Eczema
How this topic helps your child's learning
Eczema is a relatively common problem; it affects around 1 in 8 children. There is lots of help and information available, both for you and your child, and with the correct medication and a sound understanding of the condition many children are able to control and improve their eczema.
The pupil information is designed to convey some simple facts within the context of PSHE / Health Education.
For pupils aged 5-7 and for pupils aged 7-11, Boots Learning Store offers this information in the form of six different typical scenarios that a child with eczema might encounter.
The basics
Eczema is a medical condition of the skin. Normal healthy skin acts like a protective barrier that prevents water and heat from getting out and from allowing various irritants and bacteria from getting in.
When you have eczema, your skin does not work properly and it is unable to function as a protective barrier so bacteria and irritants can get in and it becomes dry, itchy and cracked. Eczema is an unpredictable condition and skin can flare up and get worse (i.e. more dry, redder, more itchy) after being fine for quite a long time. Eczema flares can vary in severity.
Eczema is not infectious or contagious. Eczema can be treated using both prescription and over-the-counter preparations. Both steroid and steroid-free creams are available.
Useful things to know
Is all eczema the same?
There are a number of different types of eczema - atopic, seborrhoeic, contact. Atopic eczema is the most common form of eczema in children. The cause of atopic eczema is unknown, however, when children with this type of eczema are exposed to an irritant or allergen to which they are sensitive, inflammation-producing cells may come into the skin. It is the chemicals that these cells release that cause skin to become red and itchy. It is most usually found on the back of the knees and elbows, the wrists and the face and neck. Areas of eczema in the creases of the body can become very hot and weepy and skin affected elsewhere can get very dry and flakey. Repeated scratching can make the skin crack and bleed which could, potentially, lead to the skin thickening. Children suffer eczema to varying degrees. Some may suffer chronically from it while others only mildly. Similarly, the degree to which they suffer is likely to change, some days being much worse than others - a 'flare'. Eczema is very unpredictable and a 'flare' can occur at any time.
What causes eczema?
There seems to be a strong genetic link where atopic eczema is concerned but, even so, there remains the need for a 'trigger' and these come in many shapes and forms, the majority of which are outlined below.
Dust - the droppings of house dust mites can cause an allergic reaction that exacerbates eczema.
Pets - animal fur, feathers and saliva can have a very negative effect on the skin of children who suffer from eczema. Some react so strongly that they are unable to stay in the same room as an animal (dogs, cats, hamsters, horses, budgies...)
Pollen - Some children may find their eczema is aggravated by contact with pollen and other plant material bearing allergens.
Humidity - dry air, either as the result of frosty weather or air conditioning and central heating are a known aggravator of eczema.
Diet - certain foods may trigger your child's eczema. Some of the most common 'trigger' foods are dairy, wheat, citrus and tomatoes.
Psychological - stress, anxiety, excitement and nerves can all make the severity and flare-ups of eczema worse although it is often hard to determine such psychological triggers in young children.
Industrial or chemical irritants such as detergents, biological washing powders and chlorine can trigger eczema.
Bath products - bubble bath, shampoos and soaps can be very irritating to the skin of those who suffer from eczema. There are alternative products available, ask your pharmacist or G.P.
Temperature - Heat will aggravate your child's eczema so try and avoid clothing them in nylons and woollens, avoid keeping the house too hot or exposing them to direct sunlight too often.
Will my child always have eczema?
If your child suffers from atopic eczema it is very likely that they will grow out of it - around 75% of sufferers grow out of it by their mid-teens though their skin will retain the tendency to be dry and they may remain prone to getting eczema on their hands throughout their adult years.
I want my child to enjoy bathtime but at the moment it just makes her eczema worse, what can I do?
Bathtime often proves to be a difficult time when you have a child who suffers from eczema and the reason why is generally because of the products that you are using. Popular bubble baths, foams, soaps and shampoos have a very drying effect on the skin which for children with eczema is something to avoid! The dryer their skin gets the more it will itch and the more they will scratch!
Ask your pharmacist or G.P about bath oils and substitute soaps. Bath oils will help hydrate your child's skin and the fine film of oil they leave will help it to retain moisture for longer. Substitute soaps, although they do not foam like normal soaps, are much kinder to your child's skin. Because they are emollient they do not dry out their skin and they still get them nice and clean!
A few other things to keep in mind when giving your child a bath is keeping the water to a reasonable temperature…too hot and it will make their skin worse. Also, pat their skin dry afterwards…rubbing too hard will damage and dry the skin out. Bath time is one of the most fun times in which you and your child can help treat their skin so it is very important to use the right products!
Can my child still go swimming despite his eczema?
It is inadvisable to take a baby with eczema to the swimming pool but it is very important that older children get the opportunity to swim and eczema needn't stop them enjoying the pool. Just make sure you follow these few simple steps:
- Before swimming, apply a thick moisturiser to their skin.
