Common myths about eczema
1 MYTH: My child has eczema because her blood is dirty and has poison in it. I want a blood test done.
FACT: Eczema is not a disorder of the blood. It is primarily a skin condition and a blood test cannot confirm if a child has eczema.
2 MYTH: Eczema is a one-off event. Once my child's flare-up has subsided, I do not need to apply the creams anymore.
FACT: Eczema is seldom a single flare-up. To prevent it from coming back, parents need to maintain their child's skin barrier by moisturising his skin frequently and using gentle non-fragrant soaps for baths.
3 MYTH: All children with eczema must have food allergies.
FACT: Not all children with eczema have food allergies. In fact, studies have shown that food is not a common trigger of eczema. So, unless you have confirmed with your doctor that your child has a true food allergy, do not deprive him of certain foods or he may become malnourished.
4 MYTH: To reduce house dust mites, it is good enough to wash bedsheets and pillowcases regularly.
FACT: Wash your bedsheets and pillowcases in hot water to kill the dust mites. In addition, mattresses should be sunned and sheets changed regularly to reduce the number of house dust mites. The surfaces in the bedroom should be cleaned with a wet cloth rather than a feather duster.
5 MYTH: No steroid creams for my child, please.
FACT: The use of steroid creams is an effective way to treat eczema. Avoiding them may cause more harm as untreated eczema rash causes the child misery and can become infected.
6 MYTH: My child's skin is dry because he did not drink enough water.
FACT: Dry skin has nothing to do with the lack of water intake.
Sources: Dr Lynn Chiam, an associate consultant at the National Skin Centre; Dr John Chiam, a general practitioner in private practice
Parents under stress
Parents are bending under the strain of taking care of their kids who have eczema.
A study by the National University Hospital (NUH) in 2008 found that incurring high expenses was the No. 1 one problem, followed by fatigue and emotional distress.
The study, published in the International Journal Of Paediatric Allergy And Immunology, surveyed 104 mothers with a child suffering from eczema.
It found that mothers whose children have eczema were less well physically and mentally. They complained of pain and fatigue and reported feeling sad and nervous.
Madam Diana Ng, whose five-year-old son has eczema, is exhausted from waking up nightly to his crying and scratching.
Madam Ng, 36, has another son, three, and a daughter, seven, both of whom have mild eczema. She said the most stressful part about having a child with the condition is the feeling of not being able to help the child.
The assistant director of a marketing communications department had eczema into her teens herself.
The authors of the study, Professor Hugo Van Bever and Dr Roger Ho from NUH, said mothers need the support of not just doctors, but also professionals from different disciplines such as nurses, psychologists, counsellors and social workers.
Parents of children who have eczema can find help through support groups at NUH and the National Skin Centre. The skin centre has published a book which gives parents tips on how to live with eczema.
Madam Ng said she could not have coped with her son's condition without her husband. The couple take turns to look after their son at night. MadamNg's mother helps in the day.
Her son has been on oral steroids for four months. His eczema began 'mysteriously' 21/2 years ago after he was hospitalised for high fever. Red, itchy patches can be found all over his body, including his scalp. His condition is so severe he draws stares from strangers.
Madam Ng is still trying to pin down the triggers of her son's eczema.
Traditional Chinese medicine doctors told her the antibiotics her son took in hospital made his immune system 'go haywire', while Western doctors pointed the finger at house dust mites.
Madam Ng thinks something else is at work.
She said: 'Every two weeks, I eliminate a certain food from his diet to find out if his eczema gets better." She has eliminated seafood, milk and cheese because his rash seemed to worsen after he ate them.
If nothing works, she is thinking of emigrating to a temperate country.
She said: 'When I took my son to Japan and Australia for holiday during winter, I found that the cooler climate there dried up his sores faster and he did not scratch so much.'
Those interested in joining support groups for parents with kids with eczema can contact:
* National Skin Centre
E-mail thomaseyun@nsc.gov.sg or call 6350-8558
* National University Singapore
E-mail enquiry@ican.com.sg, log onto www.ican.com.sg or call 6772-5566.
