Atopic eczema

Atopic eczema is a common skin disorder in childhood, which usually improves with age. Other members of the family have had had eczema, asthma or hay fever. It is not infectious. The skin is often dry and extremely itchy. Scratching makes the eczema worse and may lead to infection. Severity fluctuates from time to time.

There is no quick simple remedy but the skin can be dramatically improved by regular use of a combination of the following measures:

Use of an emollient in the bath or directly to the skin

For example, dissolve 1-2 tablespoonfuls of emulsifying ointment in a jug of hot water, then pour into a fairly cool bath (once a day, or more if necessary). This may also be massaged gently into the affected areas. Emulsifying ointment has a cleansing action although most "baby" soaps can be used.

It is important to treat itching

This if often worse at night (children often scratch in their sleep!) A syrup or tablets (called antihistamines) may be prescribed. These may cause slight sleepiness, which is often helpful, but children do not become "addicted" to them. Taking the medication a couple of hours before bedtime will often overcome any drowsiness on waking.

Use of an anti-inflammatory preparation on the skin

Ointments, although more greasy than creams, usually work better and may be required two or three times a day. The doctor may prescribe a steroid ointment. He will usually advise a weak steroid only (e.g. 1% hydrocortisone) for children's skin, especially on the face.

Treatment of infection

A course of oral antibiotics or a topical antibiotic may be required.

Diet

Sometimes, the eczema may be made worse by certain foods, e.g. cow's milk, cow's milk products and eggs.

Mothers from "atopic" families should try hard to breast feed for the first few months.

The doctor may advise avoiding certain foods for a few weeks, later re-introducing them to find out whether they really do make the eczema worse. Babies are sometimes given soya bean extract instead of cow's milk but there are no proven benefits of goat's milk which is unpasteurised.

Factors to avoid

Excessive drying of skin
Excessive heat and sweating
Clothes which are found to irritate (e.g. wool and nylon)
Material which may irritate (e.g. do not put Dettol or salt in the baths)
Skin infection: avoid close contact with "cold-sore" sufferers. Immunisations (apart from against small pox) may be performed as usual.
"Stress" - this may worsen eczema although atopic eczema itself may cause stress

A POSITIVE APPROACH TO TREATMENT IS VERY IMPORTANT