Infant eczema: Genes play a role but symptoms can be controlled, doctors say
SINGAPORE: Patches of scaly, cracked and inflamed pare on tiny feet. Blood on dress. Painful screams during shower time. Sleepless nights.
Ms Serene Koh's son was diagnosed with eczema when he was just a few months old. When he started getting itchy rashes on his peel, she took him to a hospital where he was diagnosed with the pare condition.
He would scratch his skin until information technology bled, she said.
"It was very heartbreaking to encounter because equally a baby, he could only cry, (he) couldn't verbalise the pain that he was going through," said Ms Koh, who too suffered from eczema when she was younger.
It was a "struggle", said the 37-yr-old social worker, adding that she had many sleepless nights over her son's condition.
READ: Tackling that itch: Need for aid with skin bug on the rising in Singapore
A prick examination found that he was allergic to peanuts, and then Ms Koh, who was breastfeeding her son, cut that out completely from her diet.
"It seemed to show some improvement, but information technology was nonetheless not better. They (doctors) gave creams to apply, which had steroid in them," she said.
"It would become better, then it would come dorsum, get meliorate, and so come back."
He hated taking showers.
"Every time he took a shower, he would scream. Because after he scratched, the pare would be open and red," said Ms Koh.
His crawling likewise seemed worse at night, keeping him and the family upwards.
"I would help him to scratch, not using my nails, only just to assist him with it because I know that if I helped him to scratch, I won't tear his skin."
Ms Koh tried multiple things to ease her son'southward discomfort: Probiotics and fish oil, traditional Chinese medicine, and a mositurising regime.
She as well brought her son to a dermatologist and covered his feet with socks, but he would pull them off.
His anxiety remained itchy.
"The doctors brash us to wrap his feet up then he cannot scratch it. Because in order for the peel to heal, he has to stop scratching and scratching is a habit," she said.
Pants with enclosed covering for the feet came to the rescue.
Ms Koh also avoided situations that would make him perspire.
"Heat will arrive worse, so nosotros couldn't bring him outdoors as much. So ideally, and for the nearly part, we only spend (time) in aircon and indoors because we noticed that sweat would make it worse and he would scratch," she said.
Her son is now iii years former and his condition is nether control, she said.
"There is hope. There'southward really hope, because having gone through it, I feel a lot for mums who are besides going through information technology and feel like there'due south no end in sight," she said.
Commentary: Low self-esteem, low and frequent flare-ups plague growing numbers of eczema sufferers
PREVALENCE OF ECZEMA AMONG CHILDREN
Ms Koh's son is non alone in his fight against the skin condition. Doctors CNA spoke to said they take seen an increment in the number of children getting diagnosed with eczema.
The prevalence of eczema- also known as atopic dermatitis - is around xxx per cent in babies under the age of 1, said Dr Elizabeth Tham, caput of the division of Paediatric Allergy, Immunology & Rheumatology, at the Khoo Teck Puat – National University Children'due south Medical Institute.
Among older children, this percent is 20 per cent, she said.
"There is an increasing number of children with moderate and astringent atopic dermatitis, and these patients make upward most 20 to 30 per cent of the eczema patients treated at the KKH Dermatology Service," said Associate Professor Mark Koh, who heads the service.
"There appears to be a full general increment in trend on the incidence or prevalence of atopic eczema in children over time. In my exercise I do meet more infants with eczema," said Dr Lee Bee Wah, a paediatrician at The Child and Allergy Dispensary at Mountain Elizabeth Medical Centre.
Dr Tan Hiok Hee, senior consultant dermatologist at Thomson Specialist Skin Center, similarly noted this increase.
He attributed the ascent to an "overall increase in prevalence of the status" and as well more awareness of the condition.
"Parents thus are more likely bring in their kids for a review and diagnosis when they note their children having recurrent itchy rashes, instead of cocky-medicating," he said.
WHY DO CHILDREN Get ECZEMA?
Doctors said that eczema are caused by genetic factors, but that there are other factors that may aggravate the condition.
"Children affected may have a history of other sensitive disorders such as asthma and rhinitis, and there is ofttimes a family history of similar weather," Dr Tan said.
Besides genetic factors, the high prevalence of eczema in Singapore is similar to that observed in other developed countries, "suggesting that environmental factors may exist important in determining the expression of the disease", he said.
