Meet the Eczema Team
Our primary care nurses provide support to families and young people on eczema.
What do we do?
Here at the Children and Young People's Health Partnership (CYPHP), our specialist children's Eczema nurses work with a children's pharmacist and emotional wellbeing professionals to make sure we are looking after your child and family as best we can. Emotional and behavioural issues are understandably common in children and young people with long-term or chronic conditions – no CYP wants to be "ill" or "different" in a way they don't choose. At CYPHP we're here to help you and your family with all that concerns you and your child.
We can see you at your home or at a nearby clinic, and we make sure other healthcare professionals, who are involved in your child's care, know what is going on.
We have just started so cannot yet offer our service to children with epilepsy across all of Lambeth and Southwark, but please do speak to your hospital doctor about us if you think you and your child could benefit from our service.
Check out our frequently asked questions section below too:
Q1. What is Eczema?
Eczema (also known as dermatitis) is a dry skin condition. It is a highly individual condition, which varies from person to person, and comes in many different forms. It is not contagious, so you cannot catch it from someone else.
In mild cases of eczema, the skin is dry, scaly, red, and itchy. In more severe cases, there may be weeping, crusting, and bleeding. Constant scratching causes the skin to split and bleed and also leaves it open to infection.
Eczema affects people of all ages but is primarily seen in children. Those who “grow out” of their eczema during early childhood may see it recur again in later life.
Eczema skin may not be able to produce the same amount of fats and oils of normal skin, causing the skin to lose it protective layer, lose moisture, and let in irritants and bacteria. It is prone to drying out and is easily damaged, causing skin with eczema to be more liable to become red and inflamed on contact with substances that are known to irritate or cause an allergic reaction.
(Taken from Eczema Society)
Q2. How does Eczema affect children and families?
There can be problems with embarrassment amongst peers and causing low mood.
Q3. What types of Treatments are used for Eczema ?
The majority of children and young people with asthma will have a number of medicines to manage their asthma. These are broadly spilt into two different types:
The basis of eczema treatment is using moisturiser called "emollient", which keeps the skin flexible, moist, and comfortable. There are a range of different emollients, from lotions to ointments, varying in grease and thickness. Each person’s skin will suit a different product and may require some trial and error to find the right one. See this "Emollient Ladder" PDF for more information.
There is more information about Emollients at http://eczema.org/emollients
What are they?
"Topical" means that they are applied directly onto the affected skin and work locally.
"Topical steroids" are, therefore, a group of medicines used to reduce the redness and soreness that accompanies inflammation when applied onto the skin. By applying the steroids directly, the volume of drug that your body needs to have effect is reduced.
Topical steroids come in different concentrations from mild to very potent. The aim is to balance the length of time you need to apply the steroid and the strength of the steroid to ensure you get the best treatment.
Topical steroids come in a range of products including creams, ointment, lotions, and foams. The one you use will be decided with your healthcare team and depend on:
- the type of topical steroid you need
- where the eczema is and...
- the condition of the skin.
How are they used?
Steroid treatment is used for short bursts to treat ‘flare ups’. When using a stronger steroid, a step-down process maybe used at the end of a flare up. It is important to use the correct amount of steroid.
Topical steroids should be applied with clean hands so that the affected skin just glistens. Please see the guidelines of finger tip units.
You need to make sure you leave a 30 minute gap between applying the steroid and applying any emollient. This is to prevent diluting the steroid treatment and spreading it further across onto healthy skin.
There is more information about topical steroids and their application at: http://eczema.org/corticosteroids
Wet wraps are cotton outfits soaked in lukewarm water which cover a thick layer of emollient to help:
- moisture absorb
- reduce the itch and...
- reduce damage caused by scratching
Zinc bandages are pre soaked in zinc paste, which is a useful paste to reduce itch, cool the skin, and help moisturise.
Q4. Common Triggers of Eczema
- Washing powder/ fabric conditioner
- Perfume/ perfumed soaps and moisturisers.
