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Baby Medical Q&A, Issue #072 - Eczema Update
September 01, 2012

Welcome to another edition of Baby Medical Q&A News.

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This is the first of a new look ezine which is going to focus on one condition or symptom.

This month I will be looking at Eczema

I chose this topic as Eczema is common in babies and toddlers and many parents are doing most of the right things and sometimes it just takes a bit of fine-tuning to get it right.

What can I do if I can't control my toddler or baby's eczema?

These are my top tips for getting problem toddler and baby eczema under control.

Go through each and make sure you are complying and it is likely you will see some improvement.

  • Eczema is a dry skin condition so you need to keep the skin moist by applying moisturisers (also called emollients) regularly (every hour if necessary). Lotions are usually not enough so you need to use creams or ointments
  • Don't put your fingers in the moisturiser tub. Take some out with a spoon or paper towel and apply from that. We have bugs on our skin and we need to reduce the number of bugs on eczematous skin
  • Apply moisturisers in a downward motion in the direction of hair growth. You don't need to rub the moisturiser in as it will absorb naturally
  • A daily bath is advisable to remove the old moisturisers, but use a soap substitute to prevent drying in the bath
  • Apply the soap substitute to your child before she gets in the bath and just keep her in the bath long enough to wash it off
  • Aqueous cream dries and thins the skin and although it can be used as a soap substitute, I avoid it and use Emulsifying ointment or Fatty Cream instead. Do not use Aqueous Cream as a moisturiser
  • Add some bleach to the bath twice weekly to reduce skin colonisation with bacteria, particularly Staph. Add between 2 capfuls to half a cup depending on how deep the bath is. Normal household bleach is fine. This really helps difficult to control eczema by interrupting the itch-scratch cycle
  • Use a topical steroid (that is steroids applied to the skin as a cream or ointment) once daily as needed. Use the lowest strength that will improve symptoms (sometimes you will need a potent steroid). Only use 1% hydrocortisone on the face unless specifically directed otherwise by your medical practitioner.
  • When using topical steroids, start applying sparingly (just enough to make the skin shiny) when the skin flares up and stop when it settles. Restart when it flares again and stop when it settles and so on. In the beginning, you may be using the steroid cream most days but over time you will find that the periods of use become shorter and the intervals in between use become longer.
  • For difficult to control eczema, make sure you leave a few minutes between applying the steroid cream and applying the moisturiser. It will give the steroid cream time to be absorbed
  • Weepy eczema usually indicates infection and a course of antibiotics by mouth is usually needed. Potassium permanganate compresses and baths help dry out wet weepy eczema. However, potassium permanganate will stain the bath purple, so using it is not always practical. I have heard that Rooibos tea (Red Bush tea) can be used in a similar way to dry out weepy eczema - you can add teabags to the bath or soak gauze in the tea to make a compress. I would love to get feedback on this so if you try it, let me know how it goes

To read more about the evidence behind different treatment regimes for eczema, go to the National Institute of Clinical Excellence (NICE)in the UK where they also have parent information. Go there now.

To read more questions and answers about toddler and baby eczema and to view photographs of eczema, go to the website eczema page.

I hope you like the new ezine layout. Please contact me if you have any requests for ezine topics or any comments on the new layout.

Please feel free to share this ezine with family and friends.

Till next time,

Dr Maud

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