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Sunday 24 August 2014

Demystifying childhood eczema

Sunday May 25, 2014

Demystifying childhood eczema

Statistics show that an estimated one in five children in Malaysia suffer from eczema. - Filepic
Statistics show that an estimated one in five children in Malaysia suffer from eczema. - Filepic
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In this first of four articles on atopic eczema, we explore some of the most common misconceptions people have of the condition – many of which are barriers to timely and effective treatment.
Twenty years ago, atopic eczema – a type of inflammation of the skin that is associated with the immune system – is a condition that was almost unheard of in children.
However, statistics over the past decade show that it has been on the rise, paralleling urbanisation and improvement of general hygiene standards.
Today, statistics show that an estimated one in five children in Malaysia have it.
This phenomenon may be caused by an immature immune system in children, a system that does not have the chance to mature due to a lack of exposure to potential allergens, says paediatric dermatologist Dr Leong Kin Fon.
Although the condition is now common among children, it is frequently misunderstood by parents and caregivers.
One of the most common myths is that atopic eczema is caused by a single factor.
This belief has sent many parents and caregivers on a wild goose chase to find and remove that elusive single causative factor, just to find the condition recurring even after spending a fortune on tests and treatments.
Here are some of the more common misconceptions people have of the condition.
Myth #1: There is a single cause for atopic eczema.
Atopic eczema is a multifactorial condition that is a result of the interaction between genetic and environmental factors.
Children and young adults with eczema are usually genetically predisposed to having dry skin because of a hyperactive immune system. The condition usually occurs within the first five years of a child’s life.
These factors can be aggravated by multiple environmental factors such as the weather, stress, food, bacteria, and irritants such as harsh cleansing agents and dustmites, says Dr Leong.
The combination of precipitating factors is unique in each individual, even with children from the same family who are living under one roof.
Myth #2: Atopic eczema would not recur if it is already treated.
There is no known cure for eczema, and it will recur if a child or young adult is exposed to factors that trigger the inflammation of the skin.
While treatment by a general practitioner or a dermatologist is usually needed after a flare-up occurs, the condition can be managed to prevent or minimise the severity and frequency of future flare-ups.
Myth #3: Atopic eczema only occurs in dry environments.
Atopic eczema also occurs in hot and humid environments, particularly when there’s sweating. This is because sweat could irritate the skin if it is not washed away quickly.
Changes in temperature as a child or young adult moves from a hot and humid environment to a cold and dry environment could also exacerbate symptoms for those living with atopic eczema.
Myth #4: The condition will occur in the same way every time.
The triggering factors for atopic eczema can change in an individual as he or she grows older.
For instance, a baby’s atopic eczema is more likely to be due to food allergies and exposure to harsh cleaning detergents or extremes of weather.
In comparison, a teenager and young adult’s eczema may more likely be caused by stress or exposure to contact allergens in skin care products or perfume.
Myth #5: There is one single medication or treatment that could cure atopic eczema.
There is no magic bullet or medicine for atopic eczema.
Mild eczema can be treated and managed with a suitable moisturizer and cleanser, as well as the avoidance of extreme weather (too hot and humid or too cold and dry).
Patients can also be taught to avoid scratching the skin when it itches by lightly tapping or massaging the itchy patch.
More severe forms of eczema may require the appropriate use of antibiotics, antiseptics and steroids for a limited period only.
Treatments can range from a few days to a few months, depending on the age of the patient and the severity of the flare-up.
Myth #6: There is nothing much I can do about eczema except to will it away.
About 65% of those with atopic eczema will find their condition less symptomatic after they reach 15 years old, while the rest may live with the condition for much longer, says Dr Leong.
However, when parents and those living with atopic eczema are empowered with the knowledge to manage the condition, atopic eczema can be controlled with certain lifestyle habits and suitable moisturisers and skin cleansers.
Habits such as keeping the skin clean and moist, as well as avoiding extremely hot or cold weather, could go a long way towards keeping eczema at bay.
This article is courtesy of Beiersdorf.