Eczema, It is very common skin condition in children, atopic dermatitis – or atopic eczema – is a chronic skin disease that requires daily care to prevent relapses.
Eczema, Skin Condition In Toddlers
All little ones do not have a “baby’s skin” as the familiar expression suggests. It is common that they are prone to atopic dermatitis, the most common skin disease among the youngest. If it affects 10 to 15% of the general population, it occurs most often during early childhood.
Behind the knees, in the elbows of the elbows or in the folds of the neck, the skin dries up, it is red, sometimes oozing. Small pimples and vesicles appear, which may give way to papules and nodules. And then, itching, sometimes with bleeding. “Eventually, the structure of the skin changes. It becomes drier and less flexible, “explains Professor Wolf-Henning Boehncke, Chief Medical Officer of Dermatology and Venereology at Geneva University Hospitals (HUG).
In 85% of cases, atopic dermatitis begins before the age of 5 years. It affects 20% of children under 7 and about 15% of 7 to 15 year olds. Generally, over the years, these skin problems gradually decrease, with a clear improvement after puberty.
Eczema and allergy
Generally, eczema problems stabilize in adulthood. However, so-called “atopic” children have an increased risk of developing a whole spectrum of symptoms that can reach the skin as well as the ENT or pulmonary spheres. Specifically, they are more exposed to food allergies, asthma, conjunctivitis or allergic rhinitis (hay fever).
For the minority of patients resistant to conventional local treatments, and in whom episodes of eczema are very close together, new therapeutic perspectives exist. So-called biological treatments, which aim to avoid inflammatory cascades, are coming onto the market. If they are waiting for accreditation in Switzerland, these therapies are however already used in the United States. New molecules, more specific on the mechanisms of action of the inflammatory response, are also being evaluated.
Protein in default
The family component plays a big role in the occurrence of this type of eczema. A genetic and immunological predisposition is at the origin. A deficiency of filaggrin, a protein responsible for ensuring the impermeability of the skin, makes it more porous. Result: the skin is drier and more reactive. It is more vulnerable to the passage of allergens and microorganisms (read further).
Eczema can improve with age, but it remains a chronic disease that requires daily management to prevent inflammatory attacks. “Therapeutic education is central to this disease. It is a question of explaining to the patient and / or to his family his mechanisms and the important gestures which make it possible to control it, explains Julie Di Lucca, head of clinic in the department of dermatology of the Vaud University Hospital Center (CHUV).
The basic treatment consists in the application of a moisturizer every day to fight against the drying of the skin, after the shower preferably. “A shower (rather than a bath) neither too long nor too hot. For the toilet, promote products without soap and be limited to areas that get dirty, rather than soaping the whole body, “advises the doctor. The objective of these measures is to space out the seizures as much as possible and thus to improve the quality of life, and in particular to avoid the itching that can hinder sleep. In the acute phases of the disease, doctors prescribe local treatments. But these creams containing corticosteroids arouse distrust of patients (or their parents), who fear side effects. For Dresse Di Lucca, “These treatments are not problematic if they are well conducted. Also, she summarizes, it is important, to be good for the disease, to hit hard and short, rather than weak and long “.
And the stress in all this?
There is also a lot of questioning about the factors that favor crises. “We know that eczematous skin is more sensitive to external aggressions (moisture, perspiration, pollution, dust mites, etc.),” says Boehncke. The issue of stress is delicate. “There is no evidence of this link in humans, but there is more and more interest,” says Dr. Di Lucca. Professor Boehncke, for his part, explains that stress, physical (UV, disease, etc.) or psychological, activates the immune system and indirectly promotes the inflammatory reactions at work in eczema. “In the clinic, there is indeed a link with the occurrence of infections or diseases of early childhood,” says Dr. Di Lucca. Which is sure, however, it is that skin diseases have a significant impact on well-being and quality of life, and in themselves can cause stress that, if neglected, will only make things worse. For this reason, “it is essential opinion, to consider the patient as a complete, with his feelings, and not to reduce him to his skin”.
In addition to atopic dermatitis, there are other types of eczema. Among them, there is contact eczema. Skin reactions (redness, itching, burning, vesicles, etc.) are due here to an allergen. These allergens can be preservatives, perfumers, dyes or metals (nickel), for example. They are found in many objects or common products such as cosmetics, shampoos, hair dyes, cleaning products, textiles, building materials or jewelry. An allergic contact eczema may appear a few days after the first contact with the trigger allergen. But it is also possible that symptoms appear as a result of repeated exposures for several weeks or months. Usually, the symptoms disappear if we avoid the allergen, which is not always easy. Finally, it is also possible that people suffering from atopic dermatitis develop, as a consequence of their disease, eczema of allergic origin.