What is Eczema?
Eczema is a common skin condition characterized by dry skin, severe itching, and inflammation. It affects people of all ages, from toddlers to adults. Over 50% of people who have suffered from eczema developed it during their first year of birth. Toddlers are the most vulnerable population to eczema. Toddlers with eczema have extra sensitive and delicate skin. They develop a very itchy and irritating rash, and their skin tends to dry out fast. Eczematous skin, also called atopic dermatitis, is often managed by moisturizing to reduce itchiness and restore dried-out skin.
The Causes and Risk Factors of Eczema
Irritants – causing items such as wool or synthetic clothing, shampoos, cleansers, sweat, antiseptics, and topical disinfectants, among other chemical substances.
Allergens – additives in medications, latex, perfume-based products, dust mites, bodily dandruff, and tree pollens
Foods/dietary influences – milk, eggs, peanuts, soya, and fish
Climate factors – extreme temperature and humidity, and seasonal variations
Environmental factors – hard water, smoke, and animal fur
Diagnosis of Eczema
Eczema is difficult to diagnose. However, there are certain recognized patterns of the condition. In toddlers, for instance, eczema affects the face, limbs, and trunk, and in rare cases, infants and toddlers may display a discoid pattern. Itching is the core clinical feature of eczema (Leins & Orchard, 2017). The severeness of the itch causes reflective sleep discomfort, irritability, and stress among toddlers. If the condition is not well-managed, it can also affect the engagement and performance of the patient.
Management of the Trigger Factors in Toddlers
While eczema has no cure, its effects can be successfully managed through several customized skincare strategies such as the use of creams, medications, and other methods aimed at eradicating triggers. Triggers cause a toddler’s eczema to abruptly appear or worsen. Therefore, identifying and controlling the potential triggers of eczema and treating the underlying skin abnormalities is a critical aspect of managing the condition.
Irritants and Allergens:
Primarily, triggers such as skin irritants and contact allergens cause area-specific patches of eczema. Skin irritants mostly affect sensitive body areas such as the face, flexures, and groin, whereas contact allergens cause an insistent severe and evenly restricted eczema (Leins & Orchard, 2017). Caregivers of toddlers whose eczema is assumed to be triggered by irritants and contact allergens should familiarize themselves with such triggers and minimize the toddler’s contact with them. In cases where an irritant or allergen cannot be avoided completely, skin moisturizers can be used to reduce the effects of eczema.
Food and Diet:
Food and diet play a minor part in triggering immediate or delayed eczema symptoms in toddlers. However, the trigger should be considered in patients with persistent perioral eczema (Leins & Orchard, 2017). Due to the absence of a prescribed test for diet or food intolerance, a keen trial and error method is recommended for toddlers with certain food allergies. Although the mechanism through which food and diet affect patients with eczema is unknown, some experts allege that withdrawing relevant foods suspected to contribute to eczemas such as cow’s milk, nuts, eggs, and certain fruits from a toddler’s diet can help manage eczema symptoms (National Collaborating Centre for Women’s and Children’s Health, 2007). Yet, mothers must recognize that some of these foods can be exposed to toddlers through breastfeeding.
Climate and Environmental factors:
Climate and environmental factors also influence eczema. Patients in high-temperature areas present severe symptoms due to overheating around various parts of the body. According to Leins et al., overheating aggravates itch and is more widespread during cold seasons when toddlers are overdressed (2017). If heat is a trigger, then dress toddlers in light clothing, avoid hot water baths and woolen blankets, and turn off heaters in the house. In the case of environmental factors, management may include skin prick, avoiding contact with the suspected factor, and administration of oral antihistamines before expected exposure (Leins & Orchard, 2017).
Bacterial infections trigger or heighten the severity of eczema. According to the National Collaborating Centre for Women’s and Children’s Health, the infestation of the skin, nose, nails, or groin with bacteria such as Staphylococcus aureus and Streptococcus pyogenes can develop explicit signs of clinical infection (2007). Such infections cause eczema to flare, resulting in a vicious cycle. Management, in this case, involves administering skin swabs, bleach baths, softly getting rid of crust, use of emollients, a combination of antibiotics for explicit signs, cutting fingernails short, and keeping hands clean through handwashing.
Management and Treatment of Eczema Symptoms
There are several recommended practices to suppress the general symptoms of eczema. The most current includes an understanding of the toddler’s bathing technique, the use of topical corticosteroids, bleach bath therapy, treatment of underlying skin abnormalities and infections, phototherapy, and systemic treatments.
