Eczema

Eczema, also known as atopic dermatitis, is a recurrent, itchy skin condition that commonly affects children. Eczema is associated with a personal or family history of atopy, which is a group of disorders that include eczema, asthma and allergic rhintitis.

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Eczema, also known as atopic dermatitis, is a recurrent, itchy skin condition that commonly affects children. Eczema is associated with a personal or family history of atopy, which is a group of disorders that include eczema, asthma and allergic rhinitis.

What is Eczema?

Eczema, also known as atopic dermatitis, is a recurrent, itchy skin condition that commonly affects children. Eczema is associated with a personal or family history of atopy, which is a group of disorders that include eczema, asthma and allergic rhinitis.[1],[2]

Related: Atopic Dermatitis

Symptoms of Eczema

Eczema symptoms can include intense itching, redness, small bumps and flaky, scaly skin. Children usually begin to experience these symptoms before the age of five. Appearance and location of eczema may differ depending on the age[3],[4]:

  1. In babies, eczema tends to occur at the front of the arms and legs, cheeks and scalp. The diaper areas are usually not affected.

  2. In older children and adult, eczema occurs at the side of the neck, elbow creases and the back of knees. For adults, eczema tends to affect the face, wrist, hands and forearms. Also, the skin can darken and become thick. Scars can form from repeated scratching.

The affected area can become crusted. Excessive scratching may lead to infection, which appears as painful red bumps with pus.

Related: How to Have Good Skin

Causes of Eczema

There is no known absolute cause. While the cause is not completely understood, genes involved in the formation of the skin barrier and the skin’s immune system may play a role in the development of eczema. In most people, eczema is caused by a genetic dysfunction in the outermost layer of the skin. Contrary to popular beliefs, eczema has not been proven to be associated with food allergies. See an allergy specialist if a food allergy is suspected in the child.

Related: Food Allergy

Diagnosis

There are no diagnostic tests for eczema, and diagnosis is usually based on a person’s medical history and physical examination of the skin. A personal or family history of allergic conditions and appearance of symptoms at an early age can also help to confirm the diagnosis.

Related: Skin Disorders in Young Children

Treatment

Eczema is a chronic condition that fluctuates in terms of severity, where it sometimes improves and worsens. Some people can have no symptoms for many years. It cannot be cured, but symptoms can be controlled with moisturizers, topical and oral medicines, and self-care measures.

Below are some measures that can be taken to prevent eczema flare-ups:

1. Avoiding Trigger Factors

Trigger factors include heat (overheating of the skin), perspiration and dry environment. Emotional stress or anxiety may also trigger eczema. Exposure to certain chemicals (e.g. soaps, detergents, perfumes, or cosmetics), materials (e.g. wool or synthetic fibres), dust, sand and smoke also may trigger a flare-up. It may take some effort and time to identify the trigger factors, but it is important to avoid such factors for long-term control of the condition.

2. Keeping the Skin Moisturized and Hydrated

The skin can be kept hydrated with emollient cream and ointment formulations. They are best applied straight after bathing, and to be used as frequently as possible. While lotions contain more water and are more comfortable for application as compared to creams and ointments, the latter is better at retaining moisture in the skin.

In addition, take lukewarm baths or showers to hydrate and cool the skin. Use unscented, mild soap or soap-free cleansers. Avoid hot and long baths or showers (do not exceed 15 minutes). Bleach baths may be recommended for severe eczema with recurrent infections. Speak to your pharmacist about this.

3. Topical and Oral Medications

When there is a flare-up with inflammation and itch, topical steroids may be used. Topical steroids of the right potency should be used for a short period of time to avoid side effects. It is important to apply a thin layer that is adequate to cover up the affected area. Oral antihistamines can also be given for a short period to relieve the itch. Do speak to your pharmacist about obtaining these medications.

Related: Desonide Cream or Lotion

Is there any special diet or supplement recommended for controlling or preventing eczema?

Probiotics with lactobacillus studied appear to be of limited benefit in improving symptoms[5]. There is also conflicting evidence for probiotics use in preventing eczema in children with high risk.

Supplements like vitamins, fish oil and evening primrose oil appear to have limited evidence for effectiveness. The safety and efficacy of Chinese herbal medicine have also not been sufficiently evaluated in studies. Such supplements are not routinely recommended. Do check with your pharmacists for more information regarding these supplements.

Related: Eczema

Where can I find out more?

Any further inquiries can be directed to your doctor, or to a community pharmacist.


Disclaimer

Information provided by this patient information leaflet is solely for informational purposes only and is not intended as a substitute for the advice provided by your physician, pharmacist or other healthcare professional. You should not use the information for diagnosis or treatment of a health problem or disease. Always speak with your physician, pharmacist or other healthcare professionals before taking any medicine or supplement, or adopting any treatment for a health problem. Under no circumstances will Pharmaceutical Society of Singapore be liable to any person for damages of any nature arising in a way from the use of such information.

 
Prepared by the Pharmaceutical Society of Singapore, updated July 2016.
www.pss.org.sg

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References

  1. Spergel, J. M. (2010, Aug). From atopic dermatitis to asthma: the atopic march. Annals of Allergy, Asthma & Immunology, 105(2), 99-106.
    Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/20674819

  2. Eichenfield, L. F., Tom, W. L., Chamlin, S. L., Feldman S. R., Hanifin, J. M., Simpson, E. L., et al. (2014, Feb). Guidelines of care for the management of atopic dermatitis: section 1. Diagnosis and assessment of atopic dermatitis. Journal of the American Academy of Dermatology, Asthma & Immunology, 70(2), 338-51.
    Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/24290431

  3. Kramer M. S. & Kakuma, R. (2012, Sep). Maternal dietary antigen avoidance during pregnancy or lactation, or both, for preventing or treating atopic disease in the child. The Cochrane Database of Systematic Reviews, 12(9), CD000133.
    Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/22972039

  4. Rudikoff, D. & Lebwhol, M. (1998, Jun 06). Atopic dermatitis. The Lancet, 351(9117), 1715-21.
    Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/9734903

  5. Lee, J., Seto, D., & Bielory, L. (2008, Jan). Meta-analysis of clinical trials of probiotics for prevention and treatment of pediatric atopic dermatitis. Journal of Allergy and Clinical Immunology, 121(1), 116-121.
    Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/18206506

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