A Common Concern

With statistics continuing to rise at high levels eczema has become a common problem for millions of children every year.

As the winter begins to settle in, alongside the comforting nature that the season advocates – as we crank up the central heating and wrap ourselves in our warmers – winter can bring about some pretty tough conditions for our skin to fight off.

Centrally heating our house doesn’t just burn our banks it can also consequence our skin, and this, alongside the dreadful drying effects of the wind, can cause quite a stir with our skin balances and especially our little ones whose precious skin is ultra sensitive.

Could this be the reason that eczema is rising at an alarming rate? Dr Andrew Ilchyshyn, a consultant dermatologist at University Hospitals Coventry and Warwickshire NHS Trust, believes that winter plays a large part in the flaring of eczema. “Humidity improves the quality of skin, meaning winter can cause great problems; centrally heated homes create low humidity environments which encourages skin to dry out,” says Dr Ilchyshyn.

To help understand eczema, it’s integral to understand skin, and its job role. Our skin provides a strong, effective barrier that protects the body from infection or irritation. It is made up of three layers; each containing skin cells, water and fats, and all contributing to maintaining and protecting the condition of the skin. When suffering from eczema, your skin may not produce as many fats and oils as it should, and will be less able to retain water. The protective barrier is therefore weak leading to gaps opening between the skin cells. There are several different types of eczema, explains Dr Ilchyshyn, “The most common is atopic eczema this can also be referred to as infantile eczema. This starts from early childhood, through to the toddler stage and may continue for longer.” The longevity of the condition can differ with each case and the condition is highly individual in its nature. However, it is known that children with eczema are at an increased risk of developing asthma and hay fever, as they get older. Atopic eczema, as well as asthma and hay fever, tends to run in families. If one or both parents suffer from eczema, asthma or hay fever, it is more likely that their children will suffer from them too.

Eczema is a complex condition, and certainly doesn’t carry a one-size fits all solution. Dr Ilchyshyn finds a lot of parents mistaking eczema for an allergy.

“Often parents believe that their children are allergic to something. The actual incidents of allergy are pretty low. If children are allergic it’s usually pretty clear,” says Dr Ilchyshyn. “It’s also notable that food is very rarely involved in eczema. If parents carry out any dietary manipulation it must be done under supervision to avoid  mineral deficiency such as calcium,” he adds.

According to The National Eczema Society (www.eczema.org) eczema affects a staggering 5 million children and adults in the UK every year. Research also indicates that a total of 20-30% of people will develop eczema in their childhood. According to Dr Ilchyshyn eczema can begin very early into a child’s life, with an overwhelming amount of babies visiting in their first few months. “Babies’ skin is very sensitive, I see an overwhelming amount of very young babies around 3-4 months old suffering with eczema, commonly the first patches are normally apparent on face, with redness, and scaling.

Once the child grows it’s more commonly in the folds of skin,” informs Dr Ilchyshyn. Today 1 in 5 children suffer from eczema, which is five times as many as in the fifties. This results in discomfort and sleepless nights causing distress for the parents and children and puts a lot of stress on life at home. Ultimately, a child who’s itching all night doesn’t get a good night’s sleep.

This sounds all too familiar for Lily Govan, mum to 3-year-old Louis. “Louis has suffered from eczema since birth really,” explains Lily. “By about 9 months old he was covered head to toe, but it started to get progressively worse. His hands and feet were the most affected, they were red raw and constantly itchy,” says Lily. “We don’t use any soaps or shampoos, and just bathe him in plain water,” she adds. Dr Ilchyshyn recommends avoiding soaps and detergents as much as possible. “Generally, children with dry skin should avoid using soaps and detergents as they will exacerbate the eczema. Bubble baths and fragrances can be an irritant too, causing the eczema to flare up.”

It’s recommended that parents use emollients to control the eczema explains Dr Ilchyshyn, “The job of the emollient is to improve the quality of the skin.” The emollient is a non-cosmetic moisturiser which comes in the form of creams, ointments, lotions and gels, helping the skin to feel more comfortable and less itchy. They keep the skin moist and flexible, helping to prevent cracks. In more severe cases, topical steroids will be used, which can be quite a daunting scenario for parents, but by using them effectively they should help as they suppress the eczema and give the skin chance to recover and replace itself. Lily uses emollients all over Louis and a strong steroid cream once a day on the worst affected areas to try and control the eczema.

Parents should apply emollients after bathing their child (or use in the bath), while water is still trapped in the skin for extra hydration and use liberally and frequently – at least three times a day. When applying, this should be done gently and in the direction of the hair growth. Never rub up and down vigourously as this could trigger itching, block hair follicles or create more heat in the skin. Continue to use the emollient, even when the eczema has improved as this will help prevent flare ups.

Alike to many children suffering with eczema Louis’ skin worsens during the winter months. “His eczema is very itchy in summer when it’s hot, but his skin is cracked and dry in the winter. We have to wash the sheets every couple of days on a really hot wash to kill any germs to prevent infection,” says Lily. This is due to the barrier function of the skin being impaired, meaning things that don’t normally get into the skin can.

“Many children’s suffering of eczema will be relatively mild,” explains Dr Ilchyshyn. This is the case for mother of two, Vicky Moore. She first noticed her eldest child, Sam, had eczema when he was around 4 months old. “When Sam was a baby the skin on his face was reddened, dry and scaly, but fortunately this only lasted for around 2 months.” When Sam was around 3 and a half, his eczema returned. “It first became noticeable on his inner elbow, we control it by using an emollient, but it does flare up from time to time especially during winter, and after swimming. I also know which detergents trigger it, so avoid using certain ones.”

There’s a lot of unknown territory with eczema and the reasons for the increase is not clear. What is known is that many children will “grow out” of it, with around 70-80% being free of eczema by the time they reach their teenage years.

The National Eczema Society formed in 1975, with an informative website and helpline. They’re a fantastic resource for parents with children affected by eczema, providing support and guidance on management and treatment. If you are concerned about your child’s skin, seek advice from your GP, or a health professional, as they will benefit from early referrals. Currently, there is no cure for eczema, and with the staggering statistics and trauma it causes families across the world we can only hope that in the future eczema is no longer a common concern. ✿


✽  The National Eczema Society, www.eczema.org
✽  Dr Andrew Ilchyshyn, consultant dermatologist at University Hospitals Coventry and Warwickshire NHS Trust