Proficiency in bathing technique:
Bathing removes dirt and other potential triggers from a child’s skin. Caregivers need to understand that every toddler may require a unique bathing technique. A lukewarm water bath and the use of a soft cleanser are recommended. The bath should be brief. Appropriate moisturizer should also be applied immediately after the bath. Keep the toddler’s skin moisturized all day to achieve the best results.
Use of topical corticosteroids:
Topical corticosteroids are medications that help to eliminate the effects of eczema. Commonly used topical corticosteroids consist of gels, emulsions, sprays, and lotions. It is important to always consult with a dermatologist on the best corticosteroid for the baby. Topical corticosteroids should be applied to the skin immediately after a bath just before rubbing on the moisturizer. Considering the sensitive nature of the toddler’s skin, the quantity and interval of application should be strictly per the dermatologist’s direction.
Bleach bath therapy:
Bleach bath therapy helps to minimize symptoms of eczema by eliminating bacteria and itching of the skin. Although it is not commonly used for toddlers, dermatologists may recommend it if the eczema is hard to control. For optimal results, caregivers should be mindful of the dermatologist’s instructions.
Treatment of the underlying skin abnormalities:
Eczema is unavoidably multifactorial. Therefore, treatment of underlying skin abnormalities is vital in the successful management of eczema (Leins & Orchard, 2017). Various treatment options can be considered for toddlers. For example, skin dryness in toddlers is a predisposing factor. It is a skin abnormality that can trigger eczema or accelerate its symptoms. To treat skin dryness, emollients, and medicated dressings can be administered (National Collaborating Centre for Women’s and Children’s Health, 2007). Medicated dressing includes a wet wrap remedy that improves topical corticosteroid absorption, cools, and protects the skin. The dressings are helpful in severe cases of eczema which is characterized by extremely dry skin and persistent flares. It is also imperative that caregivers avoid dry cleaners where a toddler’s eczema is triggered by skin dryness.
Treatment of secondary infections:
Taking note and treating secondary infections in toddlers with eczema is vital. Bacterial and viral infections in toddlers occur secondarily through inflammation and scratching of the skin. Treatment of these infections requires administration of antimicrobial agents such as antibiotics and antiseptics. Antimicrobials can be applied to the skin directly or combined with emollient preparations and bathing additives. According to the National Collaborating Centre for Women’s and Children’s Health, vital antibiotics for treating secondary bacterial infections in toddlers with eczema include Flucloxacillin, Phenoxymethylpenicillin, and Erythromycin (2007).
Phototherapy is an advanced technique aimed at moderating the immune response. In toddlers, phototherapy treatments are administered orally or through injections. It also involves controlled ultraviolet light treatment. Phototherapy is combined with a photogenic drug to boost its effectiveness.
Systemic treatment is another advanced technique in the management of eczema. Systemic treatment of eczema in toddlers involves the use of ciclosporin, azathioprine, corticosteroids, interferon palette, and venous immune serum globulin (National Collaborating Centre for Women’s and Children’s Health, 2007). It is however important to consider phototherapy first before systemic treatments depending on the eczema’s severity and other complications. Both phototherapy and systemic treatments should be administered under an expert’s supervision.
What Plant-based Oils and Herbal Remedies can be Used for Eczema?
There are several plant-based oils and herbal remedies for eczema. The inclination towards natural and herbal remedies in the management and treatment of eczema is due to their lesser adverse effects and high effectiveness in improving patients’ health and quality of life (Jong et al., 2013). Some of the plant-based oils that have demonstrated therapeutic efficacy in the management and treatment of eczema include coconut, aloe vera, sunflower seed, and hemp seed oils. Extracts include chamomile tea, neem leaves, fenugreek seed, and colloidal oatmeal extracts.
Sunflower seed oil contains oleic acid and linoleic acid which makes it an effective remedy for skin diseases. Oil extracted from sunflower seeds has an enhanced ability to repair skin and sustain its homeostasis. It preserves the stratum corneum’s integrity and improves skin hydration by increasing its emollient action (Lin et al., 2018). It helps to reduce skin thickening occurring because of the enduring scratching among eczema patients.
