Wednesday 24 April 2019

Why do kids get skin flare-ups?

Skin conditions affect many babies and children in Ireland. Arlene Harris talks to the experts about how you can manage and treat some common issues

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When my first baby was born two decades ago, he had perfect peachy skin. But it wasn't long before the tell-tale signs of a skin condition began to emerge.

It started with cradle cap and before long he had dry, scaly patches in the crook of his elbow and behind his knees and by the time he was eight months old, his whole body was sore and itchy looking.

The doctor told me he had eczema, which is very common amongst babies, and I tried everything from changing washing powder to altering his diet and using both conventional and homeopathic remedies.

Naturally as a parent it is heart-wrenching to watch your child suffer and while he grew out of it when he was about 18 months, his younger brother also developed eczema. He had it for much longer and it was much more severe.

And then as if on cue, my third son also went through years of bleeding, scratching, emollient-filled baths, wet and dry bandaging and much more - until finally one day, it all cleared up and despite one or two flare-ups, since early childhood, my three sons have been eczema free.

There are no statistics which tell us how many children suffer from skin conditions in Ireland (although it is estimated that one in five children are affected by eczema) but anecdotally the figures are high. Key times for flare-ups are during the summer when the pollen count is high and the warm weather causes skin to be sticky and uncomfortable, and also at this time of year when the heating is turned on and skin is at risk of becoming dry.

"As we experience chillier evenings, central heating reduces humidity and dries the skin, making it itchy, which can exacerbate symptoms of childhood skin conditions," says Dr Bernadette Carr, medical director of VHI. "Everything from drier air to the temperature changes from going indoors and outside has extra concerns for parents. Turning off the radiators or setting the thermostat to a lower temperature in bedrooms can be a solution to help manage the condition - as this will help prevent overheating and itching at night - but keeping skin moisturised is a very important treatment measure."

When my children were in the midst of their flare-ups, everyone had an opinion on why they were suffering and many suggested dairy was the problem. However, Dr Carr says this is unlikely to be the case.

"Diet, particularly dairy produce, is often blamed for flare-ups, especially in young children," she says. "However, food is rarely the cause - so do not be tempted to self-diagnose a food allergy. Make an appointment to see your GP, who will try to identify the issue and prescribe appropriate treatment.

"Atopic eczema is the most common type of skin condition and can start in young babies as a red, itchy rash on the face, scalp and body. In older children it can develop in areas with folds of skin such as behind the knees or in front of the elbows. Flare-ups can occur in response to environmental allergens such as house dust mites, animal fur, pollens, microbes and pollutants. Emotional stress and anxiety may also cause the eczema to worsen periodically."

David McMahon, CEO of the Irish Skin Foundation, says sticking to a good skincare routine is vital and using gentle washes and emollients on both the skin and scalp (for cradle cap) is essential.

"The top five skin conditions to affect youngsters are eczema/atopic eczema, chicken pox, molluscum contagiosum, cradle cap and viral rashes [from a strep throat]," he says. "Autumn and winter can be a difficult time for some children but it can be bad all year round for many and it is very difficult to pinpoint triggers as it is different for everyone.

"But it's important to establish a good daily skincare routine and stick to it - don't stop moisturisng when the skin is clear and use emollients in the bath instead of soap. Ideally shampoo should be clear, pH neutral and fragrance free and bath water should be lukewarm.

"Emollient should be applied after bathing and during flare-ups use topical steroids as recommended by your healthcare professional, but as your child grows, ask for a review as they may need adjustment to their treatment."

Dr Bernadette Carr says parents should also be on the lookout for hand, foot and mouth disease which can be a problem at this time of year.

"Hand, foot and mouth disease is a febrile illness characterised by development of tiny sore blisters around the mouth, hands and feet," she says. "It mainly affects children under 10 years of age and is frequently seen in groups at crèche or school. A child may feel unwell for a couple of days and may have a temperature. A sore throat is common and small spots develop in the mouth, which will eventually become mouth ulcers. The mouth ulcers may be painful but the temperature and spots will usually clear within a few days.

"Hand, foot and mouth is spread by getting the infection from another person, most often coughing and sneezing. Once the infection has been passed on, symptoms will develop within three to five days and it is infectious until the spots and mouth ulcers have gone. It usually last for seven to 10 days.

"So make sure everyone washes their hands properly, including small children. Teach them to cover their noses and mouths when sneezing and avoid sharing crockery, cutlery and towels."

To help the ISF try to figure out how many people are suffering with skin conditions, visit irishskin.ie/help-we-know-too-little-about-people-living-with-eczema-in-ireland

Irish Independent

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