Eczema in children

Eczema is a group of chronic skin conditions characterised by dryness, itching, dandruff, redness. In long-term eczema, the skin is thickened, covered with small scabs.

In the first five years of life, they occur in almost 10% of children.
The first signs of eczema can be visible already in newborns between two and three months with a tendency to calm down until the age of three or seven. A complete stabilisation of the skin barrier in 50% of children occurs in puberty.
Severe forms of eczema persist throughout life in a very small percentage of children.

Eczema on the children’s legs
Eczema on the children’s legs

In the period from birth to puberty, eczema in children can interfere with daily functioning if the disease is milder, and even cause sleep disorders in case of severe form of a condition.

When eczema is spread over large areas of the body, and is not provoked by direct contact with the allergen, it is called atopic dermatitis.

The exact cause of eczema is not known, but it is known that it is a combination of genetic factors and factors from the external environment.
It is often a combination of genes that will determine the inherited conditions.
Eczema reactions can be reduced, but not completely stopped.
Families with a tendency to chronic bronchitis, as well as allergic asthma more often have children with atopic dermatitis.

It is impossible to predict where eczema will appear. Nevertheless, in newborns it often appears on the cheeks, neck, scalp. Sometimes the entire body is affected, but the diaper area is spared.
In one year old children, it develops on the folds of the arms and legs, neck and around the lips.
In babies, we will recognise it by a small rash, and in young children by the skin dryness, redness, blisters.
Scaling of the soles and palms is typical for children after the age of three.

In children with dry skin, it is necessary to use oil baths and body balms as daily care.
Eczema develops very easily and quickly on a dry skin, so it is recommended to use body milks with an oily component.
Lotions are too watery and cannot restore the skin barrier that is genetically slightly damaged.
Vaseline makes good isolation from the baby’s saliva, so its use is advised to prevent redness caused by saliva.
Oil baths do not dry out the skin of babies, and the water should be lukewarm. Very warm water dries out the skin, and ordinary soaps change the pH of the skin and damage its lipid barrier.
One should not avoid intense moisturising of skin in children prone to eczema thinking that a child is exposed to a large amount of chemicals in that way. Moisturising is necessary in order to prevent the skin to dry out which can lead to skin cracking and infections.

Room fresheners, softeners, parents’ perfumes, tobacco smoke are very common and imperceptible allergens.

Exacerbation of eczema in children always happen in winter.
The air dried out by different type of heaters, cold air, wind, wearing several layers of clothing all contribute to dry skin.

It is known that milk, eggs, honey, peanuts, walnuts represent allergens for sensitive children. That’s why parents are often trying different diets, but the answer is not so easy. An uncontrolled diet can cause much more problems than benefits for the skin of children with eczema.
The rash caused by food has completely different characteristics than eczema on a child’s skin.
It is possible to do various tests that would indicate sensitivity to certain foods, if necessary.

Treatment of eczema in children

Treatment of eczema in children is complex and often quite individual.
There is no medication that can immediately resolve the problem, which is a characteristic of all genetically predisposed diseases.
When first symptoms of dryness and itching are noticed on the skin, one should begin with intense skin moisturising.
If red patches also appear on dry skin, very mild corticosteroids are added in a very short period of time.
Now there are corticosteroid creams that are not absorbed and can not lead to systemic effects in young children.
This is the parents’ biggest fear, and often the cause of non treatment of a child’s condition.

With a timely and proper care and a use of corticosteroid creams, eczema quickly resolves and does not affect the development of the child.
With persistent eczema, that recur quickly after the use of corticosteroid creams, a dermatologist can also introduce immunomodulatory creams and antihistamines, preparations with zinc, probiotics.

If patient does not follow physician’s advice, the condition worsens.
Exacerbation also occurs with constant scratching, as a result of which bacteria develop on the skin.
The development of bacteria does not allow eczema to resolve even when corticosteroids are involved, so antibiotic treatment must also be included.

With timely and adequate care, the possibility of complications is reduced, and with careful use of corticosteroid creams, most eczema is reduced to mild or medium severe form.

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