My daughter's eczema seems to get worse when she is ill. Why is this and what's the best strategy for managing it?
Illness is certainly a common cause of eczema flares. This can be through skin infections, but also unrelated viral illnesses that are incredibly common during childhood.
Have a treatment plan for when things start to flare – avoid soaps, increase the number of times you are applying a moisturiser and treat any active patches as directed by your GP. Try to recognise flare-ups quickly, as this will allow you to be as proactive as possible in getting on top of them.
GPs can be reluctant to prescribe steroids for children, but they can sometimes be the only solution to a flare-up. What are your views on this?
When eczema flares occur, steroid creams form a really important part of treatment. There's often a lot of anxiety from parents and GPs about the dangers of overusing steroids and the long-term consequences of this on the skin.
I want to reassure you that dermatologists will follow a ‘treatment ladder’ approach when deciding which strength steroid to recommend for eczema flares and will also give clear recommendations about how long it is safe to apply them for, as well as where they are safe to use. For example, the skin on the face and neck is thinner and more vulnerable to steroid side-effects, so a weaker steroid will be recommended for these areas.
The key is to prescribe the weakest strength steroid that is effective in treating the flare. Remember that, as a parent of a child with eczema, you are the expert in understanding your child’s skin and its response to treatments. It's important that you feedback to your GP or dermatologist about the frequency of flares, the number of days you are needing to use steroid creams, and roughly how long a tube of steroid cream will last. Treatments can then be stepped up or down as needed.
There are also newer treatment strategies available that do not involve steroids – these products are called topical immunomodulators, and will often be considered if you need to frequently apply strong steroid creams.
How often should you bathe a child with eczema?
Dermatologists recommend a daily bath for all children and adults suffering from eczema. This is to reduce the buildup of staphylococcus aureus bacteria on the skin and prevent infected eczema flares.
Try to keep the baths short (15 minutes maximum) and ensure the water is not too hot. Use a soap substitute such as LIPIKAR Syndet AP+ which will not strip important natural oils from your child’s skin. If you find it helpful, add a bath emollient to the water.
What makes the La Roche-Posay LIPIKAR skincare range different from the many other skincare options for children?
The LIPIKAR AP+ range not only helps lock moisture into your child’s dry skin, it also has ingredients that help soothe the skin and reduce itchiness.
It has a high concentration of glycerine and shea butter to help restore the skin’s natural barrier, and niacinamide to help prevent itchy skin and irritations. The formula also contains Aqua Posae Filiformis, which helps rebalance the bacteria on the skin surface to reduce the frequency of flare-ups.
Any tips on how to stop children scratching and do you have anything to help with the itch?
Eczema is incredibly itchy so it's a normal reaction for your child to scratch a lot. The problem is that the scratching will further damage the skin, and can also form a habit in your child. Dry skin is itchy, so keep skin soothed with regular moisturiser – you can never apply too much.
Treat eczema flares as guided by your GP or dermatologist with treatment creams, such as steroids, as these reduce inflammation in the skin and help with the itching. Some children benefit from the use of antihistamine and again this can be guided by your healthcare professional.
Keep itchy skin covered with long sleeves and trousers in breathable fabrics such as cotton or linen. Younger children can also have mitts (often built into baby sleeping bags) to cover their hands.
As your child gets older, try giving them soothing cool sprays or moisturising sticks such as LIPIKAR Stick AP+ to give them something to apply instead of itching. Also, remember to always keep their nails as short as possible.