Eczema affects around one in 20 babies, and one in eight of those with a family history of allergic conditions such as asthma and hay fever, says Lynne Niemann of the South African National Eczema Association (SANEA). About 90% of sufferers are diagnosed before the age of five and it usually first appears between six months and five years. Most children grow out of eczema before school age, but it can persist into adulthood. Here are some tips to manage it.
Eczema (or ‘dermatitis’) is an inflammation of the skin causing red, swollen lesions. They can form blisters, which break, weeping fluid that forms a crust. Chronic lesions can grow thick, dry and leathery (‘lichenification’).
There are many varieties of eczema, and causes can range from genetic to environmental – most commonly heat, dryness, infection and allergens such as grass, pollen, dust and pet dander, and food allergies like gluten and dairy. Symptoms, however, are mostly the same – itchiness that leads to scratching, and occasionally burning and pain. Scratching can cause infection and ulceration and leave scars, so take action fast.
If you see signs, get a professional opinion from your clinic sister or paediatrician, who may prescribe medicine or refer you to a dermatologist, and take these steps to help:
Take preventative measures if there’s a family history
If your baby is at high risk of allergies because of a family history, avoid smoking during pregnancy and after birth, and avoid common allergy-causing foods such as milk, eggs, peanuts, wheat and soya, while breastfeeding. “Breastfeeding is best in the case of a family history of eczema, and should carry on for at least four months after birth,” Niemann says.
When you wean baby on to solids, introduce foods carefully, trying cow’s milk, wheat and peanut extracts only after 12 months, and eggs and fish after 18. One in 10 cases of infant eczema are estimated to be allergy-linked, so watch too for reactions to citrus, tomatoes, pineapples and Marmite, and avoid foods with colourants and additives that can make eczema worse.
Keep baby cool
Heat, humidity and sweating can trigger or worsen eczema. Don’t overdress, and avoid woollen or synthetic fabrics for clothing or bedding; keep to cotton and linen, Niemann advises.
Choose detergents carefully
Use non-biological varieties such as Skip and Sunlight, and avoid enzyme-enriched ones, bubble baths, medicated soaps and household antiseptics.
Take care at bath time
Keep water lukewarm, and wash baby with mild, unscented aqueous or dermatologically- tested baby soaps and shampoos, says Niemann.
After the bath, pat skin dry and apply a non-perfumed moisturiser. Reapply several times a day to keep skin hydrated and protected. Cortisone creams can bring quick relief but should not be used in the long term as they can cause skin to thin, Niemann says. Antihistamine creams should be avoided as they can sensitise the skin.
Try to prevent scratching
Keep baby’s nails clipped short and filed, and slip on cotton mittens at night, or a long pair of socks pulled up under a long-sleeved cotton top so they don’t come off.
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