Understanding and Managing Eczema in Children: A Comprehensive Guide for Parents
Understand and manage eczema in children with our comprehensive guide. Watch our video for essential tips and advice for parents.
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Topic Breakdown
Eczema in children is a topic that concerns many parents, and understanding it can help you provide the best care for your child. Eczema, also known as atopic dermatitis, is a common skin condition that affects at least one in every five children. It makes the skin itchy, red, dry, and cracked, which can be quite painful and distressing for your child. There's also a risk that the dry, cracked skin can become infected.
The term "atopic eczema" is frequently used, and it refers to a problem with the immune system that makes a person more likely to develop allergic diseases such as asthma, eczema, or hay fever. You'll often find that children who have asthma also commonly have eczema or hay fever in addition to this.
### Causes of Eczema
Genetic factors play a significant role in the development of eczema, particularly those that lead to poor skin barrier function. Eczema can be triggered or worsened by factors that cause increased dryness of the skin, including soaps, shampoos, and even central heating in homes.
### Signs and Symptoms
Eczema can affect any area of the skin, and the severity of symptoms and areas affected can vary depending on your child's age. In infants (children between 1 and 3 years old), eczema primarily involves the face, scalp, and extensor surfaces of the limbs, while the nappy area is usually spared. In older children, eczema is often localized to the flexures of limbs, such as the inner creases of the arms and the backs of the knees. However, it's important to note that in children of Asian, Black Caribbean, and Black African ethnic groups, atopic eczema can affect the extensor surfaces rather than the flexures, and discoid or follicular patterns may be more common.
Itching is the most common and significant symptom of eczema. Scratching often makes it worse, and the itching can be severe enough to disturb sleep. Sometimes, the scratching can be so intense that areas of the skin start to bleed, and these areas may become infected, causing the skin to ooze and crust.
### Diagnosing Eczema
Diagnosis in a child is typically a clinical diagnosis, meaning the doctor or healthcare professional will assess the child's skin, document the affected areas, and make a diagnosis in the clinic. If you're a health professional, you might want to ask the parents about the following when taking a history:
1. **Presence of Itching**: The diagnosis is unlikely to be eczema if there's no itch.
2. **Pattern, Time of Onset, and Natural History of the Rash**: Atopic eczema usually starts in infancy and is episodic in nature.
3. **Family or Personal History of Atopy**: Allergic rhinitis and asthma are often associated with eczema.
4. **Treatments Tried and Their Responses**: Understanding what has been done and how effective it has been.
5. **Possible Trigger Factors**: Soaps, detergents, new foods, certain fabrics, pets, or pollen can all be triggers.
### Treatment Options
The treatment of eczema varies depending on whether it is clear, mild, moderate, severe, or infected. Two really important treatment options for eczema are emollients and topical corticosteroids.
1. **Emollients**: These are needed to soften and moisturize the skin. They should be applied several times every day to help the outer layer of skin function better as a barrier to the environment. The drier the skin, the more frequently the moisturizer should be applied. The best emollient is the greasiest one that you or your child are prepared to apply to the skin.
2. **Topical Corticosteroids**: These can help reduce inflammation and usually improve the redness and itching of active atopic eczema. They come in different strengths, and the doctor or specialist nurse will advise which types need to be used, where, and for how long. For example, for eczema on the face, neck, under the armpits, or in the groin, a mild steroid cream like 1% hydrocortisone ointment is useful and can be used for up to 14 days. For thicker skin areas like the torso or back, a slightly stronger corticosteroid like clobetasone ointment may be recommended.
There are also special bath creams that add moisture to the skin and should be used instead of bubble bath or soap. Avoid off-the-shelf bubble baths or soaps, and consult your local pharmacist for more information on bath moisturizers.
### Home Care Tips
1. **Moisturize Frequently**: Apply the most greasy, non-perfumed moisturizer tolerated by your child at least two to three times each day.
2. **Use Soap Substitutes**: Wash with a moisturizer instead of soap to avoid irritants.
3. **Treat Early**: Address eczema early to prevent it from becoming severe and difficult to control.
4. **Avoid Scratching**: Encourage your child to avoid scratching, as it can worsen the condition. Use mittens for babies and keep fingernails short.
5. **Keep Cool**: Overheating can make eczema itch more.
6. **Wash Clothes Properly**: Use non-biological washing powder and a double rinse cycle to remove detergent residues.
### Red Flag Features
Seek specialist advice or more intensive treatment if:
1. The eczema is weeping, crusted, or has pustules.
2. The child has a fever, indicating a possible secondary bacterial infection.
3. There's treatment failure of moderate eczema, widespread dry skin, or severe impact on psychosocial factors such as school attendance or daily activities.
Eczema can be managed well with appropriate treatment and by avoiding aggravating factors. For more detailed information on eczema and its treatments, check out the links in the description box of the video.
If you're a healthcare provider or someone looking to scale your medical brand on YouTube, consider booking a consultation. Alternatively, if you have products that can help in managing eczema or other medical conditions, sponsoring our videos could be a great way to reach a broader audience. Thanks for reading, and take care!
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