What is it about ?
Atopic eczema (also called atopic dermatitis or constitutional eczema) is a condition characterized by chronic inflammation of the skin, accompanied by itching. The disease comes and goes, i.e. that very painful periods alternate with times when the skin is “calm”. Atopic eczema improves with age. The food allergy are more common in children with moderate to severe forms of atopic eczema.
In about half of children, eczema goes away by the age of 2.
How to recognize it?
The main symptom is a chronic, itchy rash, which usually occurs in skin folds, on the face, neck, eyelids, trunk and thighs. The rash can take different forms. Usually, red patches appear on dry skin. Lesions are sometimes rounded and raised; sometimes they ooze, sometimes they peel. The skin may appear a little thickened. The intense itching can sometimes lead to scratching lesions which can also become infected with bacteria. The lesions will then suppurate and a yellowish crust appears.
The appearance of atopic eczema varies depending on the age of the child. In children under one year of age, it is often seen more in the face (cheeks).
A specific form of eczema affects the hands and the soles of the feet. The symptoms are then particularly serious in wet and cold weather. The buttocks and inner thighs may also be affected, especially in girls. These problems usually start 1 to 2 years before school age and usually go away by puberty.
How is the diagnosis made?
Usually, the doctor makes the diagnosis on the basis of symptoms and a skin examination, without requiring further examinations. Prick tests are only necessary if it is suspected that certain factors are making the condition worse.
The prick-tests are done at the specialist. Above all, they make it possible to detect food allergies and certain respiratory allergies. If it is not possible to perform allergy tests, sometimes blood tests are done. A diet that requires removing certain foods before reintegrating them little by little can sometimes detect certain food allergies (to cereals or milk for example).
What can you do ?
- The skin of children with atopic eczema is particularly sensitive. You must therefore protect their skin as much as possible, on the one hand by avoiding irritation, and on the other hand by applying protection.
- Avoid products like bath foam, shampoo, or foaming soaps. You can replace them with less irritating products, such as bath oil.
- Rinse the skin well after the child has swam in chlorinated water and then apply moisturizer.
- Dress your child in loose clothing, preferably cotton, and avoid coarse fabrics and wool.
- Sweating can make eczema worse. This is why you should not dress your child too warmly.
- Avoid cigarette smoke and smoky environments.
- Protect her skin by applying moisturizer twice a day to healthy skin. Preferably choose hypoallergenic creams, without perfume, dyes or preservatives. This kind of product is over the counter. Most pharmacies can also prepare moisturizers for you. You can then be sure that they do not contain any products to avoid. Usually, these creams are based on cetomacrogol or urea.
What can the doctor do?
Cortisone creams and ointments are the basis of treatment. Corticosteroids come in several strengths. The type of preparation you will need depends on the age of the child and the severity of the condition. In children under 2 years old, the doctor will favor less powerful cortisone preparations than for children who are already older. Moisturizers should be applied between cortisone treatments. If the action of the cortison-based preparations is not sufficient, the general practitioner will refer you to a dermatologist (doctor specializing in the skin).
With moderate to severe forms, the dermatologist will opt for a cream with an immunomodulatory action, i.e. a cream that stimulates the positive elements of the immune system and slows down the negative elements. During this treatment, you should avoid exposing your child’s skin to sunlight.
Phototherapy (light therapy) is a possible treatment option for serious cases. In general, food supplements do not improve symptoms.
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