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  • Shaken Baby Syndrome

    Tuesday, 21 July 2015 16:28
  • Amniotic fluid problems

    Thursday, 14 May 2015 12:54
  • Choosing a pre-school

    Friday, 10 April 2015 17:50
  • Newborn reflexes

    Tuesday, 03 March 2015 15:49
  • Mastitis

    Tuesday, 03 March 2015 15:41
  • Pelvic floor exercises

    Wednesday, 11 February 2015 17:20
  • Colic

    Wednesday, 11 February 2015 17:11
  • Antenatal Classes

    Monday, 03 June 2013 09:34
  • Strap-in-the-Future

    Thursday, 30 June 2011 13:52

Skin Allergies

CONTACT DERMATITIS

 

Contact dermatitis is an inflammation of the skin that produces a rash similar to eczema, but it is not chronic and usually does not have a genetic basis. Contact dermatitis is a physiological reaction that occurs when the skin is exposed to or comes into contact with certain substances. Most of these reactions are a result of irritants to the skin, while the remaining cases are due to allergic reactions. Contact dermatitis may affect persons of all ages but it is rare in children under the age of 12 (Collins, 2003; Leary, 1990; Lucile Packards Children’s Hospital, 2010).

 

Causes of contact dermatitis

The most common causes of skin irritation in children include soaps, saliva, perfumes, detergents, baby lotion and certain foods (Lucile Packards Children’s Hospital, 2010).

 

Other possible causes are:

·                Plants. The blister bush found predominantly in the mountainous areas of the Western Cape releases toxins when touched that temporarily impair the skin’s resistance to sunlight. If the affected area is exposed to the sun, it results in itching, redness and the development of painful blisters that take weeks to heal. If your child brushes against the plant, immediately cover his skin with clothing for a few days.

·                Metals. Nickel, chrome and mercury are the most common metals that cause contact  dermatitis. Nickel is found in costume jewellery, belt buckles, wrist watches, zippers and hooks on clothing. Contact lenses contain mercury which may be problematic for sensitive children.

·                Latex or rubber. Latex may produce an allergic or hypersensitive reaction when it comes into contact with some children’s skin. Rubber toys, balloons, bells, nipples, pacifiers and rubber gloves should be avoided by latex-sensitive children.

·                Cosmetics. Several cosmetic products can cause contact dermatitis: permanent hair dyes, dyes used in clothing, nail polish, lipstick and some sunscreens.

·                Medications. Antibiotic creams containing neomycin and local anaesthetics, such as novocaine and paraben, can cause medication-induced contact dermatitis (Leary, 1990; Lucile Packards Children’s Hospital, 2010).

 

Symptoms

·         Intense itchiness

·         Mild redness and swelling of the skin

·         Scaling and temporary thickening of the skin

·                Sometimes, blistering and weeping (Collins, 2003; Lucile Packards Children’s Hospital, 2010)

 

Treatment

The best treatment for contact dermatitis is to identify and remove the cause, if possible. For mild to moderate reactions:

·         Thoroughly wash the skin with non-irritating soap and water.

·                Wash clothing and any other objects that may have touched the irritant (e.g. plant resin) to prevent re-exposure.

·                Use a cold, wet compress to relieve inflamed, blistered skin.

·                Apply a corticosteroid cream or calamine lotion to the rash to help relieve the symptoms.

·                In the case of a severe reaction, always contact your child’s doctor.

·                If the cause is unknown, your doctor may perform a skin patch test, where a small amount of a range of suspected irritants are applied to your child’s skin to see if he has  a reaction (Collins, 2003; Lucile Packards Children’s Hospital, 2010).