Dr Tham, whose patients include infants and children upwardly to 18 years of age, said that the about common reason for eczema is a genetic predisposition, or a strong family history of allergic diseases.
"This results in excessive skin dryness even from nascency, and in some patients, there may be a genetic defect in a peel barrier protein called filaggrin which is responsible for maintaining an intact skin barrier," she said.
Assoc Prof Koh, who cited similar reasons, said that beyond the genetic basis of eczema, ecology factors "play a role in triggering or worsening atopic eczema".
He pointed to dusty environments, pets, carpets, stuffed toys, smoking, strong soaps and detergents, and insect bites as some of these environmental triggers.
Emotional stressors such every bit exams can also trigger eczema, Assoc Prof Koh said.
Atopic eczema, still, is a complex condition, Dr Lee said.
"Information technology is hard to pinpoint the reasons. The master problems in eczema is a weakened skin barrier and aberrant regulation of the immune system that tends to promote inflammation," she said.
Doctors said that the onset of the condition for virtually patients begins before they turn 1, although some children may only develop symptoms later in childhood or during their teenage years. The status may persist into after in their lives, they said.
While the condition cannot be prevented and in that location is currently no known cure, the symptoms tin be controlled, doctors said.
WHAT Tin PARENTS DO TO HELP THEIR CHILDREN?
"With the employ of gentle soaps or soap substitutes and daily moisturisers from infancy, the onset of eczema can exist delayed, and the severity of eczema can be reduced," said Assoc Prof Koh.
Early on handling once the symptoms occur is also important to forestall the worsening of the status, he added.
Assoc Prof Koh, who said that nutrient allergies accept increasingly been found to worsen the condition in infants, also said that reducing triggers can likewise aid prevent the status from worsening.
While doctors encourage young patients with eczema to maintain a healthy lifestyle including participating in outdoor activities, there are some situations that are best avoided, he said.
"When the weather gets also warm, hazy, or when your kid has an eczema flare, it is all-time to limit such activities and increase the frequency of moisturiser applications to reduce the pare inflammation," he said.
Dr Tan said that aggravating factors include exposure to sudden changes in room temperature and sure types of clothing material such as wool.
"Many children with atopic eczema are sensitive to house dust mite, and so I commonly propose reducing the amount of carpeting and soft toys which tend to trap a lot of the mites," he added.
In older children, stress and their emotional country can also aggravate eczema, he said.
"It is also of import to explicate to the child that it is not their fault that they take eczema, and to look into the psychological aspects of eczema too. Some of these children may exist teased or shunned by their peers, and may develop a negative self-epitome," he said.
Dr Lee said that skin care is important in the management of eczema. Dr Tham said that a multi-pronged approach including applying moisturisers to keep the peel hydrated, treating concurrent pare infections with antibiotics and applying topical steroids to command inflammation assistance prevent the status from worsening.
COMMON MYTHS
Although topical steroids are "essential handling modalities to command inflammation", Dr Tham said that ane of the myths near eczema is that using steroids volition brand the child "dependent" on them or that avoiding steroids volition aid the child outgrow eczema faster.
"Without acceptable control of the inflammation, the eczema tin become worse and lead to complications," she said.
These complications include infections, bleeding, and food allergies due to food allergens entering the skin, she said.
"Proper treatment with topical steroids and moisturising volition assist control the eczema well, and the kid will then be more than probable to outgrow the condition. If the eczema is uncontrolled, the chances of outgrowing it will be much lower," she said.
Dr Lee said that an of import misconception that eczema is caused by allergies.
"In fact, the scientific evidence points the other way circular - that eczema predisposes to food allergy," she said.
Among other myths surrounding the condition is that eczema is due to poor hygiene, or the mother taking excessive amounts of seafood during pregnancy, said Dr Tan. Some think that it is infectious and can be passed to others through touch or contact, which is as well a myth, he said.
"Some people believe that eczema is due to a 'weak' immune organization and need to further boost their immunity – this is not true," he added.
Despite the difficulties children and parents face with the condition, there may be calorie-free at the end of the tunnel.
A "big proportion" of mild infant eczema "does remit" every bit the kid grows older, Dr Lee said.
"The good news is that although the sensitive skin will remain with the child into his teenage years and in some cases, beyond, the eczema does tend to become better and gradually improve in most cases," Dr Tan said.
Source: https://cnalifestyle.channelnewsasia.com/wellness/infant-eczema-genetics-factor-symptoms-doctors-235391
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