Eczema is quite common in childhood. In developed nations of the west, about one in five children experiences attacks of eczema.
Most of these children outgrow the condition by the time they reach adulthood, although, in some people, the condition persists.
There are several different types of eczema that may affect your child, but the commonest is atopic dermatitis.
This disease is due to a condition known as atopy.
In this condition, your child will have an increased tendency to mount an exaggerated allergic response to environmental agents.
Children who have atopic dermatitis will often have a family history of allergic diseases, such as asthma, allergic rhinitis or food allergies.
If your child has atopic dermatitis, he may tend to have dry skin as a result of an inherent impairment of the skin’s ability to conserve moisture.
This inability to properly conserve skin moisture in children with atopic dermatitis is due to a mutation in a skin protein known as filaggrin. This protein helps strengthen the barrier function of the skin as well as increase its moisture retaining capability.
Another common type of eczema that can affect your child is contact dermatitis.
This disease is due to contact with materials that irritate the skin, resulting in the rashes and itching of eczema. This may be due to napkins, clothes made of some synthetic materials, grass, body lotions, and harsh soaps.
It can also occur when your child comes in contact with grasses and some other plants during outdoor activities.
The rashes in contact dermatitis are localized to the part of your child’s body that came in contact with the offending material.
Seborrhoeic dermatitis can also occur in your child.
This disease is due to the excessive production of oily sebum in your child’s skin by the sebaceous glands of the body.
These glands are associated with hair follicles and so are numerous in hairy parts of the body such as the scalp.
When there is an excessive secretion of oily sebum, some fungi that normally live on your child’s skin may increase in number, and this will result in the irritation of the skin, leading to inflammation, and the appearance of rashes and itching on your child’s skin.
Another type of eczema is known as nummular or discoid eczema.
This variety of eczema is characterized by rashes which aggregate into circular lesions that are present on the arms, the legs or on the body.
This type of eczema is caused by contact with some chemical products, especially those which contain metals like nickel or chromium.
It may appear in children, but it is much more common in adults.
The appearance of eczema in children
Eczema appears as rashes on the skin, with a reddish discolouration of the surrounding skin (in lighter complexions).
There is an itch which is associated with the rash. The redness, itch and rash are the effects of inflammation on the skin as a result of contact of the skin with an allergen such as dust, pollen, animal hairs and furs, rubber and latex, and some refined chemicals present in some cosmetics.
In children, eczema tends to occur around the joints such as the elbow, the knee, the ankle and the wrist. It also occurs around the neck, and on the face.
Eczema is associated with scratching, and if the eczema is not treated, or the itch is severe, there may be the eventual scarring of the skin. Long standing eczema can also result in changes in skin colour, as well as thickening of the skin.
Seborrhoeic dermatitis tends to occur on the scalp, as scales with an associated underlying rash and itching. It is often referred to as dandruff. It may also be noted on the face in which case it tends to occur around the hair follicles of the face.
In very young children, eczema may be present on the buttocks, and be distributed around the area of contact with an applied napkin. This is often referred to as nappy rash.
Treatment of eczema in children
- Make regular use of a moisturizer to keep your child’s skin moist. By using a moisturizer frequently, you will reduce the incidence of flares of eczema. This is because eczema flares are associated with dry skins. A very good moisturizer to use for the skin of your child is plain petroleum jelly. It is cheap and very effective and can be applied to the child’s skin from time to time throughout the day.
- Avoid harsh soaps while bathing your child, and after bathing the child, do not rub dry, rather pat the skin dry with a clean towel. Avoid watery skin lotions which contain perfumes, dyes, artificial colourings and preservatives, as all these can further irritate the skin of your child.
- Keep the child cool, and try to avoid sweating in children.
- Keep the child away from dusty environments, and keep the child’s room clean and dust free. If the child reacts to animal furs, then avoid keeping house hold pets.
- If your child is allergic to animal hairs and furs, try to avoid rough woolly fabrics because these can trigger an allergic reaction on the skin of your child. You may need to use light cotton fabrics to dress your child. These children nightwear and pyjamas can really be of help.
- You should discourage your child from scratching the site of eczema. You can do this by keeping the child’s fingernails short and clean. In very young children, you can put their hands into clean stockings to help reduce the scratching. Or try these children eczema gloves.
- Your doctor may prescribe some medicated ointments for you to use in the treatment of eczema in your child. These may include emmolients which also contain a blend of naturally occurring lipids, and which can help to improve the barrier functions of your child’s skin. Your doctor may also prescribe a corticosteroid cream for you to apply on your child’s skin. It is very important that you follow the instructions of your doctor closely while using the corticosteroid medication, and avoid excessive application or long-standing use of corticosteroid medications.
- National Eczema Association. Controlling Eczema by moisturizing. National eczema.org. Accessed 7th January 2019.
- Nicole Yi Zhen Chiang, Julian Verbov. Dermatology, a handbook for medical students and junior doctors. 2nd edition. London, UK: British Association of Dermatologists; 2014.
- Australasian society of clinical immunology and allergy. Eczema ( atopic dermatitis). www.allergy.org.au. Accessed 4th January 2019.