Eczema affects as many as one in eight babies and young children and appears to be on the increase. It is a red, itchy rash causing flaking of the skin, which may weep and form a crust. It can cause children great discomfort and keep them awake at night.
What is the cause?
The tendency to eczema seems to be inherited, but it is frequently provoked by allergies to foods - the most common trigger being cow's milk - or chemicals in the environment. Eczema is an atopic condition, related to asthma and hay fever.
House dust mites are a common cause of allergies, and many parents have to keep the child's bedroom, and especially their bedding, washed and free of dust. Old carpets, mattresses and duvets often have to be removed. Cotton clothes are best, as artificial fibres may provoke a rash. Clothes have to be washed in detergents that are free of perfumes and other added ingredients.
Treatment
Aqueous creams, and special emollients for use in the bath or shower, are used to keep the skin moist. Soap should be avoided and there are special shampoos for the scalp. Where this fails, steroid creams are used but it is important to get the dosage right and to use the creams sparingly. They can thin the skin, cause hyperactivity, and, used in excess, affect a child's growth.
Antihistamines are also used to treat eczema. They can cause drowsiness, which can be helpful at night, but affect the child adversely during the day. When there is a severe flare-up, the skin is often wrapped in bandages that are impregnated with coal tar, which relieves itching and inflammation.
If the eczema is bad enough to crack the skin, bacteria can enter, causing infection. When this happens a course of antibiotics must be taken.