Eczema or atopic dermatitis is the most common skin condition among Singaporean children. It affects about 20% (1 in 5) of school-going children in Singapore. For reasons that are not completely understood, eczema occurs more commonly in urbanized and wealthy countries. It can cause significant distress to both the child and the care-giver. It is not easy to take care of a child with eczema as this condition can last for many years and takes great effort on the part of the care-givers.
Most children show signs of eczema before they are 7 years old. Some outgrow their eczema in their teenage years. Many of these children also suffer from allergic rhinitis and asthma apart from sensitive skin. This is known as the atopic triad. Their family members may also suffer from these conditions as it tends to run in families.
The heat and humidity in Singapore does aggravate eczema as do harsh soaps. It will be advisable to use gentle soap in children with eczema and it is important not to over-wash them.
Many parents are adverse to the idea of applying steroids as they think steroids can cause severe side effects. In fact, steroids can help alleviate eczema and is an important part of eczema treatment. The important thing is to use steroid in the correct strength, in the correct amount, in the correct place and for a correct length of time. Problems arise when potent steroids are used for too long a period. It is important to see a dermatologist who will advise you on which steroid to use in which part of the body and for how long. It is also important to tail down the potency of the steroids once the rash is better.
Another method I find very useful is known as the wet wraps therapy. This involves applying a layer of wet cloth to the skin after the application of topical steroid and moisturizer. I only recommend this for areas of the skin that are more serious. The cloth should be left in contact with the skin for at least 90 minutes. This regime can be repeated daily for 5-7 days and will lead to improvement in the skin condition.
With the correct understanding and treatment, even the most severe eczema can get better and affected child will have a better quality of life.