Last weekend i brought Adni to meet a paediatric dermatologist for the first time...just to look for other opinions regarding her eczema.Usually we just went to her paed and get the usual medicine supplies.Recently she was having continuous flares for quite some time that makes me think to get another expert's opinion.She was restless,cranky and scratching non stop until her skin bleeds.
And the fact that i myself was quite anxious and rimas with her neverending scratching. So when i brought her to her last vax schedule, her paed suggested to see the new visiting paed dermatologist consultant in PCMC, Dr Sabeera Begum.FYI she is a specialist in HKL and only have clinic sessions in PCMS on Saturdays. Being an eczema patient myself, I think this session i had with Dr Sabeera is an eye opener and helps to manage my eczema prone children (and mine and my hubby!) better.
So just thought of summarizing the advice that we got from Dr Sabeera for my own reference and for other eczema patient parents out there :
1 The first question i asked the doctor, why are kids nowadays are prone to eczema?
She said it has something to do with kids nowadays are `too clean'.. they are not used to playing in mud, water puddles, grass etc hence their immune system does not tolerate with the `dirty' environment. Hence the system is always on alert and sometimes identify even dust and heat as 'potential danger' hence triggers eczema to some kids.Overtime, the eczema will normally subside when the immune system is relax and used to the environment.
2. Generally the eczema patient needs this combo to keep moisturizing the skin : special wash (non soap base) + moisturizer + medicine (be it steroid/non steroid) and a strict schedule. Moisturizer can be applied 3-4 times a day, while wash and medicine shall be used twice a day.
3.When you see the eczema subsides from the skin after 2-3 days, DON'T STOP applying the combo until the itchiness subsides and gone. Usually this takes about 2-3 weeks. However you can reduce the frequency of applying the medicine ointment i.e from twice a day to once a day, then gradually stop after 3 weeks.
4.Is topical steroid safe for kids? Generally it is safe if you use it the correct way, and ask your doctor first since steroid creams had several types; from mild until potent and super potent. Usually the ones prescribed for children is mild until potent. If your child had a severe eczema flares and moisturizer/non steroid cream does not work, you are obliged to reduce it by what ever ways, parents. Some anti histamine also available in syrup form - ask your doctor to find out more.
5.If your child is having severe eczema, it is advised to get ointment type rather than cream type since cream requires more preservatives that might not be good for your child's skin.
6.Parents need to be patient, patient and more patient (i'm talking to my self, really).Treating eczema needs about 2-3 weeks and no certain medicine will make the overnight wonders.
7.If you want some guide on the available products, here are some suggestions :
i. Wash - use old fashion homemade soap (like Freshpicks Criansa Soap for kids, or goat's milk soap) or special non soap body wash i.e QV moisturize wash/Cetaphil for kids. Avoid commercial soap!
ii. Moisturizer - organic balms (my favourite is Earth Mama Angel baby bottom balm or Freshpicks ultramoisturizer), coconut oil/olive oil/shea butter or QV intensive moisturizer. Avoid watery lotion/cream as much as possible.
iii.Medicine - steroid type includes Hydrocortisone (mild), Elomet (potent). non steroid type includes Protopic (but it is deemed mild - does not work for my kid.And super expensive too!). You need to try and error to know which product suits your kids skin and condition.
8.Keep your child clean and ensure their surrounding is clean and cool - wipe the excess food/saliva from her/his face as it might trigger flares as well. If possible get an air purifier.
Usually the eczema will subside as they grow up, so less thing to worry about, parents :)