Up to one in five children suffer from atopic eczema, with 80% developing it before they’re 5 years old. It is the most common form of eczema (other types include discoid and pompholyx), and can vary in severity from mild to sevvere. The good news is that 50 per cent of sufferers have no symptoms by the time they are 11.
What is it
Atopic eczema causes the skin to become itchy, dry, red and cracked. It occurs frequently on skin creases, for example behind the knees, but can flare up anywhere. Your child may suffer short or prolonged bouts.
What causes eczema?
There is no single cause of eczema; it is probably a mixture of inherited and environmental factors that act together.
It may be due to depleted levels of filaggrin (a protein that allows your skin to make a protective layer against irritants and bacteria). Atopic means a sensitivity to an environmental allergen, such as dust or pollen, though it’s not always caused by this and only 1 in 10 children with eczema has an allergy that makes it worse. It runs in families and is more common in people with asthma or hay fever, or where one or both parents have these other atopic illnesses. It isn’t contagious and sufferers may be sensitive to different allergens.
Atopic eczema can sometimes be made worse by food allergens, usually before the age of one. Foods that typically cause allergic reactions are: cow’s milk, soya, eggs, wheat and nuts. An allergic reaction to the protein in cow’s milk is the most common type of food allergy in infants and young children in the UK. As well as eczema, symptoms can include colic, vomiting or diarrhoea. According to the NHS, having a food allergy increases the likelihood that atopic eczema will be severe.
Eczema can be very, very itchy, but scratching can break the skin, leaving it open to infection, which may need antibiotics (creams or oral). Keep babies’ and toddlers’ nails short and put on scratch mittens at night.
Emollients: These creams/ointments help to lock moisture into the skin and stop flare-ups. They must be used regularly and often, even when the skin is clear. Apply liberally in the same direction as hair growth, especially after bathing. You can get these on prescription or try Cussons Mum & Me Emollient Body Cream (£3, asda.com). Sopa, bubble bath and washing-up liquid should be avoided. Aqueous cream can be used both as an emollient and a soap substititue, and is available over the ounter and on prescription. Or try Aveeno Bath & Shower Oil (£8.19 for 250ml, boots.com). For more information visit eczema.org.
Antihistamins: These are used for itching at night and for allergies. Talk to your GP before use.
Topical steroids: Given in low doses for a short time, steroids will calm inflammation. Again, talk to your GP first.
Wet wraps: In severe cases, wet wraps may be used. They are coated on with emollients, steroid, calamine lotion or coal tar (or a mixture). The first treatment is usually given in hospital.
Diet: Diet is rarely the cause of eczema, but it you think foods do cause a flare-up, keep a food diary. Speak to your GP before removing any foods from your child’s diet.
Relaxation: Stress can make eczema worse, so relaxation techniques can help. They can also distract from the itch. “Listening to a story will keep your child’s min from her skin,” says Dr Therea Whynne, principal clinical psychologist at Sheffield Children’s Hospital.
Oat soak sachets (£1.95, skinshop.co.uk) contain skin-strengthening silica and soothing avena sativa, which reduced irritation and inflammation. Simply add to a bath and enjoy.
Did you know?
Eczema comes from the Greek word ekzein, which means ‘to boil’.