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Children Skin problem Dear Paediatrician,

I'm a mother of 2 kids. My elder son is 6 years old. I feel very depressed due to his skin problem. He has dry skin. In the early stage it was still fine. As time passed his skin got worse. The paediatrician told me that it is eczema and sent us to a dermatologist for a followup. This problem started when he was 2 years old. I went to a few doctors for his problem. I started to control his eating habits such as eggs, instant foods, chocolates, etc. He is using special body shampoo. But, the problem persists and it has become even worse on his feet and fingers. Besides dry skin, it sometimes bleeds, too. Every night I have to apply cream for him, and he has to be extra careful for fear of bleeding and pain in certain areas. He can't go swimming, to the playground, or even beach play. I wish I can get some advice from you.

Thanks a lot.

Depressed Mum

Answer

Answered by Dr Hon Eczema is a combination of both genetic and environmental factors. We can only alter the environmental factors to reduce the symptoms. We start by using non soap cleanser for the body. If possible use a shower oil/bath. Try not to bathe your kids with hot water as it can strip the skin of its natural oils. Use lukewarm or slightly cold water to bathe. After bathing, apply a good moisturiser within 5 minutes after toweling dry to seal in the moisture. Use a steroid cream for the inflamed areas and add an antibiotic cream for the infected areas. When the inflammation has resolved, just moisturise twice daily. During flare-ups, use oral antihistamines and wet wraps to seal in the moisture more efficiently. A simple way of using a wet wrap is to apply the creams and wear a layer of thin cotton pyjamas before wearing his normal pyjamas. You will be using 2 layers of pyjamas this way. It will be warm so you can use the aircond at 24 degrees Celsius. If there are no flare ups, just use the fan at night as the aircond can dry up the skin. If the skin on his hands/feet are dry and bleeding, you must apply the creams and use gloves/socks at night. You can also try giving him daily probiotics like Lacto GG. It works in 50% of cases.

It's beneficial for eczema patients to swim because the chlorine from the pool reduces the bacterial load on the skin and relieves the itching but have a good shower after the swim to wash the chlorine off.

Lastly, have you consulted an allergist to find out what are the allergens which trigger his eczema? Stress can also cause flare ups.

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