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Childhood Eczema - Attention To DetailChildhood Eczema - Attention To Detail

Successful treatment of childhood eczema often comes down to the details, says immunologist and allergy specialist Dr Andrew Baker.

Dr Baker encourages parents to seek out expert advice on how to effectively use moisturisers and steroid creams. "Often, the benefits are in the details of how these are used," he says. "Regular, more preventative use of these creams, when guided by an expert, is often best, rather than reactionary use just when the eczema is bad."

Dr Baker's Top 5 Tips For Parents

  1. Consult with an expert who can supervise treatment with regular follow-ups.
  2. Successful treatment is often in the details. For example, do you wait until your child's eczema gets bad before you start treatment or do you start early? Do you put cream just on the spots or over the whole area? How much steroid cream should you put on? The Australasian Society of Clinical Immunology and Allergy website (www.allergy.org. au) has a good page on 'Eczema' which includes information on 'fingertip units' (or FTUs), which can help guide treatment.
  3. Discuss any worries you might have about using steroid based creams with your doctor or specialist. These creams vary a lot, and while some are strong, others such as 1% hydrocortisone, are actually very weak and almost certainly do not cause skin thinning. (They can be used on the face as well.) All of these treatments are approached on a case by case basis though, so regular follow-ups with your GP or a specialist are necessary.
  4. Avoid all soaps and other cleansers. Stick to a simple soap substitute such as Sorbolene 10% glycerine.
  5. Have a plan in place: When a flare of eczema improves, a plan for preventative treatment should be put in place to stop recurrent flares. This might be as simple as avoiding all soaps and using moisturiser twice a day, but another more preventative approach sometimes used is the application of steroid cream twice weekly, also known as 'steroid cream weekends'. This can be a good option for children with moderate recurrent eczema and some studies have shown less steroid cream is needed in total because exacerbations are prevented. Once again, this needs to be decided on a case by case basis, so talk to your child's GP or specialist...

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Issue: Autumn 2016