What is eczema?
The word eczema is derived from the ancient Greek word meaning “to boil over”. It was originally used to describe an itchy rash with blisters, but now it is often used to describe a red and itchy inflammatory skin condition. The most common type of eczema in children is atopic eczema [atopic eczema is a type of eczema with a clearer pathogenesis and definition]. Atopic eczema is closely related to asthma and cushings fever. Atopic eczema and atopic dermatitis are the same disease, two different names only, do not be confused. Children with eczema are prone to skin irritation due to excessive skin sensitivity.
Why do our children get eczema?
Atopic eczema is a genetic dysfunction that results in hypersensitivity of the skin (presence of defective skin barrier function). Relatives of affected children often suffer from eczema, asthma or chytridiomycosis (a form of rhinitis or even asthma that is allergic to pollen, etc.), but the probability of occurrence is not very high. Many external factors in daily life can influence the development of eczema.
Will eczema get better when my child grows up?
Children’s overly sensitive skin condition may continue into their teenage years. Most children’s eczema gets better as they get older. The age at which eczema gets better, varies from child to child. Many children will show significant improvement by age 5, and most may still have some occasional symptoms in their teens. Only a small percentage of people will have severe eczema well into adulthood.
Is eczema caused by allergies?
No. Eczema is not caused by an atopic allergy. Children with eczema have hypersensitive skin that reacts to a variety of substances that come in contact with the skin’s surface. It is impossible to really find one, two or three allergens that can cause your child’s eczema. And, when we remove “suspected allergens” from a child’s environment, it does not improve the eczema condition. Although many people are convinced that allergies are the cause of eczema, this is only their blind faith and has not been confirmed by scientific research.
Does allergen testing help in the management of eczema in children?
No. Children with eczema often show multiple positive reactions to skin allergen tests, but this is not very helpful in treatment. Blood allergen testing is also of little value.
Treatment of eczema
There is no single treatment that can cure eczema, but for most children, eczema can be effectively treated and controlled with a few simple treatment options under medical supervision.
Moisturizers and emollients These products keep the skin moisturized and soft, restore elasticity and flexibility, and help reduce itching and scratching. Moisturizers and emollients are safe and should be used topically and often as a first-line treatment option.
1. bathing up to once a day.
2. the use of mild moisturizing soaps or soap substitutes.
3. Moisturizing emollients such as Moisturel (use this product with caution) or Eucerin (eucerin) can be used freely and in larger amounts on all areas of dry skin, at least twice a day, and as often as possible. Just like you have to brush your teeth every day, children with eczema need daily moisturization because they have sensitive skin. Moisturizing measures can avoid dry skin and keep it smooth, and also significantly reduce itching and skin redness.
4, topical use of glucocorticoid ointment reasonable topical use of glucocorticoid ointment is safe and is the most basic treatment method.
Ointments, such as petroleum jelly are gray and thick. And creams are white and watery. These preparations, on red inflamed areas, should be rubbed 1 or 2 times a day. In particular, they should be rubbed once immediately after bathing, when the skin is still wet (within 3 minutes after bathing). Emollient moisturizers should be rubbed on non-redness skin areas after hormonal ointments have been rubbed first. Moisturizers should not be used prior to hormone application. Topical rubs of weak glucocorticoid ointments such as 1% hydrocortisone, deprenyl pine or Westcort (hydrocortisone butyrate) will be effective enough for most children. Occasionally, your doctor may give your child a more potent glucocorticoid ointment.
5. Topical immunomodulatory drugs If topical treatment with weak glucocorticoids does not work, or if you need to use such drugs for a long time, you need to consider topical immunomodulatory drugs, such as Elidel (Pimecrolimus-Eninta) and Protopic (Tacrolimus-Protopic) are two products that can be used in children.
6. Antihistamines are taken orally 30-60 minutes before going to bed, such as Benadryl, Advil, Xantamin (Cetirizine), which can help your child have a comfortable night and sleep well. Some younger infants and children may become more irritable and irritable after taking antihistamines. If this happens, you should inform your doctor and stop using the drug.