- Dust mite
- Pet danda
- Clothing- manmade fibres, labels
Q5. What does an infection look like and how is it treated?
Bacterial infection presents with weeping eczema with yellow crusting or oozing. The skin will be red and inflamed and may feel hot to touch. Treatment can include antibiotics creams, antimicrobial baths, or oral antibiotics.
Candida (thrush) tends to develop in warm moist areas such as skin folds, nappy area. The area looks red and sore and may have little yellow pustules. Treatment usually involves an antifungal cream with or without a steroid alongside it.
Tinea (ringworm) can look very similar to discoid eczema; it develops as a ring-like pattern across skin. Treatment usually involves a antifungal cream with or without a steroid alongside it.
Chicken Pox Vesicles develop across the child’s skin. These are very itchy. Usual treatment for the skin is lots of emollients and calamine. Avoid wet wrapping whilst the child has chicken pox and using steroids until the vesicles have crusted over.
A condition known as ‘eczema herpecticum’ may develop if eczema becomes infected with Herpes simplex. The symptoms are flu-like and the skin feels sore and tender rather than itchy and there may be small blisters present on the face, hands, and fingers. The majority of cases are mild but if you suspect eczema herpeticum you should always seek medical attention. Eczema herpeticum may require treatment with an antiviral drug.
Q6. School/ Nursery Support
School and nursery can be very supportive.
There are education packs available from eczema.org and ideas for activities to do with the whole class: http://eczema.org/new-eczema-information-pack-for-schools
There is also an App, created by The Eczema Society for children managing eczema.
You can find out more about it here: http://www.emollizoo.co.uk/
Q7. What should I do if I’m also worried about my child’s emotional wellbeing, mood or behaviour?
It's always ok to ask for help if you are worried about your child's moods or behaviour. It may seem like a silly thing to say but sometimes it can be hard to start a conversation with your child about how they are feeling.
You might be worried because you have only seen them act aggressively when playing with their toys or because you don't think they can really understand what death of a close family member means. You might be worried about making whatever is bothering them worse by asking them about it – it won't - the most important thing is to start talking with your child so that they can get the help they need.
If you are struggling with how to start the conversation you can contact the YoungMinds Parent's Helpline with any question: https://youngminds.org.uk/find-help/for-parents/parents-helpline/
Trying once is often not enough to get to the bottom of things so if you've tried several times and your child still isn't opening up, try talking to their teachers or close family members to see if they can shed any light.
If you have been worried about them for some time and feel like you are not getting anywhere make an appointment to see your GP.
Q8. What should I do if I’m also worried about my teenager’s emotional wellbeing, mood or behavior?
Getting teenagers to talk openly about what is bothering them can be particularly difficult. Try using some of the tips contained here to start the conversation: http://www.nhs.uk/livewell/mentalhealth/pages/talkingtoteens.aspx or go to the Young Minds parents helpline for advice, https://youngminds.org.uk/find-help/for-parents/parents-helpline/
Often teenagers do not want to speak to people "in authority", i.e. people like parents or teachers. Urge them in that case to speak to their siblings, friends or a counsellor through Childline, https://www.childline.org.uk/get-support/
Q9. How can I talk to my healthcare professional about my emotions or concerns for my child?
It can be really difficult to talk to your doctor about your mental health or concerns about your child's mental health. There is no right or wrong way but you have to make that first step to get the help you need. It can be really difficult to talk to your doctor about your mental health or concerns about your child's mental health. There is no right or wrong way but you have to make that first step to get the help you need.
- Being as open and honest as you possibly can. This might be difficult the first time around especially if you don't know your doctor very well but say what you can. This video from the charity Mind has some useful tips on how to prepare: https://youtu.be/Dqb-n_L5hIA
- Remember that your doctor has been trained to listen to very sad or difficult things that have happened to you or your child and are there to help you work through how they are making you feel or behave.
- Focus on how you feel and responding to questions they ask you honestly.
- Don't worry if you don't really know what the problem is or that it might not seem important enough – your doctor is there to help you with emotional problems every bit as they are there to help you with physical problems.