Constitutional eczema in children
In eczema, you have itchy patches on your skin with flakes, bumps, fissures or crusts. If you have fair skin, the spots are red. If you have fair or dark skin, the spots are darker. Eczema in children is often due to hereditary predisposition. The medical name for this is: constitutional eczema. It often begins in babies, sometimes as early as three months after birth.
Eczema is not dirty or contagious. You can touch and hug each other without problems. Most likely, with eczema, a protein in your skin is different. This causes your skin to retain water less well and dry out more quickly. Often children with eczema are also allergic and hypersensitive to certain things. Often family members also have eczema, hay fever and/or asthma.
Eczema can be made worse by several things:
- Washing frequently with soap and water or shampoo, which dries out your skin
- Sweating
- Warm or just cold weather (for example, when it's freezing)
- Wooly clothes
- Scratching
- Stress
- Sickness from viruses, such as sore throats, colds or the flu
- Cleaning agents
A few tips?
- Prevent scratching. Scratching makes eczema worse and increases itching.
- Cut your child's nails often. You can put mittens or socks on your child's hands, or sew up the ends of the sleeves. If your child starts scratching, you can do something to distract them, such as reading to them or playing a game.
- Prevent the skin from drying out. Dry skin is more sensitive and more itchy. Water and soap dry out the skin. Therefore:
- Don't shower or bathe too often (no more than 2 or 3 times a week)
- Not too hot water (lukewarm water, 37 degrees, is fine)
- Don't shower or bathe for too long (no more than 5 minutes)
- Don't use soap, shampoo or bath foam (or only occasionally)
- You can add a few drops of oil to the bath water (soybean oil, peanut oil or any other oil without perfume)
- After washing, immediately rub your child's skin with a soothing cream or ointment (without perfume).
- Choose airy clothing, preferably cotton. Heat or wool can irritate the skin, especially at night when itching can get worse.
Important: You do not have to do anything against dust mites, pets or pollen. Eczema does not get less from these. Eczema is not contagious. You can just touch the skin and cuddle your child. This is important for children. For more information about constitutional eczema in children, visit www.thuisarts.nl.
Non-prescription drugs
So-called "indifferent agents" such as indifferent (oily) creams are recommended worldwide as a basic treatment for psoriasis and (constitutional) eczema to moisturize the skin, reduce scaling, dryness, itching and irritation, and strengthen the skin's barrier function. Indifferent means "without perfume and other additives."
Crèmes have a soothing and protective effect on the affected skin and are suitable for neutral skin or sometimes wetting skin (as in wetting eczema). The oily creams/fat creams have a (strong) moisturizing, protective and soothing effect on the affected skin and are suitable for dry to very dry skin (depending on the amount of petroleum jelly).
Prescription drugs
Adrenal bark hormones, also called corticosteroids, can be applied to the skin. They reduce inflammation, scaling, itching and swelling by constricting blood vessels. This makes eczema less likely to get worse, reduces burning and reduces redness. The skin can recover, becomes more supple and looks better. Adrenal bark hormones on the skin are classified by strength:
- Weakly active hormones: Are used when an oily cream or ointment does not work enough. Example: hydrocortisone.
- Free strong-acting hormones: Are used when weak hormones don't work enough. Examples: betamethasone, clobetasol, clobetasone and triamcinolone acetonide.
- Strength-acting hormones: Are used when other hormones do not work enough. Examples: deoximetasone, fluticasone and mometasone.
These medications are often used in combination with the indifferent creams or ointments. When used simultaneously, the recommendation is to apply indifferent agents at least one hour after the corticosteroids.
Further, it is important to consult with the pharmacist about the maximum dosage that may be applied to the skin per day and per week.
Prednisolone to take
For severe eczema, the doctor may prescribe prednisolone as a short course. This works quickly. Sometimes use prednisolone temporarily when switching to another drug until the new drug works.
Source: Pharmacotherapeutic Compass.com