At around the age of 5 months I developed eczema and whilst I suffered with the chronic itching and soreness, it was my lovely mum who struggled, battled, emolliated, bathed, soothed and tried to stop me scratching. She coped with the sleepless nights and the day and night care. As a common condition, the impact of eczema can be trivialised but if your child is diagnosed with eczema, what will it mean for them… and for you?
What is Eczema?
Eczema and dermatitis mean the same thing; inflammation of the skin characterised by redness, swelling, itching and excoriation (scratch marks) in the acute form. In the chronic (persistent) form, regular rubbing of the skin through itching and scratching, leads to thickening or ‘lichenification’, scaling and post-inflammatory darkening of the skin.
What are the causes?
There are several different types of eczema with different causes:
- Atopic eczema; common in children and related to other allergic conditions such as asthmas and hay fever.
- Allergic contact dermatitis: an eczema caused by an allergic reaction to something coming in to contact with the skin (such as a fragrance). This can be identified by means of a patch test.
- Irritant contact eczema: an eczema caused by a chemical irritating the skin (such as soap or disinfectants)
- Lichen simplex chronicus: a thickened itchy area caused by repeated rubbing and scratching
- Nodular prurigo: similar to lichen simplex, multiple small itchy areas of thickened inflamed skin
What does it look like?
Acute eczema is red with swelling of the skin, sometimes to the point of tiny blisters or vesicles appearing. It is often symmetrically distributed. Chronic eczema that has been rubbed repeatedly might be thickened and darkened.
How might it affect me or my child?
The key feature of eczema is that it is itchy! This can be a minor distraction or a major feature that interferes with your life. In children it can prevent sleep which causes unhappiness at home. The condition can cause redness and thickening of the skin which might affect one’s appearance and confidence.
What are the treatments?
The treatment of eczema can be divided into three basic strategies depending on severity, namely creams, phototherapy (ultraviolet/sunlight) or systemic medication (oral or injectable drugs).
- Creams include emollients, soap substitutes, steroids or tacrolimus.
- Phototherapy involves precise doses of ultraviolet light being delivered by a medical UV-machine.
- Systemic medications include tablets such as prednisolone, azathioprine, methotrexate and ciclosporin. These powerful drugs are reserved for severe or life-limiting Eczema Lichen Planus.
Allergic contact dermatitis can be treated by identifying the allergic cause and avoiding it!