Eczema is hereditary
Eczema is in the genes. As long as you or your husband had childhood eczema, it’s likely your kids will have it too. The skin condition doesn’t spontaneously develop and tends to manifest early in life, especially once a child has been exposed to allergens that trigger the condition.
“Most children who are going to develop atopic dermatitis will show signs of the condition by the age of two years,” says Dr Cheong. If your child has eczema, your primary goal is then to recognise the triggers that aggravate his/her flare-ups and eliminate them.
Climate is a big trigger
Dr Cheong says the weather in Singapore traps eczema sufferers between a rock and a hard place. “The high humidity exacerbates eczema as it results in increased sweating,” he says. The salt content in sweat then dehydrates the skin and irritates it, causing the eczema to flare up.
But keeping your little one in an air-con bubble doesn’t help him either – air-conditioning also aggravates eczema. According to Dr Cheong, it dries out the skin, resulting in more itchiness.
When your child’s skin is irritated by either the heat or cold, his natural reaction is to scratch. This can lead to tearing of already weakened skin, and cause lesions and infections to develop.
To stop the itching before it even starts, use an electric fan in your child’s room instead of air-conditioning, says Dr Cheong. If junior needs to be in an air-conditioned room for prolonged periods, apply moisturiser liberally to prevent the skin from drying out. Moisturising the skin also soothes the itch and reduces discomfort.
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Your home could be making it worse
“Dust, dust mites, carpets and stuffed toys can also trigger flare-ups,” says Dr Cheong. Viruses and bacteria collecting on the surface of household items can also exacerbate skin inflammation and eczema.
Get rid of furry items like wool blankets that trap dust and replace them with hypoallergenic alternatives such as cotton or silk. Also use anti-dust mite covers on all pillows and mattresses.
Choose stuffed toys that do not have faux fur. Every four to six weeks, freeze them overnight then wash in warm water and leave in the sun to dry. This will kill off any dust mites on the toys.
Your beloved – but fluffy – house pets may also cause severe eczema flares, so keep them out of your child’s bedroom. You may also need to keep other areas of the house pet-free to ensure your child has reduced contact with allergens.
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Check on what your child eats
Dr Cheong also advises parents to watch their children’s diets carefully. “The most common food allergens are milk, egg and peanuts,” he says. A child who is sensitive to these foods will experience itchy flare-ups after eating them. If you suspect your child’s eczema is triggered by a particular food, your doctor can do skin or blood tests to pin down the exact cause.
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There are ways to prevent it
If you, your spouse or your kids are prone to eczema and are worried that your new baby will suffer from it too, Dr Cheong says you can take action to prevent it.
He cites a recent study which found that regularly applying moisturiser on a newborn for the first 32 weeks of life can help reduce his risk of developing the condition.
Moisturisers help protect your infant’s skin barrier so it does not develop sensitivity to allergens. Brands like Physiogel, available at pharmacies, contain lipids similar to those naturally found in the skin, which help repair and restore the natural moisture barrier.
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Have good bath time practices
“Atopic dermatitis is related to a weakened skin barrier,” says Dr Cheong. “Therefore, skincare is integral to management of the condition.”
During bath time, use a soapless cleanser such as Ezerra Extra Gentle Cleanser, which strengthens the skin and helps alleviate symptoms. Avoid hot water baths as this will dry out the skin. Keep shower time to less than 10 minutes and apply moisturiser within a few minutes of the bath.
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“Regular use of a dermatologically-tested moisturiser goes a long way in minimising flares of eczema,” says Dr Cheong. Apply the moisturiser beyond the affected areas and on normal-looking skin as well. This prevents further inflammation of the surrounding skin.
Don’t rely too much on steroid creams
Moisturiser alone may be insufficient to treat eczema. If you don’t see an improvement in your child’s skin after two weeks, see a doctor who may prescribe a steroid cream to manage the itching and inflammation.
Depending on how severe Junior’s eczema is, different grades of steroid creams may be prescribed. However, Dr Cheong also warns that long-term use of a potent steroid cream can lead to thinning of the skin, which further weakens the skin barrier function.
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“In extreme cases, using it over extended periods of time in young children may lead to Cushing’s syndrome,” says Dr Cheong. Cushing’s syndrome is a hormone irregularity that can result in obesity and high blood pressure.
Once the eczema has cleared, stop using the steroid cream. With a potent steroid cream, you should see improvements within a week; milder creams take more than two weeks to take effect. If the condition persists, speak to your doctor who may advise switching to a different cream.
Dr Chong encourages parents to routinely apply therapeutic moisturisers with anti-inflammatory and anti-itch effects as these can reduce the reliance on steroids over time.
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Text: Davelle Lee/Herworld, Additional reporting: Elizabeth Liew