iii: Of Weeds & Weans
Eczema, dry skin, and kids Joseph Nolan Skin problems can be so distressing. They can be itchy, painful or both; they can be unsightly; they can be inexplicable and intractable; avoiding irritants can be burdensome, and treatment regimens can be messy and time consuming. Skin problems are a drag for children and their parents, no doubt about that. At a rough estimate, half of my paediatric practice is concerned with skin problems, and the largest part of that is eczema. So, let’s talk eczema and its less annoying sibling, dry skin. Dry skin is just that. Eczema comes with intense itching and obvious inflammation, dry skin doesn’t. Often it is flaky, somewhat itchy, it may crack or feel tight, but it doesn’t erupt with inflammation like eczema. However, people with eczema often have dry skin too, so it is worth discussing them together. Eczema is an atopic condition, meaning that it is due to a heightened inflammatory immune response— similar to that you get with an allergy. People with atopic conditions often also have multiple allergies and intolerances, demonstrating the close link. In eczema, inflammatory overreactions show up in the skin, with dryness, itching, cracking, bleeding, blistering, and weeping. The itching can be maddening, and many people will scratch until it bleeds. Wearing thin cotton gloves at night can help with nocturnal scratching. Exacerbating factors include: Heat— being tucked up in bed or overdressed Chemical irritants— soap, hand sanitiser, swimming pools, and the
well-intentioned application of essential oils Wet wearing— wet clothes or sweaty synthetic fabrics, being overheated and sweaty, hot water, frequent washing. Why do children get it? In short, no one is quite sure. Certainly, family history is often a factor, but I have seen many children who are the first in their families to suffer with atopy. Diet and nutrition, the child’s environment, medications, other health conditions, and stress, also contribute. So, here are some things you can do at home to help: Topical Treatments Topical applications are obvious with skin problems: you see them, they are uncomfortable, you want to put something on them. Certainly, to manage the itching and pain, something must be put on. Let’s think this through... If you have a hot, itchy, irritated, possibly bleeding, weepy thing, what do you want to use on it? Oil holds heat— it’s great for basting meat and warming up grandma’s arthritic knees, but do you really want it on itchy inflammation? Aloe gel is cool and soothing when fresh, but it dries tight and hard, removing oil from the skin. Great for hot, blistered, weeping skin; not so great if it is dry, flaking, and cracked. Cream is the thing. Cream is a mixture of oil and water, and it possesses the perfect blend of cooling moisture and softening oil. The drier the skin, the richer the cream it needs; hot and weepy requires light and cool.
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