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SKIN IN CHILDHOOD: EXTERNAL IRRITANTS FOR ECZEMA
Heat
Overdressing babies aggravates eczema considerably. Once the skin warms up it can become quite itchy, and scratching it soon sets up an itch-scratch cycle. Children with eczema should be kept as cool as possible, especially if the skin is actively inflamed. It is best to keep clothing and bed clothes to a minimum and to turn off heaters overnight. As well, cool to tepid baths are preferable to hot baths.
Dryness
Children with eczema tend to have dry skin with poor barrier function, which is easily irritated. The protective outer fatty layer of the skin is defective, so water evaporation occurs more easily. If children with eczema are exposed to further dryness from heaters, air-conditioners or excessive washing, their skin becomes even drier and so more irritable and itchy.
In order to avoid excessive dryness heaters and air-conditioners should be turned off whenever possible, or a humidifier, which creates water vapour, should be used. Commercial humidifiers are available through chemists but you can create the same effect by placing a tray of water near the heating ducts. Steam is created as the water evaporates, which humidifies the atmosphere. The best room heaters are the Dimplex heating bars as they do not blow out dry heat.
Children with eczema should have short, tepid baths containing a bath oil to help replace the deficient fatty layers of the skin. Examples include Alpha Keri Bath Oil, Aveeno Bath Oil, Hamilton’s Bath Oil and Q V Bath Oil. Normal soap should be avoided but moisturizing soaps such as Aveenobar, Dove and Oilatum bar can be used. After bathing the skin should he patted dry, rather than rubbed, and a non-perfumed moisturizing cream should be applied all over the body. Aquatain, E45 cream, QV cream, sorbolene cream and 10% glycerol in sorbolene cream are all good products. If the skin is excessively dry, a liquid and soft paraffin mixture works best. Urea-based creams should be avoided as they often cause stinging. Moisturizing creams which contain perfume, as many over-the-counter preparations do, should also be avoided as perfume is a major irritant to eczema skin.
Wool
Wool is a major irritant to skin with eczema. All woolen clothing, woolen toys and sheepskin and lambs wool bed and pram covers are best kept well away from the skin. Woolen clothing may be worn over the top of cotton undergarments such as T-shirts and skivvies, as long as the wool does not come into direct contact with the skin. This can be a problem with school uniforms. To prevent eczema from flaring up, a long-sleeved cotton shirt should be worn inside the jumper or cotton sleeves sewn in under the woolen sleeves.
Woolen carpets present a problem for babies at the crawling stage. Long, cotton trousers should be worn during this period.
Other clothing
Synthetic fabrics, rough seams and labels often irritate skin with eczema. Children should wear soft, cotton clothes next to their skin. In addition, all seams should be soft and all labels removed. Nylon and other synthetic fabrics are best avoided.
Shoes
With the increasing popularity of runners and jogging shoes, foot eczema is becoming very common. Runners do not allow the feet to breathe, causing sweat to irritate the soles of the feet. Children with eczema should therefore be encouraged to wear leather shoes and cotton socks as much as possible. Runners should only be worn for sporting activities.
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