Allergy Awareness Week 2018: Top tips for parents of children with eczema from Dr Karolina Gholam

Dr Karolina Gholam

What is Eczema? How it affects the children?

Eczema is a condition of the skin which affects 15 to 20% of children. It consists of having dry skin, which is itchy and can get infected. If left untreated it can lead to poor quality of sleep and missing days from school for the older children. It is therefore very important to manage it promptly and efficiently.

Top tips for parents of children with eczema 

There is increased evidence of the beneficial role of using emollients (moisturisers) when treating eczema. They restore the damaged skin barrier and protect the skin. Patients should have three types of moisturisers; a soap substitute to clean the skin, a bath oil as a bath additive and an emollient cream or ointment to apply two to four times a day. Emollients need to be used long term even after eczema has settled to prevent a re-occurrence.

Topical steroids and other anti-inflammatory creams are used to gain and maintain control of the inflamed skin. It is important to apply them as prescribed to all the affected areas as under treating eczema will lead to continuous inflammation, itching and possible infections. There is a lot of concern regarding side-effects of topical steroids but the right steroid for the right area under medical supervision can be used safely and is paramount to treating the skin.

Children with eczema will have a higher rate of food allergies than the rest of the population especially when it starts very early in life. Your doctor can assess whether there is a history suggestive of food allergy and recommend a trial of excluding a particular food from the diet for a specific period of time to see if there is an improvement to the skin. However, it is important to understand that eczema is not due to food allergies and removing foods from the child’s diet will not lead to resolution of eczema. It can also be dangerous as a restricted diet may mean that the child is not getting all the nutrients that are necessary for growing and has social and financial implications. Additionally, when the food is reintroduced it may lead to an allergic reaction.

Eczema is a very common condition that can have a significant impact on a child’s life. Early advice from a specialist doctor is needed to manage the condition and minimise the effect on the child’s quality of life.

Karolina Gholam

Paediatric Dermatology Consultant

Dr Karolina Gholam is currently working as a Paediatric Dermatology Consultant at Great Ormond Street Hospital and as an Honorary Lecturer at the Institute of Child Health. She is one of only two doctors dually accredited in Paediatrics and Dermatology in the UK.

She obtained a Master’s Degree in Clinical Paediatrics and her thesis on Familial Haemophagocytic Histiocytosis was published in the journal Clinical and Experimental Immunology. She completed the Paediatric Educator’s Programme and lectures regularly on paediatric dermatology related topics. She has published on the use of propranolol for infantile haemangiomas and other paediatric dermatology conditions.
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