eczema

Don’t scratch that itch

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Your Health - Dr. Gita Mathai

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  Skin deep
  Keep eczema away
  
  Use a non-perfumed, moisturising soap. Apply lotion or oil after a bath. Add a tablespoon of coconut oil to the bathwater
  
  Apply mild steroid creams (only with a prescription) for relief. Avoid oral steroid medication
  
  For relief from scratching, take anti-allergy pills that do not make you sleepy
  
  Reduce stress with exercise, yoga and meditation

Eczema is a common skin condition, affecting 10-30 per cent of the population. The word is derived from Greek ekzein, which means ‘boil over, break out’. It is diagnosed when the skin is chronically inflamed in certain areas, with redness, itching and rash. The constant itching makes people scratch. Children are sometimes unable to reach the area, whereupon they rub it against clothing and available hard surfaces. The affected area may then begin to bleed or become secondarily infected. The skin can eventually become thickened and leathery.

The most common type of eczema is called “atopic dermatitis”. It starts in childhood. Affected children have close relatives with atopic dermatitis or other allergies such as constant sneezing. The attacks may be triggered by exposure to allergens in food such as cow’s milk, peanuts or food colouring. Contact with wool or synthetic fibres may aggravate the itching. Perfumes, soaps and detergents may also be precipitating factors.

Atopic dermatitis appears on the front or back of the knees, around the elbow, at the neck, on the scalp, hands or cheeks. It can appear as itchy dry red areas, which can eventually become discoloured. The itching can be severe enough to interfere with schoolwork, daily activities and disrupt sleep.

Infants fed on cow’s milk or formula can develop eczema because of cow’s milk protein. Sometimes rashes make their first appearance during weaning, when solid food like egg is introduced.

Most children grow out of their eczema. They start getting better around the age of one and are completely “cured” by the age of four.

Eczema may also be “contact eczema” where the reaction occurs only in areas in contact with the allergen. This is particularly common with nickel-plated artificial earrings or necklaces. Changing your brand of soap or shampoo can also precipitate a reaction. This type of eczema is easy to treat. Just removing the precipitating factor will make it clear up rapidly.

Sometimes the palms and soles of the feet are affected. Blisters form, the skin becomes rough and it may flake off. This is called dyshidrotic eczema.

Nummular or discoid dermatitis occurs in adults as oval-shaped patches, or blister-like sores. They occur on the arms, hands, feet and chest. They exude fluid, become scaly and can get secondarily infected.

Seborrhoeic dermatitis appears on the scalp (dandruff, cradle cap in infants), nose, around the umbilicus, sides of the nose, eye and skin folds under the breast. On the scalp, applying mineral oil, brushing away the flakes and then using an antidandruff shampoo usually clears the flakes.

Dr Gita Mathai is a paediatrician with a family practice at Vellore and author of Staying Healthy in Modern India.