Eczema Basic Treatment Plan

General Advice For Parents of Young Children With Eczema (and adults as well)

This advice is made available to complement exsisting advice already available on this site and can be used in conjunction with advice from your medical practitioner. The Treatment plan which is supplied only in basic form was compiled by dermatologists and the nursing staff of the Royal Childrens Hospital in Melbourne. This plan was devised for our child and is a mild variation of the general plans available on the RCH website  which has extensive resources to battle this condition. The steps I have put here are in simple form to help you get a quick grip on how to treat and what to look for (and avoid) with eczema.

Step 1: Prevent Eczema Outbreaks
Easier said than done and sometimes a flareup will occur without warning and you will have to go to step 2.
Preventing an eczema outbreak involves knowing what causes one to occur. The following factors play a big part in bringing on an eczema incident and should be avoided or controlled to minimize effect.

What Causes Eczema?

• Drying of the skin. Dry skin quickly becomes itchy and results in scratching episodes, damaging the skin and speading the outbreak.
• Heat - over heating the body can bring on an eczema reaction and if not treated quickly may take days to regain control of the affected areas. Overheating is often caused by wearing too much clothing, restrictive clothing and long car trips without frequent breaks. Doonas and hot beds are also common causes of sleepless nights with a distressed child.
  
• Prickle - Irritation of the skin from soaps detergents and clothing or bedclothes.
• Allergies to foods and environment, (animals, plants, dustmites etc.) Not in my big 3 but certainly an issue for some.
• Viruses and infections can often bring on eczema.
• anxiety - Was not included in my child's treatment plan but I can see evidence of increased activity when my child is anxious or worked up. I put this down to heat as the body will heat up in times of stress and illness.

Above are the major causes of eczema events with heat and dryness the most common visible and easiest elements to treat.

Steps To Prevent Eczema
The best we can hope for is to reduce the probability of an eczema attack by limiting exposure to the causes mentioned above.

• Keep the skin moisturised even when eczema is not visible. Create a daily routine which includes applying moisturiser at least morning and evenings and include a daily bath with approved bath oil. It is important to moisturise the body within 2 minutes of getting out of the bath to avoid dryness of the skin.
• Don't let the body get too hot. Dress your child in light cotton pajamas at night. Avoid thick woolen winter PJ's as they will overheat and prickle the body providing 2 elements of an eczema event. Turn the heating down and put on a jumper if you are cold. Take the doona off your childs bed and use a light sheet and a thin non itchy blanket if needed. Don't take long trips without planning frequent stops to let your child out of the car and the the body cool down. Keep the car temperature under 20 Celcius and put a shade on the window where you child sits. Make sure your child is wearing light clothing when in the car.
• Use approved soaps and cleaning liquids and don't put scratchy clothes on your child. Cottons and silks are smooth and will not create prickle.
• Keep your child calm and avoid anxiety attacks as this can cause an increase in body temperature.

Daily Plan
After attending a workshop at the RCH we were given this plan to manage eczema on a daily basis.

Mornings:

• Moisturise all limbs and trunk with Dermeze or approved moisturiser.

Evenings:

• Cool or tepid bath with approved bath oil and soap replacement.
• moisturise body within 2 minutes of exiting the bath.

Apply moisturiser as needed throughout the day.

Step 2: Treating An Outbreak of Eczema
Sometimes the eczema can get away from us and we need to step up the care required to return the skin to normal. An outbreak (sometimes refered to as a flare up) can be quite serious if not contained and may require medical intervention. If it is a serious flare up you will need to see your medical specialist to prescribe ointments and creams to battle the eczema. You may even need antibiotics to get rid of infection. when things get to this stage see your specialist and obtain the necessary medicated creams then follow the plan given to you or refer to the steps below.

Treating Eczema Daily Plan (Active Eczema)

mornings:

• apply medicated creams and ointments as prescribed by your specialst
• apply moisturiser to whole body
• dress in light cotton clothing

day:

• moisturise as required
• keep cool and avoid hot environments

nights:

• cool or tepid bath
• apply medicated creams and ointments as prescribed by your specialist
• moisturise all body within 2 minutes of exiting bath
• apply wet dressings to arms and legs to remove heat from the skin (more info on wet dressing here PDF fromat)
  
• apply cold compress to other affected areas (they will feel warm or hot like a fever)
• wear a wet tshirt under PJ's if trunk is badly affected
• light bed clothing and cool sleeping environment ( a warm sluggly bed to us is an itchfest to a eczema flare up sufferer)

Follow the above steps until the flare up is gone then revert to the  normal daily plan.

This action plan is simplified and there may be some gaps in info I have provided. Please visit the Royal Childrens Hospital Website for more detailed resources and help.