These are questions which parents ask time and again. If you are a parent of a child with eczema, you would probably have similar concerns and uncertainties.
Uncertainty #1: Is Eczema is caused by food allergy?
No. Trust me, even if you were to feed your child nothing but rice water everyday, your darling will still have eczema. Yet, there are parents who continue to subject their children to numerous, and often, costly tests, only to be told that they are "allergic" to nearly everything under the sun. When parents act on these test results, eliminating vital foods such as milk or eggs from the child's diet, they risk depriving the child of precious nutrition required for growth and health.
If you still suspect that it was the spinach from yesterday's dinner, speak to a dermatologist or allergy specialist about it. Have it properly evaluated. It also helps to keep a food diary. In the diary, detail the foods which your child has taken, and the reactions that follow.
Uncertainty #2: We do not have eczema, so why should our child?
Not having the disease, does not equate a clean slate. This is because the genes for eczema can remain hidden, till an opportune time. Or change as they are passed on.
Junior inherits genes from both parents. Eczema can be analogised to hitting the jackpot. The "perfect" combination lands Junior the "prize". Also, the disease becomes more or less severe depending on the genetic permutation.
One of the key genes which has been widely studied, is the Filaggrin gene. Filaggrin is found in our skin. It behaves like a sponge, trapping precious moisture within the skin. Children with eczema has lower than normal amount of fillaggrin. So the skin dries out too quickly, cracks up and itches.
The cornerstone in eczema treatment is therefore to use a moisturiser regularly. (More about Moisturisers later)
Uncertainty #3: No more steroid creams for me, please!
There is certainly no lack of bad press surrounding topical corticosteroid creams. While it is true that topical corticosteroids can cause undesirable side effects such as dryness and thinning of the skin, they are mostly a result of unregulated and unsupervised use of these medications.
Steroid creams are prescription-only medications in Singapore. Topical corticosteroids are available in various strengths (potency) and your doctor will advice on the appropriate one for your child.
Topical corticosteroids are still by far, the most effective treatment for reducing the symptoms of eczema. Do not be too hasty in rejecting them outright. When used appropriately and under a dermatologist's supervision, they are effective and safe.
I always provide my patients with specific instructions on when and how corticosteroid creams should be used. This ensures speedy recovery, which is safe at the same time.
Most of all, we fear what we do not understand. But to understand is half the battle won.
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