Eczema in children: How to control the itch?


As doctors, we always get asked by parents: “My son has eczema, can you recommend the best moisturizer for me to apply?”. There is no single best answer for the treatment of atopic eczema, and definitely not one brand of moisturizer can do the job. The most important part of managing eczema is for parents to understand the disease and only possible to achieve good outcome.
Atopic dermatitis, also commonly known as eczema, is a condition where the skin gets red, dry, irritated and itchy. Atopic eczema usually begins in infancy or childhood, but can develop at any point in a persons’ lifetime. The main characteristic is the ‘itch’, which can be quite unbearable, causing a child to want to scratch constantly, or a baby rubbing on the bed, especially at night, therefore causing disrupted sleep. The common sites of eczema are on the face, inner elbows or behind the knees, but it can appear anywhere on the body.
If a child has moderate to severe eczema, it may lead to area with inflamed skin, which bleed when scratch. When the skin is very dry, any cracked, raw or bleeding areas are especially prone to secondary skin infections.

According to Dermatological Society of Malaysia, approximately one in five children (20%) of Malaysian children are affected by eczema.
As the condition is getting more common over the past few decades, it is very important for parents to be educated on the disease and how to manage it. We understand that some parents struggle as much as when the child is suffering.
What are the treatment options?
For most types of eczema, 3 groups of treatment modalities can appropriately manage the condition.
Eczema care includes bathing with a gentle cleanser and applying moisturizers to lock water into the skin and repair the skin barrier. This will help in controlling flares by combating dryness and keeping out irritants and allergens.
However, despite doing all the “right” things, flare up of eczema may still happen and requiring medications such as topical non-steroidal/steroid creams, oral medications and injectables. Occasionally topical or oral antibiotics will be prescribed if the eczema gets a secondary bacterial infection.
All parents or caregivers should be educated on the knowledge of eczema: how to identify early eczema, finding out environmental factors that can trigger flare up, and seek treatment when the condition worsen.

Dr Tiong has successfully completed Atopic Eczema – Doctors course and is certified as a counselor in atopic eczema. This course is hosted by Persatuan Eksema Malaysia, in collaboration with Dermatology Chapter, College of Physician, Academy of Medicine Malaysia.
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