a common occurrence for that area to become infected with bacteria. We all have certain amounts of specific bacteria on our skin, most of which is harmless and offer a protective barrier which repels the more harmful bacteria. Broken or damaged skin allows these harmful bacteria to multiply as the barrier has been breached and they tend to thrive in moist areas. Staphylococcus aureus is the most common bacterial infection which is what causes impetigo (school sores) and boils. If this bacteria has infected the skin, the eczema will begin to spread and will begin to weep, have yellow crusts and will sometimes also ooze pus. The lymphnodes in your child's neck and groin may swell, and they will develop a slight temperature. These symptoms are not always evident, and if a worsening in your child's condition is noted, it may be a good idea to have your doctor check to make sure it is not an infection.
Streptococcus is another bacterium, which is not naturally found on the skin, and may be detected if your doctor performs a swab test to isolate the infecting bacteria. This particular form of bacteria can cause sore throats, and has been linked to rare heart and kidney infections.
As in all bacterial infections, the bacteria itself is contagious and can be passed around to anyone who comes in contact. If this occurs it is extremely important that a high level of hygiene is observed by everyone.
Eczema Herpticum
Although the virus which can infect your child is common, the complication caused by it in a child with eczema is rare. It is important though to be aware of it, especially if someone in the family is susceptible to Herpes Simplex, more commonly known as the cold-sore virus. The is extremely infectious and is usually passed by kissing, as cold sores usually appear around the mouth.
Most people become immune to the virus, and reinfection is rare, but the virus can remain in the skin, and reappear when a person becomes rundown. A very serious problem occurs if the virus makes it's way into the bloodstream via the broken skin of the eczema, as this can cause problems with the internal organs.
Eczema herpeticum usually appears as little clusters of small blisters on the skin. At first they will be filled with a clear fluid which will eventually turn to pus. The blisters become encrusted once they have been scratched and become raw and weepy. If you notice that your child's eczema is getting worse, and you have seen the blisters described, then it is a definite possibility that they have developed this complication. A high temperature and a general unwell feeling and lethargy can also accompany the complication.
Ensure when you see your doctor, that you mention your suspicions about your child having developed Eczema herpeticum, as this is a complication usually overlooked due to it's rarity.
Allergens & Eczema
Contact with certain allergens tends to flare-up the condition, and if you are aware of what things cause these flare-ups, and try to avoid them, it can help improve the eczema. Some known allergens which can effect eczema are: flaky scales from the skin of animals, animal hair and even grass. If you notice that the eczema worsens in the Summer and Spring, chances are that it is the pollens that you or your child is sensitive to. The skin will itch, sometimes unbearably, and can cause the child to break out in hives. Once you have recognised when the flare-ups occur, and what your child has come in contact with during that time, you will be able to avoid such things, making your child much happier, more comfortable, and your life less stressful and worrisome.
Eczema & Food Allergies
Some foods, such as cows milk, eggs, soy protein, wheat and seafood, have been known to irritate eczema, even to the point of making it extremely itchy and causing an outbreak of hives. If your child's eczema is going to be irritated by a certain food, you will usually see the result within an hour of eating. Babies will show more subtle signs of the reaction than a child or adult, and may become more irritable or you will notice a worsening in the rash.
If you are unable to identify the offending food you can ask an allergy specialist for a RAST blood test, or skin pricking test which will help in the identification. Once you have been able to identify the food which is causing your baby's bad reaction, eliminate it from their diet temporarily. If the condition improves it is then recommended that you re-introduce the foods, one at a time, and see if there is any reactions. If, after having eliminated the offending foods from your child's diet for 2 weeks, the condition hasn't improved, it is unlikely that those foods will cause a problem. The good news is that any food allergies which aggravate the condition disappear after the first few years of life.
Please ensure that you seek medical advice before eliminating foods from your child's diet as the elimination of certain foods can cause malnutrition unless supplemented appropriately.
Allergen Complication In Eczema
Anaphylactic Shock
A severe reaction to an allergen is when your child goes into anaphylactic shock. Although rare, it is an urgent condition that requires emergency medical attention.
The most common symptoms of anaphylactic shock are:
• dizziness
• headache
• chest tightness
• breathing difficulties
In a very severe case it can cause your child to sweat profusely, collapse, and lose consciousness. There is also an extreme state of anaphylactic shock where your child may require resuscitation. This is rarer, but can be fatal.
Anaphylactic shock is brought on by the injection of allergic substances directly into the bloodstream. Such substances can include; antibiotics, vaccine injections or bee and wasp stings. The ingestion of some foods, such as peanuts, eggs, fish, milk and other nuts can also cause this reaction, and is probably the most common in children with eczema.
The good news is the serverity of this reaction lessens over time, and most children will completely outgrow it. If your child has ever had a severe reaction to any of the things mentioned above, your doctor will usually prescribe you an emergency injection to have on hand, and to administer yourself, should it occur again.
