What is Atopic Eczema/Dermatitis?
Atopic eczema is a very common skin condition. It presents with dry, itchy and inflamed areas of the skin. The term “Eczema” is used interchangeably with “dermatitis” and refers to inflammation of the skin. Atopic eczema is also known as Atopic to develop a group of hypersensitivity disorders, namely eczema, asthma or hay fever, due to a genetic predisposition.
How does Atopic Eczema present?
Atopic eczema commonly presents in infancy and childhood, but also occur for the first time in adults. It affects both sexes equally. In infancy, common areas affected include the face and outer aspects of limbs. During childhood, it usually affects the skin folds such as the elbow bends, back of knees and neck. Eczema may also occur around the lips, the eyes and other parts of the skin.
We were at National Skin Centre(NSC) today after fighting with the rash for more than 2 months. (The rash was discovered on somewhere mid April. and we went back to doctor again in end May and request to see a skin specialist. We were refer to National Skin Centre by our GP.)
One reason we did not want to see the specialist immediately because, I wanted to observe Yvette and wanted to test Yvette whether she is allergies to any food.
What causes atopic eczema?
The cause of atopic eczema is not fully known. However, we do know that genes play an important part as atopic eczema often runs in families. Alterations in the immune system are thought to play a part in the development eczema. In addition, the skin barrier in atopic eczema is impaired, leading to dryness and susceptibility to bacterial and viral skin infections.
The Dermatologist did check with me about our family history. Unfortunately, we did not have cases for Eczema but both of us do have rather sensitive skin at time.
Can atopic eczema be cured?
At present, there is no cure for atopic eczema. However, the skin condition can be improved and controlled with good skin care and use of appropriate medications. In general, the eczema tends to improve as child gets older and 50% may clear in the teens. However, the eczema may still occur on and off, even in adulthood.
Do certain types of food make the eczema worse?
It is rare for food allergies to cause eczema , although food allergies may make eczema worse in some people. Prevalence of food allergies is highest in young children with severe eczema. It may be present in about one third of children less than 3 years of age with severe eczema. In adults, food allergy is very uncommon. Common food allergens in childhood include cow’s milk, hen’s egg, peanut, nuts, shellfish, wheat & soy.
Screening test for food allergy include skin prick test and specific IgE test called RAST test. The results of these tests must be interpreted by an experienced dermatologist.
Thanks to all mummies who had given me a list of food to test out and I could single out Mushroom is one of the cause. (Thanks Nicole for telling me Mushroom!)
We did a Scrape Test to single out Fungal Infection and Skin Cancer too. Phew, it wasn’t that.
The skin specialist in NSC confirmed the rashes are Eczema and prescribed Desonide 0.05% Cream. Another new cream for Yvette.
What treatments are available?
Treatments commonly prescribed for eczema include moisturizers and topical steroids. Topical steroids are useful in reducing the inflammations. They are safe it used appropriately. Some possible side effects of prolonged use of steroids include skin thinning and atrophy. This may occur with prolonged and inappropriate use of topical steroids.
More recently, steroid-free topical medications have been developed and are available for the treatment of eczema. These TCI creams are costly and doctor will assess the suitability and appropriate use of these medications.
Oral treatments for atopic eczema include oral antibiotics when the skin is infected. Antihistamines are commonly prescribed to reduce the itch. In severe cases of eczema, other treatment such as Phototherapy or Systemic Immunomodulators may be indicated.
I request to skip oral medication this round. One reason is Yvette was once prescribed with oral medication, but it didn’t help her much.
How do I care for the skin?
- Avoid scratching, rubbing and picking the skin. This aggravates the eczema and may also lead to unsightly pigmentation, open wounds and scars.
- Avoid irritating soaps and detergents. Soaps use should include gentle soaps or soap substitutes.
- Moisturize the skin frequently. Moisturizers do not cause thinning of the skin and should be applied liberally and frequently. The best time to apply moisturizers is right after a bath. Remember to apply moisturizers after swimming.
- Certain clothing material such as woolen fabric and linen often irritate the skin and materials such as cotton are more comfortable for the atopic skin.
- When in a dry or cold environment, it is important to keep the skin well moisturized to prevent aggravation of the eczema.
The doctor recommended me two brands for the skin care. I opt to try out Cetaphil first. But I kind of regret for now because there is an unpleasant smell for the lotion.
We have another appointment 6 weeks later and I do hope there will be improvement on Yvette’s skin.
P/S: Those Q&A in pink are from brochure from NSC.