Eczema???

Sumber : BabyCenter Malaysia

 

What is eczema?

Eczema is a condition affecting the skin. Most doctors use the terms dermatitis and eczema to describe the same thing. There are different types of eczema, depending on the root causes of the problem. They all have one thing in common: they result in dry, itchy, red and cracked skin, which can become sore and bleeding through scratching. The areas most affected are the hands, face, elbows and knees. Atopic eczema often runs in families. Atopic conditions, which include eczema and asthma are on the increase but no-one is completely sure why.
Eczema may also be triggered by an irritation of the skin caused by chemicals, such as the detergents in washing powders and fabric softeners. This is called contact eczema. A child with atopic eczema could develop contact eczema as well so the two types of eczema do sometimes occur together. When this happens, try changing your detergent because it may ease the condition.

It is also possible to have allergic contact eczema. This is usually a reaction to a specific substance such as the nickel in jewellery. However, the allergic reaction may spread to affect other areas of skin.

Eczema can be extremely distressing in babies and young children because they find it very difficult not to scratch, which can lead to infections.

 

What is the treatment for eczema?

The treatment of eczema depends on how serious it is. If your baby has a mild case of contact eczema, you may simply be advised to use a short course of a low-strength steroid cream.

Atopic eczema is dealt with in two ways. It is known that dryness of the skin makes it worse and so preventing flare-ups by moisturising the skin is crucial. There are a huge variety of moisturisers or emollients available and you may have to try several to find the one that suits your child best. These are available as creams, ointments, lotions and bath additives. You may have to use large quantities on a regular basis and your doctor may consider issuing repeat prescriptions once you know which one works best.

Secondly, some doctors will recommend that babies with atopic eczema use steroid creams from time to time. It is vital that these are used sparingly to avoid the risk of side-effects, especially in young children. Eczema may also be complicated by skin infections (often caused by scratching until the skin is broken) and so antibiotic creams are being used increasingly. Oral antihistamines are sometimes used to combat itchiness. The ones normally available for young children often cause drowsiness and so will tend to be used at night. You should seek your doctor's advice before giving young children anti-histamines.

Homoeopathy can sometimes be very helpful in treating eczema and in some countries, like the UK, it is even available through the National Health Service. However, it is important that you find a well-qualified homoeopath.

 

How can I help?

There are other self-help measures you can try:

• It is thought that exposure to some foods can aggravate eczema. Reactions to individual foods can obviously be helped by avoiding that food, but you should not change your child's diet drastically without talking to your doctor.

• Doctors will usually only advise getting rid of a pet in severe cases but pets can be restricted to one part of the house or an outside run.

• House dust mites are thought to trigger some cases of eczema. You can reduce the amount of dust moving around your house by using a damp cloth rather than a dry duster for cleaning, and in extreme cases, you may want to change from carpets to hard flooring. Frequent washing of bedding at high temperature is thought to help, and there are a number of specialist products on the market such as vacuum cleaners, filters and sprays.

• Breastfeeding exclusively for at least four months helps to protect against eczema and other allergies. Some babies and children who develop eczema may be allergic to cow's milk but it's important to talk to your doctor before removing cow's milk (or cow's milk formula) from your baby's diet.

• Cotton or cotton mix clothing may help, whereas woollen and synthetic fibres may make it worse.

• Overheating can make eczema more severe, so you should keep bedding and clothing light and layered, in order that the temperature can be easily adjusted.

• Keep your child's nails short to help prevent skin irritation from scratching. You can also buy cotton mittens to help babies who scratch at night.

 

Will the use of steroids harm my baby?

Many parents have heard about side effects from overuse of steroids, and are reluctant to use them, particularly on babies and young children. "Steroids are very safe if used appropriately," advises Collette Hoare from the UK’s National Eczema Society. "Their main side effect is thinning of the skin, but there is no evidence that this is permanent. It is very important to use the correct strength, depending on the severity of the eczema, so steroids should always be used under the supervision of your paediatrician."

When using steroid cream, keep usage to a minimum by only using on the affected areas, and remember always to use plenty of emollient cream. Whilst some steroids can be bought over the counter, it is recommended that when treating babies and young children, you always seek the advice of your doctor.

 

Reviewed October 2008