7. Wet compresses Wet compresses soften the skin and relieve itching. The following six steps are necessary.
(1) Rub the child’s skin with glucocorticoid ointment.
(2) Take an infant pajama (a thin cotton towel will do) and dip it in warm water.
(3) Twist the infant pajamas dry until they are slightly moist.
(4) Place the wet baby pajamas on the child and cover the outside with a dry baby pajama. Be careful never to wrap it in a plastic bag on the outside. The moisture on the infant’s pajamas must remain in a state of constant evaporation.
(5) The room should be kept warm enough.
(6) Your child may be uncomfortable at first, but you have to hold on to it for a while, and then it will become comfortable.
Wet compresses exert their therapeutic effect through several mechanisms. The continuous evaporation of water causes a drop in skin temperature, which has a calming effect on the temperature-sensitive nerve endings in the skin. This continuous cold stimulation prevents the onset of itchiness. Wet compresses also restore moisture to the skin surface and allow glucocorticoid ointments to work more effectively.
When applied wet, it also prevents the child from scratching the skin incessantly, which is a vicious cycle between dermatosis-scratching. Your doctor may want you to apply wet compresses continuously every night (all night) for 5-10 nights, or change the dressing every 8 hours for 24 to 72 hours. If your child has an acute eczema flare-up, using the wet compress method will stop the flare-up in one to two nights.
Are glucocorticoid ointments dangerous?
They are safe when used correctly. Topical glucocorticoid ointments vary greatly in potency strength. Topical glucocorticosteroids of weak or moderate potency are very safe when used under medical supervision. Many parents are concerned about the use of topical hormones, but only the misuse of strong glucocorticosteroids can cause the problems they fear, such as thinning of the skin. Strong glucocorticosteroids are not routinely used in children. Topical rubbing of a weak hormone, such as 1% hydrocortisone ointment, on the eczema rash once or twice a day is safe even for long-term use. However, hormones should not be used on the face of children for more than two weeks. Those children who need topical strong glucocorticoids or who require prolonged use of medium-acting hormonal ointments are advised to switch to topical immunomodulatory drugs.
What is the amount of topical hormonal ointment used for skin?
Apply the ointment to the surface of the eczema area (at the red or pink rash skin area) in an even, thin layer (a shiny layer of skin is visible in the evening light). A fingertip-length amount of ointment is sufficient to apply to the entire arm or leg. Usually apply the ointment or cream in a downward direction so that it forms a thin layer on the surface of the skin. Be careful not to repeatedly apply and rub until the cream is not visible. The “use with caution” notice written on the tube of ointment may cause parents to worry and may reduce the amount used. However, the use of adequate amounts of hormonal ointment is necessary to achieve satisfactory results.
Is there any harm in taking a bath?
After bathing and undressing, children will take the opportunity to scratch “like crazy”, so it is important to prepare for bathing. After undressing, you should quickly put your baby in the bath. Before preparing for the bath, an undressed baby will scratch the skin and cause the skin condition to worsen. Bathing cleanses the skin and removes dead skin and scales, which can help prevent infection. Adding the right bath oil to the bath water is beneficial for eczema and keeps the skin from drying out. Immersion in water for 10 minutes helps restore moisture to the skin and softens the skin. When the bath is over, apply a moisturizing moisturizer immediately (within 3 minutes) while the skin is still damp. Do not use a towel (hair can be used).
Can antihistamines be addictive?
No. Antihistamines are not addictive and there is no evidence that long-term use can be dangerous. Antihistamines reduce itchiness and have a sedative effect. Therefore, they can be used at night to help you sleep and should be given at least half an hour to one hour before bedtime. Antihistamines that do not have a sedative effect can be used during the day, especially to help children who suffer from cushings in the summer. Ointments or lotions containing antihistamines should not be used for eczema because they may cause allergic reactions.
Are bacteria colonizing the skin of children with eczema important to the condition?
