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Eczema - the good, the bad, the ugly

Eczema in your little one?


Eczema is a common skin condition, affecting around 30% of children. Some children do grow out of their eczema, and for others they may have the triad of eczema, allergies and asthma.

So why is there a link to those three conditions? It is still somewhat of a mystery to medical professionals, but they are all related to inflammation in our bodies. Now this does not mean that if your child has eczema they will also have asthma and allergies, the risk factor just increases. So it is something to be aware of going forward.

First let's cover what eczema is, and how you may recognise it in your child.

Eczema presents as dry red rough patches on the skin. You may find it in the creases, on the cheeks, the torso, scalp, the hands - or widespread. It is incredibly itchy and uncomfortable, and the risk of infections increase in those with this condition. Bacteria sits on the skin of children with eczema, and when they itch (because it IS itchy!), they can break that skin, and the bacteria (or virus) can enter causing an infection. Signs the eczema may be infected are weepy, crusty and broken patches of skin. Sometimes these infections may need antibiotics to treat. So this can become a vicious cycle and can be really difficult to manage. This is why it is so important to keep the eczema under as much control as possible and to treat it as soon as it appears.


If you feel your child may have eczema, take them to the GP to have it checked and diagnosed.

Now that we have covered what eczema is, let's have a look at what you will do to treat it during a "flare up" (when it worsens) and how you will manage it every day.

FLARE UP - TREATMENT


My youngest Charlotte was diagnosed with eczema at 9 weeks age. It was quite bad, needing cortisone (steroids) and lots of trialling of various creams and ointments until we found what worked best on her skin. We now have it well under control through daily management and treatment of the occasional flare ups.


Our treatment with flare ups are:


🛁 Daily warm baths with fine pool salt and QV oil - no soaps when eczema is flared.


🧴Cortisone as prescribed, immediately after bath


🧴MOISTURISE, MOISTURISE, MOISTURISE. For us, QV adult INTENSIVE is the cream that works best for C’s skin. However RCH recommends either QV adult cream, Cerave or dermeeze ointment as other options. It’s all about finding which one works best on your little ones skin - we went through all of them! We put it on 4 x day when flared.

Hopefully you have a management plan in place once getting a diagnosis of eczema. Some children need bleach baths. Others need wet dressings.


Bleach Baths - used to kill off the bacteria in the skin and prevent secondary infections in children with eczema. It also assists in getting severe eczema back under control. A link to the guide for bleach baths (RCH) is listed at the bottom of this blog.


Wet dressings - Reduces the itch, treats skin infections, maintains hydration, protects skin from scratching and aids in sleep (lots of benefits!). It also reduces the amount of steroids needed to be used.

If steroids have not improved the eczema within 48 hours after starting, wet dressings are advised.

A link to a guide for wet dressings (RCH) is also at the bottom of this blog.


Top tips during treatment stage

  • Wash hands before applying any creams

  • Use steroids at first sign of eczema to prevent it getting out of control (much harder to treat once it does!) don’t be afraid of the steroids.

  • Use a pump cream or if using a jar make sure you don’t double dip and risk contamination

  • Daily baths to keep skin clean from bacteria.

  • Bleach baths when needed to strip the bacteria from skin (reduce infection risk)

  • Wet dressings when really bad

  • Avoid their triggers

  • If your worried, get them looked at especially if you think it may be infected.

  • Moisturise moisturise moisturise


MANAGEMENT

Once the eczema is under control, we then manage it on a daily basis to keep it that way.

Continue daily baths, with a soap free formula to wash.

QV oil and pool salt in her bath. The pool salt assists in her skin absorbing the oil and keeping her moisturised

After her baths, she is patted dry and she has her moisturiser popped on head to toe. She is also moisturised in the morning, so twice a day.


Finding any triggers for your child’s eczema is KEY.

HEAT, DRYNESS AND PRICKLE all exacerbate eczema.

Avoid over heating, particularly at night. Keep them in light cotton clothing. For us this doesn’t trigger her skin, but it does for many other kids with eczema.

Dryness increases the itchiness of the skin in children with eczema, which is why moisturising is such an important component in both the treatment and management phase.

Using a mild washing powder/ one that we know doesn’t aggravate her skin.

Prickle talks about the type of clothing - ie. wool, lace tags etc


For us, Charlotte is actually anaphylactic to cows milk protein and egg, and cutting dairy from my diet while breastfeeding when we first were diagnosed had a huge positive impact for her eczema. Dairy was a trigger for her so eliminating it improved it.

Around 20% of children with eczema will also have food allergies. If you think this may be a trigger for your child, keep a food diary and take photos of their eczema to then discuss with your health professional prior to eliminating any food groups from you or your child’s diet.


Below are some helpful eczema information booklets from Royal Children's Hospital (RCH). All information provided in this blog has been via RCH.



Bleach baths formula - https://www.rch.org.au/uploadedFiles/Main/Content/derm/eczema-bath-information.pdf


Wet dressings guide - https://www.rch.org.au/uploadedFiles/Main/Content/derm/Wet_dressings_eczema.pdf

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