First lets talk about the long duration or recurring eczema. The common one is Atopic dermatitis . It can start in infancy when it will be termed infantile eczema. This continues in young children as Atopic Dermatitis, and most of the time, gradually disappears in the early to late teenage years.
A lot of mothers tell me anxiously “I have heard eczema cannot be cured, Is that right?”
or “Is this an eczema doc?”
and then wait with bated breath for the dreaded axe to fall – “yes it is” and then start weeping because they see their child as having this terrible itchy, weepy, red, infected and discoloured skin. The distress is from seeing the poor child tear at the skin till it bleeds, and going from doctor to doctor in the hope of some relief, from seeing it develop into dark rough ugly patches that other children shun, and in severe cases will retard healthy growth and precludes the child from taking part in active sports.
BUT – IT IS NOT SO & need not be so. Let us understand why and how
The aim of treatment is to control the worsening when it happens and to prevent outbreaks; to control it until time eliminates it. Atopic skins have a reduced ability to maintain water, have reduced oil and sweat glands and so their skins are dry. A dry skin increases the scratching which further causes infection and the other complications described above.
So the important thing is to moisturize – but an ordinary moisturizer won’t work. It needs good humectant properties, i.e. it must be able to retain and hold moisture on the skin.
MANAGING ECZEMAS IN GENERAL:
How to prevent itching or scratching:
1. A good humectant moisturizer
2. In more severe cases, applying a specially diluted steroid cream; diluted to a degree where it is safe to use over long periods of time, without any side effects.
3. Avoiding the things that you have noticed make the baby itch more – certain foods, certain garments or material touching the skin makes it itch more. This applies to the infantile eczema and atopic dermatitis.
And to prevent infection: Just the mechanical “hosing” down with water, of the parts affected, will not allow any harmful bacteria to lodge in the broken skin and to multiply there causing an infection.
But, washing frequently can dry the skin a lot. So a common mistake is to either reduce the washing to prevent drying, or to wash just once, but insist on using some soap substitute as the person feels the skin must be “cleaned”.
So the way to wash the skin frequently (twice a day at least, and definitely after playtime) without drying the skin, is not to use any type of soap or soap substitute at all. Plain water will do ; plus a cream to spread generously on the skin during the wash; and a bath oil to add to water and rinse with. All this will replace the oil washed away by water.
To sum up – wash two or even three times daily in hot sweaty weather, but use the replacement oils and creams each and every time, during the wash or bath. And never use any soap or it’s substitute at all. Then apply the moisturizer after each wash.
We have a range of therapies that help soothe and improve eczemas. Eczemas that occur due to any reason need washing and creaming. Such skins cannot tolerate any soapy agent no matter how high the oil content is in the soap. Eczema-prone skins also cannot tolerate any perfume which is unfortunately present in most moisturisers.
So I prepare a cream to clean and wash with (Aqueous Cream), and another cream (Customised) and an oil (Drizzle Bath Oil) to moisturise with. It is not necessary to use all these in every case. And sometimes I tweak these washing and moisturising creams as the person or child requires.