There is some evidence from recently published research that eczema is more likely to occur when a child is raised in a very clean environment, which may be one reason why it seems more common in western, developed countries. Breast-fed babies are less likely to develop eczema, or they grow out of it early if they do suffer from it. Wheat, tomatoes, strawberries, citrus fruits and nuts are among the most common foodstuffs, apart from cow's milk,to provoke an allergic reaction, or cause eczema.
The most common external substances that can cause eczema are minute house dust mites or their faeces, which are found in bedding, carpets, and household dust; hairs and skin cells from cats, dogs, and other pets; and perfumes and cleaning agents found in cosmetics, shampoos and soaps and chemicals such as pesticides and fertilisers.
Eczema is usually treated with creams and other moisturisers to keep the skin moist. These should be used during and after bathing. Soaps and other cleansers that dry the skin should be avoided. If the eczema is severe, steroid creams should be applied to the skin. These medications come in different strengths and need to be used with care, as it is important to keep to the right dose. In severe cases the child's skin can be wrapped in specially treated bandages. Occasionally hospitalisation is required.
If the eczema causes the skin to crack and weep, it can become infected with bacteria or viruses. The most common bacteria to infect eczema are staphylococcus aureus and streptococcus. A course of antibiotics is needed to clear the infection. If raw eczema is infected with the cold sore virus, the resulting condition, Eczema herpeticum, can be a medical emergency. The child can quickly become extremely ill as the infection spreads through the bloodstream. Treatment is normally with the antiviral drug acyclovir, and a short stay in hospital may be necessary.
Like other skin conditions, eczema may be worsened by stress and other psychological factors. In small children, it can get worse or improve from day to day for no apparent reason. If a child suffers from bad eczema, parents and carers need to tread a careful path between protecting the child and enabling them to lead a normal life.
