Allergic eczema

Infantile eczema, otherwise known as Atopic Dermatitis or Atopic Eczema, is a chronic relapsing itchy disease of the skin. It may commence after the third month of life as a weepy red rash on the face and outer surfaces of arms and legs and then progress in later childhood as a dry scaly itchy rash commonly of the inner creases of the elbows and knees. There may be associated sandpaper-like roughness of the skin with cracked skin on the palms, around the ears and scaling of the scalp. Very often there is a family history of other allergic diseases such as asthma, hay fever and eczema. Some children may not outgrow eczema and the condition often continues or relapses in adulthood. Adult eczema predominantly affects the neck, ankles and wrists.

"It’s not the eruption that itches but the itch that erupts".

Prevention

Diet:

We tend to institute general allergy prevention measures in high allergy risk new-borns. The risk for developing eczema is high in families who suffer with severe eczema, asthma and nasal allergies. Prevention measures include avoidance of smoking by parents during pregnancy and after birth and breast-feeding until at least 6 months of age. Common allergy-provoking foods such as milk, eggs, fish and peanuts should be avoided in the breast-feeding mother’s daily diet. Avoidance of solid foods in babies up to 6 months of age followed by the careful introduction of the potential allergy-provoking foods such as cow’s milk, wheat and peanut at 12 months, and eggs and fish only being introduced after 18 months. Up to a third of infantile eczema is food allergy related and food additives and colourings may also aggravate eczema in older children. In addition adverse reactions to citrus fruit, tomatoes, pineapples and Marmite, are common in patients with eczema. Infants can be skin tested for food allergy from 4 months of age.

Clothing:

Children should avoid hot humid and cold dry weather, excessive sweating, woollen or synthetic clothing close to the skin and perfumed soaps. Cotton underwear as well as cotton clothing and bed-linen are recommended.

Detergents:

Non-biological washing powders should be used instead of enzyme enriched detergents. Bubble baths, household antiseptics and medicated soaps are best avoided. Swimming pool chlorine may also irritate and dry out the skin. Local household skin irritants include wool, mohair, nylon and feathers. Housedust mites, bacteria and dog or cat skin flakes may aggravate eczema.

Bath:

Daily bath water should be lukewarm and moisturising emollients must be applied to the skin within 3 minutes of patting the skin dry (never rub the skin dry). If the non-perfumed soaps such as Dove, Pears or Neutrogena irritate the skin then the use of aqueous cream as a soap instead.

In Bed:

As much skin as possible should be covered with non-allergenic lightweight cotton clothing, taking care not to overdress or overheat the child. Cotton night-gloves as well as neatly clipped fingernails will reduce scratching at night whilst asleep. Sometimes elbow splints need to be applied to stop intractable scratching at night. House dust mite exposure may exacerbate eczema and levels of these troublesome mites in the bedroom should be reduced read more