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How to save your baby from itchy scratchy skin
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I've seen many patients with itchy, painful skin caused by eczema and I'm very interested in new treatment ideas for this distressing condition.
As a dermatologist, I'm pleased that latest research has confirmed what I've been preaching for years - the key to keeping eczema at bay is to keep skin well moisturised by using the right washes and bath products and slathering on the right creams.
I know this to be true from experience, as eczema runs in my family. Six of my grandchildren have had baby eczema but we've managed to control it by sticking to a strict moisturising regime and now it's all but gone.
However, my 35-year-old son is also an eczema sufferer, born before we knew how best to treat the condition in children.
I believe that failing to nip it in the bud is why he didn't grow out of it and still suffers to this day.
Thankfully, it's now possible to prevent eczema flare-ups and, with the right care, to avoid children developing it in the first place.
What is eczema?
Eczema is an inflammation of the skin that causes dryness and itching, starting what's called the itch-scratch cycle. You scratch the itch which causes more inflammation and skin damage, which causes even more itching so you scratch again.
This results in red, flaky skin which can weep and bleed.
What causes it?
If eczema, hayfever and asthma run in your family, you and your children have a higher risk of developing eczema as it's almost certainly down to a group of genes, one of them being filaggrin
My theory, shared by a leading allergy specialist, is that the current rise in childhood eczema is due to the increase in mums bottle-feeding their babies.
Formula milk contains cow's milk, which not only seems to trigger eczema in a baby but can set off a lifelong cascade of allergies, starting with eczema and moving on to asthma, hayfever and dermatitis. Indeed, I believe this is what kicked off my son's eczema.
Although I largely breastfed him, as a working mum I had to supplement his feeds with the odd bottle of formula milk.
Stop it before it starts
If you're from an atopic family, you can prevent your child developing eczema by...
/ Breastfeeding: In the UK we have the lowest breastfeeding rates in Europe. If you can, it's better to avoid bottles for the first six months. Many babies start straight on standard formula milk, which is probably why we also have the highest allergy rate.
/ Using hydrolysed formula milk: This has been specially processed to break down the milk protein so it won't trigger allergies.
/ Being vigilant in hospital: If nurses have to give your newborn milk, they'll provide standard formula milk. So take hydrolysed milk with you and insist on using that.
/ Not relying on goat's milk: Although it's commonly thought of as a safe alternative, goat's milk has the same potential to produce allergies.
/ Exposing your baby to allergens after six months: After avoiding cow's milk for the first six months, allergy experts think it's a good idea to then expose babies to all potential allergens before they're 12 months old. This includes cow's milk - and nuts and shellfish as they near a year - to strengthen the immune system and protect against allergies later in life.
Preventing flare-ups
Keeping skin moisturised is the key to reducing eczema flare-ups. There are three ways you can maximise moisture:
1) Slather on cream
Most people use just a thin smear but you should slather on handfuls of moisturiser. For babies, you should do this every time you change their nappy. For children and adults, it should be every time you wash, if not more often.
As a rule, I'd say you should get through two to three tubes of emollient cream a week. Don't use aqueous cream to moisturise as it becomes an irritant left on the skin.
2) Wash with care
NEVER use soap as it's far too drying on the skin. Only use aqueous cream and wash it off thoroughly. Use a moisturising bath emulsion designed for eczema - they work by leaving a film of oil over the skin, trapping in moisture.
3) Avoid detergents
Any detergent on the skin can cause irritation, so wash clothes in the mildest non-biological formula you can find, and rinse them thoroughly. Try putting clothes through an extra rinse cycle on the washing machine.
Easing the itch
/ If itching keeps you awake at night, antihistamine medication can help with sleep, while local antibiotics may be needed if skin has become infected through scratching.
/ Swap feather and down pillows, which can cause irritation, for synthetic fibres or special allergy pillows.
/ Heat can make the itching worse, so keep cool on hot days and wear loose clothing when playing sports. Cool showers also help.
An off switch for itches?
Scientists have recently discovered what makes us itch. They found nerve cells in the spinal cord which spring into action when something irritates our skin.
These cells transmit the message to the brain, which then tells the body it's time to start itching.
Researchers now hope to find a way to switch off these nerve cells in eczema sufferers to remove the urge to scratch.
Stop scratching..
Until scientists develop a way to stop the itch altogether, there are techniques you can use to help resist the urge...
/ Wear cotton or an under layer of cotton clothing to reduce irritation.
/ Keep nails short and filed smooth and try to only use the back of nails if you must scratch.
/ Wear gloves at night to stop sleep scratching.
/ As soon as you feel the urge to scratch, clench your fists for 30 seconds - this gives you time to try to fight the urge rather than giving in automatically.
Additional information:
Issue 123: Eczema in Baby Allergies at Newsletter Archive
Children's Allergies Allergy Facts and Myths Essential Baby
The Most Common Baby Food Allergies Associated Content
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Food Allergies Ask Heidi: Baby Questions WhatToExpect.com
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