Coconut Oil is an ideal natural extract used in the treatment of atopic eczema. The oil is extracted from kernels of mature coconuts. It contains substantial amounts of free fatty acids such as lauric, myristic, palmitic, caprylic, capric, oleic, stearic, and linoleic acids which play a key role in improving skin barrier function, anti-inflammatory, and antimicrobial potency (Arora et al., 2022). Studies indicate that applying coconut oil to the skin in toddlers for 8 weeks improves symptoms of eczema (Evangelista et al., 2014). The free fatty acids therein also help to moisturize the skin which helps people with dry skin and eczema.
Hemp seed oil is linked to health benefits including treating skin infections such as eczema, psoriasis, acne, and scars. The oil contains omega-6 fatty acids which have skin anti-inflammatory, regenerating, nourishing, and moisturizing properties. Hempseed oil is used to reduce skin inflammation and irritation caused by eczema. It protects and heals the skin without blocking skin pores.
Aloe vera gel is extracted from the leaves of the aloe plant. It is one of the oldest herbs used to treat skin diseases including eczema. It possesses antibacterial, antimicrobial, anti-inflammatory, antioxidant, wound healing, and immune-boosting properties. Aloe Vera consists of phytoconstituents like aloin and aloe-emodin which are responsible for managing and treating the effects of eczema (Arora et al., 2022). Aloe vera gel hydrates and mollifies skin damage caused by eczema. Patients should start with a small amount of the extract to gauge skin sensitivity because aloe vera has a burning effect. Nevertheless, it is safe and effective to use in both adults and children.
Chamomile tea is an effective remedy for eczema, inflammation, and other skin infections. This herbal tea consists of extracts obtained from Chamomilla Recutita. The medicinal and therapeutic properties of chamomile are associated with the presence of volatile oils and metabolites such as terpenoids and flavonoids that relieve skin irritations. Chamomile tea does not exhibit any allergic reactions (Srivastava et al., 2010). Its natural polyphenols and phytochemicals speed up the skin’s healing process, improve hydration, and reduce wrinkles.
Neem leaf extract has anti-inflammatory, antifungal, immune-modulator, antibacterial, antiviral, antioxidant, and anti-mutagenic properties. These properties make the plant an effective remedy for skin diseases such as eczema. The therapeutic potency exhibited by the neem extracts can be linked to the presence of nimbidin, Mogollon, gallic acid, catechin, and polysaccharides (Arora et al., 2022). Taking a bath in water with neem leaf extract cures skin disorders. The application of the extract on the skin helps to relieve itching and inflammation arising from eczema.
Fenugreek or methi seeds extract is an effective natural remedy for improving eczema symptoms. The seeds extract has antimicrobial and anti-inflammatory properties which promote the repair of damaged skin and improve skin function. Fenugreek seeds are known for their bitter taste; therefore, it is rational to consider applying their extracts topically to reduce skin inflammation and itching in toddlers.
Colloidal oats extract has anti-inflammatory and antioxidant properties. Colloidal oatmeal improves skin dryness, scaling, roughness, itchy intensity, and irritation from eczema. The extract also helps to maintain skin surface pH (Catherine et al., 2012). Patients are recommended to soak in oats extract bath for about 10 minutes to relieve eczema itch. They should not soak for too long because this can lead to skin dryness which may aggravate the itch and eczema.
Eczema is multifactorial and episodic in nature. Caregivers should therefore use a combination of treatments and practices to ensure effective management of eczema in toddlers. The choice of management and treatment of eczema depends on the triggers, symptoms, severity of the condition, the presence of an underlying skin problem or secondary infection, and other significant factors affecting the toddler’s quality of life.
The severity of the eczema is the most vital aspect that caregivers should consider in tailoring their management and treatment strategy. One should also pay attention to the effectiveness of the chosen strategy.
Dermatologists recommend that emollients should be used as the primary agents in the management and treatment of eczema. Emollients should be applied to toddlers with eczema even after the symptoms have cleared. Robust therapies such as phototherapy and systemic treatments can be used in extreme eczema cases. Plant-based extracts and natural remedies can also be used in the treatment of eczema. The most used extracts and oils include coconut oil, aloe vera, sunflower seed oil, hemp seed oil, chamomile tea, neem leaves extracts, fenugreek seed extracts, and oat colloidal extracts.
In case the eczema symptoms in toddlers persist for more than a week after using over-the-counter emulsions, the caregiver should consult a specialist. Caregivers who require further knowledge or treatment demonstrations should also seek dermatology assistance. It is recommended that eczema should be treated immediately after signs and symptoms are noticed. Late management of eczema can be difficult and life-threatening.