 

 

ECZEMA

 

Eczema, also known as atopic dermatitis, is a non-contagious skin condition that has an allergy mechanism similar to that of respiratory allergies, except that the target organ is the skin. Approximately 1 in 20 children suffer from this condition. Children usually develop atopic eczema before the age of 18 months, and it may come and go over several years. Children with eczema have extremely sensitive skin, resulting in 3 major problems: dryness, itching and infection. The cause of eczema is unknown, but it generally affects children whose close relatives also suffer from allergic conditions, such as eczema, asthma or hay fever (Cincinnati Children’s Hospital, 1999-2010; Collins, 2003; Leary, 1990).

 

Symptoms

·         Itchy, red, inflamed skin (skin edema).

·         The skin may also be dry, crusted and cracked.

·         Weeping, flaking, blistering and bleeding may occur.

·                Although the rash may occur anywhere on the child’s body, areas that are commonly affected include the face, cheeks, scalp, neck, trunk, elbows and knees.

·                Itching is one of the primary symptoms of eczema. Itching leads to scratching, scratching further irritates the skin, which leads to further itching. This is known as the itch-scratch cycle and may produce temporary discoloration or thickened areas of the skin over time (Cincinnati Children’s Hospital, 1999-2010; Collins, 2003; Wikipedia, 2010).

 

Causes

There are many things that may make your child’s eczema worse:

·                Identify and eliminate exposure to allergy triggers that may irritate your child’s skin such as detergents, soaps, grass, etc.

·                Eczema may be worse in hot or cold weather, depending on the child. Eczema that flares up in winter is often associated with dry skin. Ensure your child’s skin is well moisturised at all times (see treatment below). During summer, keep your child’s environment as cool as possible. Wearing cotton clothing will help reduce skin irritation.

·                Minimise emotional stress because the skin tends to mirror the emotions and stress may cause eczema flare-ups (Collins, 2003; Leary, 1990).

 

Treatment

 

Medication

·                Corticosteroid or immunomodulator creams and ointments are effective for controlling and suppressing eczema symptoms. Generally your doctor will prescribe less potent ones before trying the more potent ones. It is important to use steroid creams as directed and stop when the rash has recovered. If a mild inflammation is evident, apply the prescribed cream to prevent a rash from developing.

·                In severe cases, your doctor may prescribe oral corticosteroids, such as prednisone, or injections to bring about rapid improvements to the skin.

·                If your child has been scratching and an infection has developed, treatment may include an antibiotic or antiseptic ointment. In some cases, an oral antibiotic may also be required.

·                Antihistamines may be prescribed, especially if eczema symptoms (itching) are keeping your child awake at night (Collins, 2003; Wikipedia, 2010).

 

Skin barrier emulsions

·                Eczema is exacerbated by dry skin. One of the primary treatments of eczema is to keep the skin moisturised in order to promote healing and relieve symptoms.

·                Bathe your child daily in tepid water, i.e. not too hot or too cold.

·                Soaps should not be used on affected skin because they strip the skin of its natural oils and lead to increased dryness. A light emollient, like aqueous cream, can be used as an alternative body wash. Use soap only in areas where it is necessary (underarms, groin). Choose an unscented soap that has an oil or fat base. Patch test the soap on a small area of your child’s skin and repeat until you are certain of its results.

·                Avoid using washcloths, loofahs or sponges as they abrade the skin.

·                After bathing, pat your child’s skin dry, leaving it slightly moist. Avoid rubbing the skin.

·                Immediately apply a moisturising cream, such as aqueous cream. However, if your child has excessively dry, flaky skin, he may require a thicker ointment that has less water content, stays on for longer and requires less frequent applications, like emulsifying ointment (Cincinnati Children’s Hospital, 1999-2010; Collins, 2003; Wikipedia, 2010).

 

Food

If the eczema is severe or widespread or your child has known food allergies, your doctor may suggest that he stops eating certain foods (Collins, 2003).

 

Outlook

Since eczema can last for years, it is important that your child see your doctor regularly in order to keep him as comfortable as possible. In young children, the rash often disappears by the age of 4 and never returns. In other children, the rash may reappear, or appear for the first time, between the ages of 4 and 10. In many children, eczema decreases in severity or disappears completely by adolescence. However, 50% of children with atopic eczema later go on to develop other allergic conditions, such as asthma (Collins, 2003).

