Tuesday 24 October 2017

Eczema: Under your skin

Sorcha Corcoran

ECZEMA is quite a common condi­tion in children, with 15–20pc of young people getting some form of it. However, a lot of cases are quite mild and can be managed at home, says Professor Alan Irvine of Trinity College Dublin and Our Lady’s Children’s Hospital Crumlin.

Also known as atopic dermatitis, eczema is an allergic and in.ammatory skin disorder. In mild cases the skin is dry, scaly, red and itchy. In more severe cases there may be weeping, crusting and bleeding. Constant scratching causes the skin to split and bleed and also leaves it more open to infection.

“Children begin to present with eczema most commonly around four months of age and 90pc of them will get it before the age of two. The rash initially appears on the face, then the outer parts of the arms and then in the skin folds. The pat­tern changes as the baby grows,” Irvine explains.

“The main symptom is extreme itchiness, discomfort and loss of sleep for the child and par­ents. Babies with severe eczema don’t put weight on and this has a big effect on their development.”

Eczema has a big impact when children go to school, he adds. “Children have been asked to graduate how things affect them and eczema scores higher than epilepsy or diabetes. This is because they feel so uncomfortable they can’t concentrate and they don’t like their skin looking funny.”

Regarding treatment, Irvine says the simple things are the best. “Avoid anything that will agg­ravate the condition such as foamy things in the bath or detergents, as these strip the lipids out of your skin. There are now lots of different soap-free alternatives to conventional shampoos and bath additives. Sometimes you have to try several to .nd one that works for you.”

In addition to this, he recommends using a good moisturiser two or three times a day and adds that you should keep the heating in your house down so the air doesn’t become too dry. He also recommends staying away from rough cloth­ing, such as wool.

Certain types of clothing can actually help too, such as a range by Cotton Comfort, available now in Ireland from www.econatural.ie (pictured right). Made from 100pc organic cotton, this range has natural silver-soothe properties. Silver is recognised as a natural anti-bacterial agent. Natural silver ions have been added to the fabric to soothe the skin, ease night-time itches, remove bacteria overgrowth and help prevent the spread of organisms and the risk of secondary infection.

Irvine says some foods can provoke an outbreak of eczema, so if you think they do, make sure your child avoids them. Dusty environments will also make the condition worse.

Why do children get eczema?

This question has preoccupied health professionals and researchers for many years. Professor Alan Irvine of Trin­ity College Dublin (TCD) says eczema is the result of a combination of genes and environmental factors.

“It runs in families – if parents have it, their children are more likely to have it. Three and a half years ago we found the .rst major gene to in.uence eczema – .laggrin, which protects against environmental insults or bacteria. When you have a mutation of this gene, you’re more likely to get eczema.”

An international collaboration between TCD scien­tists and researchers in Scotland and Japan reached a breakthrough earlier this year in terms of understanding eczema.

The TCD team was led by Professor Padraic Fallon. “I have worked out a mouse model of the .laggrin muta­tion. It develops the features of eczema in the mouse, so we can understand how it can cause the disease in children or adults,” he explains.

“One of the big questions is around why children with eczema have a predisposition to subsequently develop other allergic conditions, particularly asthma. We are using the mouse model to work out why that happens. Ultimately, we hope the characterisation of this model will be a useful tool in the development of new therapies for this major disease.”

Irvine adds that eczema is getting more and more common in urbanised societies. “Nobody knows what factor is most important – it could be anything from central heating to diesel fumes.”

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