- After swimming make sure your child either baths or showers with an emollient wash.
- Pat the skin dry and apply an emollient cream to keep the skin well moisturised.
I have just booked a holiday abroad, what extra precautions do I need to take to look after my child's skin?
For hundreds of years the sun has been used to treat a variety of ailments from T.B to rheumatism to skin complaints and the benefits of sunlight are still very much recommended for the treatment of eczema today. Heat and sweating can make your child's eczema worse though so try and make sure that your child is kept cool at all times, maybe dress them in a damp t-shirt in very hot weather. Also ensure that they have a very high factor sunscreen on at all times so that their skin doesn't burn. Make sure that the sunscreen you use is eczema friendly! (check with you pharmacist or doctor if you are unsure).
I suspect that my child has eczema, who should I check this with?
There are a number of people who will be able to help. You may wish to try your pharmacist or school nurse first or go straight to your G.P.
What is an emollient?
An emollient is a 'medical' moisturiser and it is a proven way of effectively treating eczema. Both adults and children find emollients very useful because they replace the lost water that their dry skin needs and help to prevent further moisture loss. Emollients come in lots of different forms; oils for the bath, soap substitutes, creams and ointments. Some bath oils, for example, contain extra ingredients such as antiseptics and antipruritic ingredients which help relieve itchiness alongside hydrating the skin.
I am worried about how my child will cope with their eczema at school.
Around 1 in 8 children suffer from eczema so it is very likely that your child will not be the only one but this is obviously, not your only concern. Due to the pain and irritation of eczema, your child may suffer many sleepless nights as a result of this condition. If you have concerns about how this may be affecting both their home life and education while at school it is very important that you talk with your child's teacher. A number of points that many parents have found helpful in raising with their child's teacher are as follows:
- I am concerned that my child, out of my watch, will be tempted to scratch their eczema a lot. Could you help me in encouraging my child to pat or rub their skin instead?
- Heat aggravates my child's eczema, would it be possible to place my child out of direct sunlight and away from the classroom's radiators?
- I am worried that my child will suffer teasing because of their eczema. I think it would help if their classmates understood a little about this skin condition to avoid hostility at school.
I don't want my child to be on lots of steroids if I can help it, what other treatments are available?
Steroids have been used since the 1950s to treat eczema (they do NOT have anything to do with the steroids that bodybuilders use!). They are an anti-inflammatory drug and vary in strength from the mild over-the-counter hydrocortisone cream to the much stronger prescription-only treatments. As a parent you may feel concerned about using steroid treatments on your child but when used as directed by your G.P or pharmacist they are well tolerated and can have excellent results. If you do have concerns about steroids the first thing you should do is talk to your nurse or G.P who may be able to prescribe some other non-steroid treatments.
Tips & treatments
Applying Cream
The best way to apply cream to your child's skin is to do it very gently and to apply it in a smoothing action, following the direction of the skin. This minimises the chances of causing the skin to itch.
Stopping Scratching
We all respond to praise much more positively than criticism and the same applies to your child. Try praising your child when they don't scratch their eczema rather than telling them off when they do! Trim your child's nails regularly so that when they do scratch their skin the damage they cause is minimal. Teach children to pat or pinch their skin when it itches rather than scratch (best of all do this through their clothing). This will cause less damage to the skin. Distraction! Try and focus your child's attention away from itchy skin by suggesting activities, giving them 'special' jobs or by challenging them to clench their fists and count as high as they can. Anything that stops them thinking about itchy skin should work!
Clothing
Heat is a major aggravator of eczema and so tickly, woolly and nylon clothing are likely to irritate skin. Try clothing your child in cotton or at least place a layer of cotton between their skin and their outer garments. Use a non-biological washing powder to wash clothing, bedding, towels etc. If your child's skin is extra sensitive try giving their clothes an extra rinse.
In the House
Try and keep the house, especially your children's bedrooms, cool and humid. You could try placing a saucer of water in rooms to keep moisture in the air. If the central heating is on, your child will probably need to moisturise more regularly. Use cotton bed linen and avoid feather pillows and duvets. To keep the number of house dust mites down, the droppings of which can make some children's eczema worse, wash bed linen regularly and vacuum frequently.
Bathtime
Bath water should be run tepid or warm... remember to always try to keep your child from getting too hot as this can make their skin more itchy. Avoid using bubble baths and soaps as these are very drying on the skin. Instead, use oils which are soothing and hydrating and choose special emollient soap substitutes which, although they don't foam up like normal soap, are just as good at their job.
Sources of help and information
National Eczema Society
Talk Eczema
Net Doctor
The Eczema section of bootslearingstore is supported by an educational grant from Novartis Pharmaceuticals.