 

 

HIVES

 

Hives is an allergic skin reaction that may itch a great deal and make your child generally uncomfortable. Hives appears as pale, raised welts that often have a circular, red-coloured border the size of a 5 cent piece. They may also have a mosquito bite-like appearance that may keep changing shape and even location. In children, hives are most commonly found on the arms, legs, back and torso (Hivestreatment.com; Leary, 1990).

 

Causes

The exact cause that triggers the onset of hives is unknown. The following are possible causative factors:

 

·                Children may be allergic to certain food substances, colourants or additives. Avoid preservatives as many children are allergic to them.

·                Certain medications may produce hives in children. If a hives rash appears on your child’s skin after you have given him a specific medication, stop the medication immediately and take him to your doctor for further medical investigation.

·                Extreme temperatures or temperature changes may trigger the allergic reaction of hives.

·                Very tight fitting clothing or undergarments may produce a hives reaction.

·                Unhygienic conditions in day-care centres or schools increase the possibility of the presence of pinworm and giardia which may then produce a hives reaction in your child.

·                Certain viruses and bacteria such as staphylococci have been known to produce hives on children’s skin.

·                Cholinergic hives occurs in adolescence as a result of stress and depression.

·                Some children are allergic to sunlight and react with a severe onset of hives (Hivestreatment.com).

 

Treatment

Hives is usually harmless and can be treated by:

·                Rubbing calamine or milk of magnesia on the affected skin, to help alleviate itching.

·                Antihistamines can safely be administered to children and are effective in reducing the severity and number of hives.

·                Make your child more comfortable by controlling the temperature in his room. Hives is aggravated by very hot or very cold temperatures.

·                If your child is lying down, cover him with a sheet.

·                Dress your child in loose, comfortable clothing, preferably cotton because it easily absorbs sweat from the body (Hivestreatment.com).

 

In severe cases, hives may result in swelling of the tissues throughout the body, including the eyelids, hands, vocal cords and airways. As a result, your child may have difficulty swallowing or breathing. This is a medical emergency and requires immediate treatment. An injection containing adrenalin is usually administered to alleviate general inflammation and breathing problems (Leary, 1990).

 

Parenting the allergic child

Most allergies are chronic illnesses and your child may suffer from allergy symptoms on a daily basis, depending on the severity of his condition and whether or not it is under control yet. Allergies may also involve frequent trips to the doctor, chronic medication and environmental controls. This may give your child the feeling that his world revolves around his allergies, he is always sick and somewhat different to other children (Leary, 1990).

 

As a parent it is natural to feel distressed and anxious when your child is uncomfortable on a daily basis and to over-emphasise his illness. It is also normal for children who are unwell to act out, but too much pampering may cause them to use their condition as an excuse for avoiding their obligations. A balance therefore needs to be made between acknowledging and being sympathetic towards your child’s illness and initiating parental discipline and boundaries (Cavett, 2010).

 

Another consequence of being a loving parent is the need to keep your child safe at all times. Parents with allergic children may find themselves avoiding certain places and activities for fear of cross-contamination and exposure to allergens. It is important not to pass on your anxieties to your child, but rather convey the message that although allergies are a problem, they need not affect quality of life. For example, for family functions take a plate of food for the allergic child. Use allergy medications so that the child with environmental allergies can also enjoy the trip to the park. If there are certain activities that your child is unable to do, consider alternatives that the entire family can enjoy (Cavett, 2010; Leary, 1990).

 

Parenting a child with allergies has its own unique challenges and it is often difficult raising a child with a chronic illness. Families should be encouraged to find their own unique solutions for their particular problems, so that despite his allergies your child can lead an otherwise normal, healthy life (Cavett, 2010; Leary, 1990).