Help, my kid's itching all over
Cases of children with eczema - a skin condition resulting in dry, red and itchy patches - are on the rise. But health experts cannot explain why
By Lea Wee
Madam Diana Ng has tried everything to help her five-year-old son deal with a rash that keeps popping up all over his body, including his scalp.
Each month, the assistant director of a marketing communications department spends up to $400 on medication and moisturisers to soothe the angry rashes.
Recently, she borrowed an electrolyte machine which converts tap water into alkaline water for drinking. Reason: Another mother had told her that drinking alkaline water improved her children's health. If it helps to improve her son's eczema, Madam Ng plans to fork out $1,600 for a machine too.
Then there was laundry detergent additive she spent $130 on, because it claims to kill dust mites. Next on her shopping list is an air filter which will cost her about $700.
The itching is so bad that her son gets only 21/2 hours of sleep every night. He scratches his sores till they bleed.
Madam Ng does not like applying steroid creams on her son's rashes. These creams are prescribed by doctors to reduce the redness and itching. When used over long periods, they cause thinning of the skin and can slow down a child's physical growth.
Cases of children with eczema are on the rise here. At least one in five under the age of 12 is affected, a study published by National University Hospital (NUH) in 2003 showed.
In 2006, a report in the medical journal Lancet noted that cases of eczema among six- and seven-year-olds in Singapore rose from 2.8 per cent to 8.9 per cent in seven years.
In contrast, asthma cases in the same group fell from 15.7 per cent to 10.2 per cent.
Children with eczema have sensitive skin which reacts to triggers in the environment. Dry, red and itchy patches erupt, typically at the wrists, the backs of knees and the insides of elbows. Babies have flare-ups around their cheeks and mouths.
Associate consultant Lynn Chiam from the National Skin Centre said the increase is a worldwide phenomenon, especially in urban areas.
One hypothesis is that city kids are under-exposed to bugs and mites from young, so their immune systems cannot handle the triggers. However, this does not explain why asthma cases, which has the same triggers, has gone down in the same period.
Evidence has emerged in recent years to pinpoint a strong genetic cause for eczema. The gene, which produces the protein filaggrin to protect the skin, has been found to be defective in those with eczema.
A genetic predisposition is then triggered by environmental factors, the most common of which are house dust mites, said Dr Chiam.
Other triggers are heat, sweat, stress, food and dust, for instance, from nearby construction or renovation works.
With 150 children - or three out of four - showing up at the National Skin Centre each month with eczema, a workflow plan for doctors and a dedicated team of nurses to counsel patients and their families was put in place.
At NUH, there are nurses assigned to look after these children and their families.
Two out of every five children seen at the hospital's allergy clinic have eczema, said Professor Hugo Van Bever from the NUH University Children's Medical Institute.
General practitioner John Chiam, who is in private practice and has an interest in dermatology, sees one new case of childhood eczema every week, compared to one every fortnight five years ago.
It is not always possible to pinpoint the triggers but the good news is, three out of four children will outgrow the condition.
Dr John Chiam said the most effective way to battle eczema in children is to guide parents on the use of soap substitutes, moisturisers and medication such as steroids. Some soaps strip the skin of its natural protection so parents should avoid using them.
New-generation steroids have fewer side effects such as skin thinning. But Dr John Chiam warned that all steriods, when used long enough and in the wrong way, can cause side effects. This is why steroid creams should be applied in thin layers and children should stop using them once their eczema clears.
There are also non-steroidal creams available and they are safe and effective.
A few studies suggest that probiotics supplements may be beneficial, but other studies, including one done at NUH, have shown no such beneficial effect.
Madam Ng wanted to give probiotics to her son too. 'But the doctor said probiotics works only if my son starts taking it before he turns two," she said.
1 in 5 kids under the age of 12 has eczema
and of course my dear good friend. 
RSS Feed (xml)