Yes, eczema predisposes to the colonization of specific bacteria. Staphylococcus aureus can be found on the skin of most children with eczema. The presence of Staphylococcus aureus on the skin does not necessarily indicate the presence of an infection. It only indicates that the child with eczema is highly susceptible to some bacteria and may exacerbate the eczema. Children with eczema are susceptible to skin infections because of skin scratches and cracks. Acute outbreaks of eczema are often associated with secondary bacterial infections and often require antibiotic treatment. Your baby will feel very uncomfortable when there is a bacterial infection. If an infection is suspected, you need to contact your doctor early. Babies with eczema must not come into contact with patients who have herpes in the acute stage to avoid the virus from the skin.
Is breastfeeding better?
Yes. Breastfeed whenever possible. Although there is no evidence that breastfeeding can stop the development of eczema in children. However, for infants within the first few months of life, breastfeeding has a protective effect that reduces the severity of eczema, so breastfeeding should be encouraged. However, extended breastfeeding beyond 9 months of age is not recommended.
Does my child have to avoid eating and drinking?
It is now generally accepted that children with eczema do not need special dietary restrictions. Many parents believe that their child’s eczema is caused by the foods they eat, but regular dietary restrictions are usually ineffective. Parents of children are also generally discouraged from giving soy milk feedings.
Eczema and sun exposure Eczema usually subsides after sun exposure, especially when going on vacation. In hotter weather, children with eczema should wear loose cotton clothing to keep them cool. Overheated skin can easily lead to heat rash. It is recommended to prevent sunburn with some proper sunscreen products. On hot days, have your child wear a loose wet T-shirt to lower skin temperature and reduce itching.
Swimming in the sea is very beneficial to relieve eczema. While in the pool, the chlorine in the water can irritate sensitive skin. Preventive measures:Apply a thick layer of moisturizer, such as petroleum jelly, before swimming in the pool and soak for a while in water with added bath oil after swimming. Younger children with severe eczema are better off not swimming in pools. Children over the age of 4 should be encouraged to learn to swim and be active in a variety of sports.
Immunization issues
Children with eczema should receive all routine immunizations as normal children do, and parents need not be concerned. For children with eczema who have a history of egg allergy, the triple measles-mumps-rubella vaccine and the measles vaccine are safe. However, these injections should be administered under close supervision at a local hospital. Any of the immunizations may occur a few days after vaccination to make eczema worse, but the incidence is relatively small and not serious.
What factors can cause eczema to worsen? Many environmental factors can affect eczema, and treating eczema should take these factors very seriously. This is especially true of those substances that come into direct contact with the surface of the skin.
Aggravating factors include.
1. Man-made fibers or woolen textiles. Children must wear cotton clothing or clothing containing as much cotton as possible.
2, biological cleaners or clothing softeners using non-biological products.
3, irritating foods and drooling lemons, tomatoes and other sour fruits can cause perioral eczema.
Licking lips and drooling can aggravate eczema. Applying petroleum jelly around the mouth has a protective effect and is used: 2-3 times a day, before meals. Infants who drool often have chapped skin around the mouth and lips, chest, and hands. After cleaning with a soft cloth, apply petroleum jelly or other emollients to these areas.
4, smoking in a closed room, smoke can irritate the skin, it is best not to smoke in the room
5, dogs and cats and other pet problems in fact all furry pets have an effect on the skin of children with eczema. Even though the animals themselves are not around, cats and dogs leave dander everywhere, so eczema children are always under the influence of pets. Avoid letting dogs and cats linger in the room. If you really need a pet, you can instead have a goldfish!
6, other practical advice nails should be cut short, avoid overheating, use cotton sheets, pillows with non-feather, quilts with cotton. Good room ventilation is also important. A home room humidifier can be beneficial for eczema. Hard water can irritate the skin; using a soft water processor is also good for eczema.
Parents should also be aware of some of the problems they may encounter at school and maintain good communication with the teacher. It is best for children with eczema to sit in the middle of the classroom, away from classroom doors, windows, and radiators. Avoid contact with laboratory animals such as Dutch pigs, hamsters, and rabbits at school. Children with eczema should bring their own special soap and moisturizing lotion to school. After good communication with the teacher, the school will take care of these aspects.