Kids with eczema

It is stressful when your children are with eczema. Sleepless nights, daily routine of applying topical treatment and the anxiety that your kids are look at or bullied in school. I can relate and emphatise with all of you. I have seen kids as young as 7 days old with bad eczema, it is heartbreaking and wish that I have a magic wand to help anxious parents.

Eczema is a dry skin condition, where moisture on the top layer of the skin are lost leading to dry and irritated skin that are prone to infection. The first line of treatment are emollients that include moisturisers (cream and ointment), bath oil and soap substitute. There are loads of moisturisers available i.e cetraben cream, diprobase, hydromol, epaderm, E45, doublebase, hydrous cream and etc. The best moisturisers for each individual are the one that the patient likes thus enabling good concordance.

School age kids are able to choose and try different moisturisers. Health practitioners in the UK usually give small samples of moisturisers to try and then prescribe it for them. Try to avoid using soap or bubble bath, these are alkaline base and aggravates your kids dry skin but instead use soap substitute. Most moisturising creams can be use as soap substitute, it does not ladder and your kids may not like it initially but soon they will get use to it.

If your kids like having a bath, adding bath oil will help. If your child eczema is weepy most likely it is infected then a bath oil with added antiseptic is beneficial. Once infection subsided, just use the normal bath oil. Now if your child's skin are red, itchy and inflame (bumpy)then topical steroid is needed. Topical steroids have four strenght; mild, moderate, potent and super potent.

Children with bad eczema use moderate steroids for few days (3-7 days) then reduce it to mild strenght. Depending on patient's age and the site, your child might have to use different strenght. Face, the thinnest skin, a mild steroids are commonly use. Hydrocotisone oint/cream is an example and Eumovate on the trunk and limbs as a moderate strenght.

Potent steroids are rarely use and it is usually prescribe by your dermatologist for few days to control the flared eczema. Once the eczema subsided, you can use the mild steroids or just use moisturiser. Eczema flare is on and off, what is important is that you know what to do if there is a flare of eczema. The following tips might be helpful:

1. Establish a routine with your child, bathing and showering, make it enjoyable for them. Explain the reason why a bath oil has to be added, then add some toys in the bath to motivate them. It is difficult initially but the buttom line is establish a routine.

2. Pat the skin dry and avoid rubbing towel on their skin. It will stimulate scratch-itch cycle. Once they start scratching it is difficult to stop.

3. Apply the moisturiser all over, it will trap the moisture in, thus reducing ithing and soreness. Apply the cream/Oint in down ward stroke to avoid folliculitis and clogging the hair follicles causing the patient to itch.

4. After 30 minutes to one hour apply the topical steroids as prescribed.

5. Using a cotton vest and leggings is helpful.

6. Your kids nails should be always short. Preventing skin damage when they scratch.

7. If kids always scratch, use cotton mittens on their hands

8. Let the kids participate in the application of cream if possible

9. Have enough supply of moisturiser. Place a tub in the living area, bath room, and bed room. Accessibility to these cream will increase compliance and your kid will apply the cream once their skin itch.

10. Have a mild, and moderate potent steroids at home. Use the moderate potent steroid for few days then reduce to mild strenght. If eczema is controlled, use only emollients. Then repeat the cycle if eczema flares. It is ok to use topical steroids as long as have a rest period in between, not to use it continously.

11. Avoid wool clothing, vacuum the room if carpeted, wash stuff toys if not place in a plastic bag and keep inside the freezer over night to kill the houst dust mites.

12. Join the national eczema society in your locality, this will give you the chance to meet mum with eczema kids. Sharing experiences can be helpful.

Skin Surgery Wound

Skin cancer cases are on the rise, this could be attributed to increase drive of the government in educating people with regards to awareness of early detection and treatment of skin cancer. Surgical removal of the suspected skin lesions are far the best treatment options. Specimen is send for histology, giving proper orientation to the whole lesion under the microscope and it removes the cancerous cells with adequate margin (including margin of healthy skin).

The following are practical advise to look after your wound:

- Keep the area dry after 24-48 hours, then you can have a shower but avoid soaking your wound not unless it healed.

-It is best to keep the wound without a dressing after 48 hours not unless you are intructed to do so. Surgical wound is a clean wound and exposing to the air can promote wound healing.

-Apply vaseline ointment 2x a day on the area , moist environment promotes wound healing. Remember to wash your hand before applying the ointment.

- If bleeding continues, apply a pressure on the area for 10-15 minutes. Place your hand and apply a gentle pressure, this helps to stop the bleeding. If persistent, see your health practitioner.

- avoid strenous exercise, heavy lifting, bending, flexing near the area, these can cause the wound to open.

-Take paracetamol for pain but avoid aspirin and brufen. These meds can aggravate bleeding because it reduce the blood to clot.

- If soreness persist, the areas are red and the wound secretes yellow to greenish exudates then most likely it is infected. See your health practitioner to treat it with antibiotics.

-See your nurse for removal of stitches as instructed.