Non-Allergic Eczema
Some eczema is not allergy related and are caused by constant contact with such common things as: water, grease, soap, or chemicals which can damage the outer, protective layer of skin. This is very common. Have you noticed for example that if you are constantly washing up, your skin tends to peel and reddens? This is a form of dermatitis or eczema. Even if you are not allergic to foods, there are still certain foods and beverages that can irritate eczema. The most commonly known one's are: curries, alcohol – and most especially red wine, tomatoes and strawberries. Believe it or not, stress can also worsen eczema. Ever heard of someone breaking out in hives when overly stressed?
How Do I Treat It?
There are many cortisone creams, natural remedies, and alternative medicines out there, some prescription, some over-the-counter, but it is always best to consult your doctor first to ensure you have the correct treatment for your or your child's individual condition. Every condition is different, and the use of an incorrect treatment can cause more unnecessary irritation.
The best advice would be to avoid allowing the skin to dry out. Keep it well moisturised, even in babies, and when bathing try using a bath oil to help keep the skin's protective barrier intact, and use soaps which have a moisturiser in them - Goat's Milk soap is ideal. Also avoid the irritants as much as possible and you will find that your child will lead a life that is flare-up free.
Prevention is Better Than Cure
An old adage but a good one.
Caring for a child with eczema can be a very time-consuming and exhausting process. It can also be very emotionally draining as it is hard for any parent to see their child suffer, no matter what their condition. In eczema though it can be a long haul from the time they develop it, to the time they, hopefully, grow out of it. (The table at the end of the article will show you the estimated time your child will suffer according to studies)
The identification of the triggers which tend to worsen their condition is the first step in preventing eczema from developing, and or from flaring up.
Avoiding Household Allergens
Keeping your house as dust free and clean as possible, without going to the extremes of sterility, is very important in keeping your child's eczema at bay.
All homes have the ever-present, microscopic little house-dust mites whose droppings can cause an allergic reaction in your child. Living off the flakes of our dead skin, they can be found in mattresses, bed linen, pillows, carpets, even your child's plush toys. In order to keep these little blighters, who reside in the millions, to a bare minimum it is important to regularly do the following:
• Damp-dust the furniture and any other dust covered surfaces in order to avoid spreading the allergens.
• Vacuum everywhere. Under beds, in the corners, carpeted areas, even your child's mattress.
• Wash your child's bedding, clothes and washable toys regularly at a minimum of 60 degree temperature. This will ensure the mites die. Even curtains should be washed regularly.
A house with as much tiled, wooden or vinyl flooring will go a long way in helping to combat the infestation of the dust mites. You can also buy bedding and mattress protectors which are allergen free. Another thing to note is that dust mites are less attracted to artificial fibres than natural ones.
Pets
Cats more commonly affect eczema sufferers more so than dogs as they tend to shed skin and fur continuously. Their saliva and urine are also known to be allergenic. Some children have been found to be so sensitive as to have a reaction to a room which hasn't had a cat in it for a day or two. Others can stroke a cat without reaction, but when having one occupy the same house for any length of time, they do have a reaction.
If your child does want a pet so badly that you can't bear to deny them, then one that is outside or that they have limited access to may be okay. Also, if your child does react to animals, it is important that visitors to your home do not bring their pets along, and that you avoid situations where animals are bound to be present, such as a friend's house or even the zoo in some cases.
Clothes
The clothing your child wears is also important to preventing eczema from being irritated. Light, loose-fitting clothing, preferably those made from organic fibres which breathe are the best as they prevent the skin from sweating and causing your child to itch.
For babies, Babyjo Bamboo ( found at Modern Little Munchkins ) is ideal as they breathe, are hypo-allergenic, anti-bacterial and help to keep baby 2 degrees cooler in Summer or warmer in Winter. Cotton sheets and light bedding are the best for any child, no matter their age, as it allows their skin to breathe, but try to find those made from organic materials as most non-organic baby products contain harsh chemicals which can irritate bub's skin.
For all other kids, anything made from organic cotton as opposed to synthetic is best. School uniforms can be a problem, but if you look or ask around alternatives can usually be found or made.
Clothing & Night-Wakings
Babies and children with eczema are known to wake a lot at night due to their condition being aggravated by overheating, sweating and just a feeling of hotness which is caused by either the temperature, their clothing or the bed linen. Ensure that their room is kept at a comfortable temperature, their clothes are lightweight and allow air to circulate under them and keep bed linen to a minimum making sure that they are not over-burdened with unnecessary layers. Natural fabrics are a better choice as opposed to synthetic as they breathe and allow the air to touch baby's skin reducing the chance of them becoming hot and irritating their eczema. The constant circulation of air in the room can also help to keep baby's skin cool and calm. Avoid having your child sleep with you or having woollen covers or blankets or plastic under their sheets as this promotes heat and sweat.. Also try to use clothing with a minimum of seams as these tend to rub against bub as well and can irritate.
