Information for parents and carers
Do you have a child with Eczema? Our dermatologist Dr Katureebe a certified licensed specialist at Kampala Dermatology answers common questions regarding Eczema
What is eczema?
Eczema is a common inflammatory skin condition affecting one in five children. It is known medically as atopic dermatitis.
Children with eczema have dry skin with itchy, reddened skin patches. Eczema can get better over time, but can also get worse or ‘flare up’.
About 60% of children will grow out of eczema by the time they are teenagers.
What causes eczema?
Eczema is caused by a problem with the skin’s natural barrier. This problem can often run in families.
Normal skin has tightly packed skin cells, which create a natural barrier. This normal skin barrier helps the skin to keep water in. It also helps to stop allergens and irritants in the environment from getting through the skin’s outer barrier.
With eczema, the skin barrier is abnormal, as the skin cells are not tightly joined together. Water is lost from the skin’s surface, causing dry, cracked skin. Allergens and irritants in the environment are able to get past the skin barrier, causing itching of the skin, inflammation and redness. Itching produces chemicals, which in turn can cause further itching, inflammation and damage.
What might irritate the skin?
Many things can irritate your child’s skin, including:
• soaps and detergents
• aeroallergens, such as grass and tree pollen, animal fur, house dust mites
• synthetic or rough clothing
• infection (bacteria or viruses)
• stress
. over-heating
. food allergens.
How can I treat my child’s eczema?
Avoid irritants
Normal soap and bubble baths can dry out the skin and may make eczema worse. Use a soap substitute or non-soap bath oil additive (such as Oilatum) for washing and bathing. Bath oil can make the bath quite slippery, so extra care should be taken – a bath mat can make this safer.
Maintain skin barrier
You should use an emollient moisturiser to try to maintain the skin’s barrier function. This should be used at least twice a day, although many of the thinner creams need to be used even more frequently. Smooth the emollient onto the skin in the direction of the hair growth (rather than rubbing it in). Following application, you should wait for about 15 minutes before applying the corticosteroid ointment followed by the emollient moisturiser. This is also fine – the important thing is that you wait for 15 minutes between each application.
Emollients come in a variety of types, so if you find that a particular emollient irritates the skin, you should try another.
Using emollients is an essential part of eczema management and should be continued even when the skin is clear with no eczema. Try to make it part of your child’s regular routine.
Treat skin inflammation
When areas of skin become dry, itchy, red or swollen, this is called a ‘flare’. Medicated ointments and creams called corticosteroids (or topical steroids) are used to treat the inflammation under the surface of the skin, which makes eczema red and itchy.
Corticosteroids come in different strengths and your child may need a different strength for different parts of their body. They also come as either greasy ointments or white creams. The greasy ointments generally work better.
How to use: Apply the corticosteroid using the Finger Tip Unit (FTU) method. One FTU is the amount of corticosteroid that is squeezed out from a standard tube along an adult’s fingertip (from the end of the finger to the first crease). This should be enough to cover an area of skin twice the size of the flat of an adult’s hand with the fingers together.
Are there any complications that I should look out for?
Bacterial infection: If eczema ‘flare up’ does not improve following corticosteroid treatment or has patches of broken skin with weeping or yellow crusts, this may indicate an infection. If you notice this, please contact your GP, who may prescribe antibiotics.
Viral infection: The virus that causes cold sores (herpes simplex) can cause a worsening of eczema with tiny blisters, which then burst to leave tiny ulcers. If you notice this, please contact your GP, who may prescribe antiviral a thicker one before bedtime.
• You usually do not need to buy specific clothing for children with eczema, but you may find that synthetic materials, such as nylon and acrylic, will make the skin itchy and hot. Wool will also cause itching. Look for 100% cotton clothing.
• Continuing itchiness is often a sign that the inflammation underlying eczema is under-treated. Consider stepping up to a stronger corticosteroid.
Babies and children with eczema sometimes get a red, irritated skin reaction around the mouth after eating irritant foods such as tomato and some citrus fruits. This can be reduced by applying the emollient moisturiser around the mouth area just before eating these foods.
SCHEDULE AN APPOINTMENT FOR A CONSULTATION
For a knowledgeable consultation and a pleasant, safe experience, contact us or book an appointment on our WhatsApp account at +256 780 907156 today. Our lead physician, Dr Ronnie Katureebe is a trusted medical, cosmetic and surgical dermatologist in Kampala. We are conveniently located in Bugolobi Bandali Rise