Allergens and eczema
In this third installment on eczema and children, The Asian Parent talks to Dr Tan Siew Pin on how allergens in our daily environment can worsen the eczema condition in children and what are the steps parents can take to deal with the nasty flares up on their precious little ones.
Allergens and eczema
The Asian Parent: What’s the link between allergens and a damaged skin barrier?
Dr Tan Siew Pin: Skin acts as a barrier to prevent external agents such as dust and bacteria from entering the body. At the same time, it acts as a wall to keep body and tissue fluids from leaving the body. The skin barrier is damaged when it cannot perform these functions. Bacteria and other allergens can enter through the defective skin barrier and cause allergy and infection in the skin.
TAP: Dr Tan, what would you say about the physical characteristics of eczema and are there any way parents could identify the symptoms should it occur in their kids?
Dr Tan: Eczema is a recurring and often chronic skin condition that affects certain individuals. It can begin as early as infancy and manifest even in adults. There is a rash that appears mostly in the areas of the face and body creases such as the front of the elbow and back of the knees though it can occur elsewhere in the body or be widespread as well. The typical features of the rash include the spectrum of scaly, fissuring, thickened skin to blistering, cracking, inflamed, weepy and open skin sores. The eczema sufferer almost always complains of an intense itch and because of the increased risk of infection, there may be pain and pus.
TAP: What actually causes eczema then?
Dr Tan: There is usually a genetic link in that there is likely to be a family history of eczema and other allergy based diseases. For some there are known triggers which include the following:
- Environment: House dust mites, animal fur, dander, grass, clothing material
- Food: Common allergens would include egg, dairy and nuts
- Weather: Extreme weather like cold or heat can worsen eczema
- Psychological: Emotional stress is also a known trigger
These triggers then evoke a cascade of events leading up to chemicals in the body that cause localised or occasionally extensive inflammation of the skin and dryness.
TAP: What are some practical ways that parents can prevent these eczema-triggering allergies for their children?
Dr Tan: Before applying any new lotion, cream, or soap, make it a habit to do a test patch to check if your child may be sensitive to it. Avoid unnecessary showers as too many of them will strip the natural skin oil found on the body’s surface.
Finally— a comment on probiotics as these have been seen to help persons with eczema. It is recommended that they have it daily as a supplement. And for mums to remember that breastfeeding is best for their kids.
Repair the skin barrier to stop the dryness and itch
TAP: Can a damaged skin barrier lead to eczema?
Dr Tan: Damaged skin barrier will aggravate the allergic tendency and delay healing and hence it's wise to promote and repair the skin barrier with appropriate moisturiser.
TAP: How then can we repair the skin barrier?
Dr Tan: One can repair the skin barrier by using moisturisers regularly. A damaged skin barrier is dry and porous, so applying moisturisers regularly will help to repair the barrier and keep symptoms like eczema flares and itching under control. Apply moisturisers at least twice a day, ideally within five minutes after bathing when the skin is still moist and the moisturiser would be absorbed optimally.
Choose a moisturiser which repairs the skin barrier
TAP: What makes an ideal moisturiser for children with eczema?
Dr Tan: There is no one perfect answer for all kids so there may be a period of trial to see which moisturiser gives the best result for your child. A good moisturiser should be sufficient to keep skin well hydrated with minimal application, removes the itch sensation and repair the defective skin barrier bringing about restoration of the texture and integrity of the skin. It should be preferably fragrance free, hypoallergenic and free or low in preservatives. Moisturisers, which mimic the lipid structure of skin, will act as a natural barrier to give longer lasting hydration.
How eczema can profoundly affect children
TAP: How does eczema affect the quality of life of children who suffer from the condition?
Dr Tan: Children with chronic eczema are often troubled by itch and discomfort and hence it’s important to relieve them of their symptoms. It may disturb their sleep and cause them to be distracted. They can’t focus on an activity if the itch is not addressed.
For eczema with secondary infections, if it’s not managed properly there may be scars or change in the texture and colour of the skin. Kids who have specific food triggered eczema have to observe certain food restrictions. This is unfortunate and distressing to some who particularly enjoy that food.
Keep in mind that animal hair can also be a source of allergy, parents may have to review the desire to have a pet as it may be a source of eczema exacerbation.
TAP: What are some of the common culprits that can lead to skin allergy conditions like eczema?
Dr Tan: Parents need to be mindful of carpets, rugs, fabric furniture, which can cause their child’s eczema to flare up. Other allergens would be animals, stuffed toys, art and craft materials and finally food. Avoid introducing new foods while out. If they have known food-triggered eczema, be aware of the foods you order for your child; for example, there may be traces of nuts in certain foods. For known triggers, parents can easily avoid but if the triggers have not been evaluated, they can bring their child for skin prick tests or blood tests to look for the actual trigger. Avoid unnecessary showers as too much of them will strip the natural skin oil found on the body’s surface.
Dr Tan Siew Pin
Paediatrician, MBBS, MMED(PAEDS), FAMS
Dr Tan graduated in 1985 from the National University of Singapore medical school and went on to pursue paediatric training in the National University Hospital of Singapore. She obtained her post graduate degree, Master of Medicine (Paeds) in 1989 and made a fellow of The Academy of Medicine in 1988. During her years in the department of Paediatrics in NUH, she specialised in nephrology. She was there for more than 10 years, after which she established her own private practice, Olive Tree Baby and Kids Clinic.
This series has been brought to you by Physiogel® and theAsianparent.
*The content above is for educational purposes and readers should consult their own doctor if they have further enquiries.
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