More Than Just A Rash


Seeing your child suffer from an eczema flare can be heartbreaking. Here are insights and important steps that will help you and your child reduce the detrimental effects of eczema.

Eczema is also known as the ‘disease among the wealthy.’ The reason why this skin condition is often classified as such is because it tends to be more common among children from a wealthier background or those living in the city compared to those living in villages. A probable cause is a lifestyle pattern that has been labelled as the hygiene theory.

Consultant Dermatologist at Sunway Medical Centre, Dr. Bong Jan Ling explains uncovers hygiene theory and reveals more about this condition.

It’s a rash

 “Eczema is a type of skin rash. It often appears as a reddish rash and is usually very itchy,” says Dr. Bong. “This is a chronic condition whereby no cure is currently available but treatment options are available which can effectively manage the symptoms.” The onset of this eczema is more common among children than adults. In fact, it affects about one in five children in the developed world although in underdeveloped nations, the numbers are lower.

Eczema in children is known as atopic eczema. “Eczema can affect children as young as three to four months old and the rash usually appears on the cheeks. As the child gets older, the rash will tend to ‘shift’ to the areas of the body which as known as the ‘classic area’,” explains Dr. Bong. The ‘classic area’ refers to the front of the elbow, back of the knee and the neck.

Identifying the signs

The typical signs of eczema include having symmetrical symptoms whereby symptoms tend to appear on both the left and right side of the body. For example, if there is an eczema flare on a child’s palm, it will appear on both the left and right palms. Besides that, the other two common symptoms include dryness of skin and itching.

Eczema is divided into mild and severe varieties. “For some children, they may experience eczema with mild symptoms (such as a little redness and itchiness) and it may not terribly affect their lifestyle. Severe eczema, on the other hand, could appea from head to toe and it could be so severe that it affects the child’s growth rate,” says Dr. Bong.

With all the itching and scratching, there is also a risk that the affected area will become infected. “When the skin around the affected area is dry, that is fine. However, if it turns weepy, meaning there is fluid oozing out of the affected area, this indicates that it is infected,” she explains.

Besides becoming infected and affecting a child’s growth rate, eczema when left untreated, could also affect a child’s sleep quality, mood and performance in school. This is why receiving appropriate treatment is vital to manage the symptoms.

Help is available

Steroid medication is a proven method to treat patients with eczema. These medications are available in the form of tablets, cream and injections. Although it is effective, parents are usually not keen to choose this treatment option.

“Due to the possible side effects which may be presented when steroids are used excessively, there has been a lot of concern about the use of steroid medication, expressed by parents,” reveals Dr. Bong. The possible side effects of excessive steroid use include skin thinning, weight gain and muscle weakness. “What is important here is that, parents need to know how to use steroid medication, safely. Steroids should be used with the guidance of a specialist,” she emphasises. “Do not blindly purchase them at a pharmacy as this increases the risk of a person becoming steroid dependent.”

Proper education on the use of steroids plus the help of a specialist such as a dermatologist and paediatrician, can be an effective way to treat atopic eczema. “A specialist will be able to take into account the dosage and length of treatment. Hence, prescribing the best treatment option available. For example, if needed, steroid tablets might be prescribed for short-term use. However, if medication is needed for the long run, other forms of medications such as immunosuppressant medication or steroid alternatives may be prescribed instead,” she says.

A note to parents

Besides medication, another important step parents will need to know about is to moisturise their child’s skin. It is also important to ensure that the moisturiser does not contain any perfume and has minimal preservatives. “Keeping the skin moisturised helps to reduce the chances of an eczema flare,” advises Dr. Bong.

Dr. Bong’s parting advice to parents of children with eczema is, “Firstly, it is important that parents ensure their child receives treatment. I often see a lot of cases whereby treatment has been neglected. Parents also need to weigh the pros and cons of treatment with the guidance of a specialist. Parents need to take into account the fact that with treatment, this can tremendously improve their child’s quality of life.”

It’s important to always ask!

Always ask your doctor the name and ingredients of the medication prescribed to treat your child’s eczema. “It could be an injection, tablet or cream. You should always find out about the type of medication as at times, the packaging may not include this information,” says Dr. Bong

She stresses that this is important to avoid excessive use of medications with steroids. Knowing the type of medication prescribed and keeping a record of it will also help if you decide to seek an opinion from another doctor.

Did you know?

70 percent of children with atopic eczema stop experiencing symptoms by the time they leave school.

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