Eczema

This is a condition that may commence after the third month of life as a weepy rash on the face and outer surfaces of arms and legs.

In later childhood it becomes a dry scaly itchy rash in the inner creases of the elbows and knees. Some children may not outgrow eczema and the condition often continues into adulthood.

Diet

Parents should institute general allergy prevention measures in newborns are at a high risk of allergy. These include avoidance of parental smoking during pregnancy and after birth and breastfeeding until at least six months of age. Common allergy-provoking foods such as milk, eggs, fish, peanuts, wheat and soya should be avoided in the breastfeeding mother's daily diet.

Avoidance of solid foods in babies up to six months of age, followed by the careful introduction of the potential allergy-provoking foods such as cows' milk, wheat and peanut extract at 12 months. Eggs and fish should only be introduced after 18 months.

About 10% of infantile eczema is food allergy related and food colourants and additives can also aggravate eczema in older children. In addition adverse reactions to citrus fruit, tomatoes, pineapples and Marmite are common in patients with eczema.

Clothing

Children should avoid hot, humid and cold, dry weather, excessive sweating, woollen or synthetic clothing close to the skin and perfumed soaps. Cotton underwear, clothing and bed linen are recommended.

Detergents

Non-biological washing powders such as Sunlight and Skip should be used instead of enzyme enriched Punch, Biotex, Surf or Omo. Bubble baths, household antiseptics and medicated soaps are best avoided. Swimming pool chlorine may also irritate and dry out the skin. Local household skin irritants include wool, mohair, nylon and feathers. House dust mites as well as dog and cat skin flakes may aggravate eczema.

Bath

Bath water should be lukewarm and moisturing emollients applied to the skin within three minutes of patting the skin dry. Never rub the skin dry. If non-perfumed soaps such as Pears, Dove or Neutragena irritate the skin then the use of aqueous cream, Aquabar or Cetaphil lotion are recommended.

In bed

As much skin as possible should be covered with non-allergenic lightweight cotton clothing, taking care not to overdress or overheat the child. Cotton nigh gloves as well as neatly clipped finger nails will reduce scratching. Sometimes elbow splints need to be applied to stop intractable scratching at night.

Immunisations

Routine childhood immunisations should be given. Consult your doctor if you have any concerns about these immunisations.