Caring For The Skin
Keep your child's skin clean and moisturised. The avoidance of bubble baths, certain soaps and other products which tend to dry out the skin is very important. Baby oil is a great bath additive as it helps keep the skin moist.
The application of creams ointments and lotions which have a hydrating quality are also good for your child's skin, but look for the ones which contain plant or herb oils as these will be the most beneficial, preferrably organic. They should also be fragrance free, as some perfumes can also cause irritation.
If your child is uncontrollably itchy, the addition of Bicarbonate Soda to the bath water can ease this, so too can the application of calamine lotion.
Some Psychological Aspects
It is believed that 40% of children with eczema have some psychological difficulties. Some are from the condition itself, others are related to the lack of skin-to-skin contact with Mum, who fears hurting or irritating her child's eczema. As a baby we relate a cuddle from Mum to comfort and warmth, a soothing experience that calms our fears and worries, and that doesn't change as we grow either. Sometimes, even though Mum has her child's best interest at heart, the lack of cuddles or skin-to-skin contact can leave mother and child with a gap in their relationship.
Your Child's Self-Esteem
Having a such a shallow society who doesn't look for the beauty within, and is so big on appearances, doesn't make things any easier for your child. Not only do they have to suffer the symptoms of eczema and doing without certain things, they also have to put up with an inconsiderate world who make insulting remarks about their skin, who tease, or just rudely stare.
It is obvious that this would upset most people, but for a child it can affect them more than the condition itself and have longer lasting affects. Praising your child and reinforcing how beautiful they are to you can go a long way in re-establishing their self-confidence. Find positive things to say about their appearance, and talk with them about what people are saying to them, helping them find ways to deal with it.
It is also important to ensure that when you are talking to other adults about your child's condition, and especially their appearance, that your child cannot overhear you. Your attitude towards your child and their condition will go a long way with helping them accept it, and feel more at peace with it, so then what other people think won't worry them as much.
The Siblings
For older siblings having their parent's attention taken away by a new baby can be devastating enough, but when that same baby develops eczema and their need for Mum and Dad's attention pretty much doubles, well, it can leave that older child feeling very much left out.
It can be hard on Mum and Dad too. They know they need to give their other child or children attention too, but between baths, feeds, medication, applying creams and ointments, and just general cuddling and soothing, there is not always a lot of time or attention to spare.
But there are ways of making your other children feel a part of what you are doing, and also helps to strengthen your bond with them, and their bond with the younger one.
• If they're of an age to understand, explain the condition to them, and why you have to do what you do.
• Include them in the care. Teach them to gently apply the creams, or get them to help bath their sibling.
• If you need to buy special foods, soaps, moisturisers etc, buy for the whole family so that it is not deemed as a special thing that only their sibling can have or use.
• When the child that is suffering from eczema is sleeping, spend that time with your other children doing fun things, and most especially cuddling them.
All kids want to feel loved, and don't like to feel that one is more special than the other. It can be a tiring task trying to divide your time, but once you have established a system that suits the whole family, you will find it easier to cope.
As soon as you are able, give your child some of the responsibility of taking care of their eczema. The sooner they gain that bit of independence, the sooner their siblings don't feel they are being left out, and the sooner your child can begin going over to their friend's houses.
The Parents
Don't allow the condition to rule yours, or your child's life. Change as few of your usual habits as possible. Allowing eczema to take over your life can have devastating affects on Mum, Dad, and the rest of the family, including the child with eczema. Since Mum is usually the primary caregiver, she looks after the child all day, as well as looking after the house and any other children you may have, and at night, when your child can't sleep due to the irritation, she usually does that shift too because Dad has to go to work the next day.
The pure exhaustion that Mum feels can lead to family arguments and a constant state of tension in the house, which is neither healthy for you, or your child. It is important for everyone in the family to do their share and learn how to deal with the different treatments and flare-ups that is a part of having a child with eczema, after all, if Mum burns out, who else is there. Mum and Dad need to be able to trust someone to care for their child so that at least one day a week, even if only for a few hours, they can both spend some quality time together, out of the house. Their marriage, and the family's happiness could depend on it.
It is hard caring for a child with eczema, and the more people that understand all the emotional, physical and mental effort that goes into, then the more support those families will have. Friend's and family need to be more understanding of the reasons behind the lack of visits, or the special diets etc, not only because friend's and family should, but because if you don't, you may end up alienating yourself from them.
Estimated Length Of Eczema For Those Developing It By The Age Of 1
• 50% will stop having problems by the age of 5
• 25% will still be having problems by the age of 9
• 12% will still be having problems by the age of 13
• 6% will still be having problems by the age of 17
• 3% will still be having problems by the age of 21
Chances of the eczema lasting longer are increased if the eczema develops later than by their 1st year.
For More Information We Recommend:
Website
• http://www.eczema.org.au/
For Organic Baby Clothing & Skincare which is beneficial to eczema we recommend:
http://www.kidsinaustralia.com.au/business-109/Modern-Little-Munchkins.html
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