Chapter 8

General recommendations for eczema

While you have eczema, there are many ways to minimise your discomfort. Some of the following information is age-specific, so take from this list what is relevant to you in regards to age and living arrangements. This chapter ends with some information on what to do if your eczema becomes infected.

Create a healthy home

The environment you live in can irritate sensitive skin, however changes can be made to create an eczema-safe home, such as the following:

• Avoid mould—place moisture absorbers in all damp areas (these are available from hardware stores).
• Avoid cigarette smoke.
• Avoid using electric heating or airconditioning as they dry out the skin (if this is not possible, frequently apply an emollient to minimise moisture loss).
• Avoid pesticide and chemical exposures: farms that use crop spraying, living on a busy/polluted road, chemical cleaning products, nail polish containing formaldehyde, new carpets, new cars and new home and office furniture all release chemicals.

Healthy alternatives

Favour natural cleaning products (there are natural cleaning product recipes). If you live on a farm or near an area that uses crop spraying, or on a busy/polluted road, ensure you eat a variety of alkalising eczema-safe vegetables and take antioxidants as these help the liver detoxify the chemicals you are being exposed to. Ventilate the house by opening the windows each day as this will help to disperse chemicals released from furnishings.

Use eczema-safe bedding and fabrics

While you have broken skin you may be sensitive to dust mites and some types of fabrics. Ways to minimise discomfort include the following:

• Change bed linen weekly.
• Wash sheets in hot water or use a dryer to kill the dust mites.
• Take off tags from clothing as they can irritate the skin.
• Use 100 per cent cotton bedding.
• Avoid using doonas/duvets because they cause overheating (and eczema sufferers heat up quickly).
• Use woollen ‘breathable’ blankets in winter (but don’t let woollen blankets touch the skin as they can cause irritation; ensure cotton sheets are long so they completely cover blankets).
• Dress in 100 per cent cotton clothing.
• Clothing can be worn inside out so the seams don’t irritate babies with eczema.
• Wash clothing in sensitive skin or ‘allergy’ washing powder and avoid fabric softeners.

Improve sleep

Eczema sufferers benefit from having a sound night’s sleep. To promote sleep, try the following:

• Avoid overtiredness (go to bed early rather than late).
• Laugh before bedtime. Funny films are useful in treating night-time waking in children with eczema according to research by Dr Hajime Kimata from the Department of Pediatrics and Allergy at the Ujitakeda Hospital in Kyoto, Japan. The benefit may be attributed in part to changes in the hormone level of ghrelin, which stimulates hunger. Compared to healthy children, salivary ghrelin levels are significantly elevated in patients with atopic eczema (which may make them feel hungry at bedtime or during the night). Research shows that viewing a humorous film before bedtime lowers their salivary ghrelin levels and, as a result, children with eczema can experience a more restful night’s sleep.[1]
• Melatonin, the hormone that promotes proper sleep, is often lower in eczema sufferers compared with healthy people and eczema sufferers can experience disturbed sleep as a result. Dr Kimata reports that watching a funny film increases melatonin production. In breastfeeding women, laughter increases melatonin in their breastmilk.[2]

A note on vaccinations

Vaccinating your child is a personal choice and I do not wish to advise you to be for or against it. If your child has eczema here are some basic facts to consider:

• Catching the measles or having vaccinations for measles, mumps and rubella (MMR) can trigger the appearance of atopic dermatitis, according to several research studies.[3] This may be related to nutritional deficiencies such as vitamin C. Studies show that vitamin C is depleted after receiving vaccinations, causing blood histamine levels to markedly increase and this can cause adverse symptoms. Taking vitamin C before and after vaccinations may assist with recovery, and babies on solids can be fed vitamin C-rich papaya.
• Some vaccines such as MMR vaccines and the flu vaccine contain traces of egg so if your child has an allergy to egg mention this to your doctor as there are egg-free alternatives.[4]
• Immunisations can and do save lives when outbreaks occur.
• Some doctors advise delaying immunisations if a child is unwell or has atopic eczema.

If you are concerned about vaccinating your child, please seek further information from your doctor.

Infected eczema: symptoms, care + prevention

Having eczema can sometimes make you feel as if you are sitting on top of an ant’s nest, waiting for the ants to leave. And sometimes you just end up scratching even though you know you shouldn’t. Scratching causes broken skin and an increased risk of bacterial, viral and fungal skin infections, school sores (impetigo) and cold sores (herpes simplex type 1)—all are good reasons to avoid scratching your skin!

Infections can also delay the healing of eczema so it’s important to identify and treat them early. How do you know if your skin has become infected? It’s sometimes difficult to spot an infection but if your eczema suddenly worsens and does not respond to topical treatments you should suspect an infection and immediately see your doctor. Also refer to the following list of symptoms.

Symptoms of infected eczema

Note that not all of these signs will be present at one time:

• hot and sore skin that is red and angry

• weepy/yellowish crust

pus

• folliculitis (small red spots around the body hairs)

• tender, swollen glands in the neck, groin or armpits

• candida/fungal infection signs: red, itchy and sore skin and possibly tiny yellow pustules; white patches on the skin

• school sores (impetigo)

• cold sores (herpes simplex type 1)

• Eczema herpeticum signs: small blisters containing clear fluid or yellow pus, which break open and ulcerate; high temperature; general unwell feeling.

Infection care

If you suspect you have an infection see a doctor or visit your local hospital emergency room. Your doctor can do a fast and painless swab test to help identify the cause of the infection. Swabs help to identify which prescription would be most effective at eradicating the infection before it spreads and becomes dangerous. For example, the test may reveal the skin is infected with the bacteria Staph. aureus or streptococci and these would require a vastly different treatment to a candida/fungal infection. By quickly treating your skin with the most appropriate medication, the infection should rapidly clear up.

Prevention

Even when you take the best care of your skin, it’s not always possible to prevent eczema from becoming infected. However, you can reduce the risk of skin infections by following these guidelines.

Preventing infection in eczema

• The Eczema Diet boosts the immune system and promotes healthy skin barrier function so it can reduce the risk of infection.

• Avoid scratching itchy skin and minimise the itch by consuming alkalising foods and drinks.

• Do not share towels and face cloths/washers with other family members, especially if they have an infection such as a cold sore.

• Protect the skin’s barrier and reduce dryness and cracking with daily use of moisturising creams and bath oils.

• Avoid soaps and dehydrating environments (such as airconditioning and heating) that dry out the skin and increase the risk of skin cracking.

• Avoid using unpreserved skin care products (preservatives prevent bacterial growth in a skin care product).

• Wash your hands frequently with a gentle hand soap (especially before applying emollients to your eczema).

• Avoid using old or out-of-date skin care products.

• Avoid using old or out-of-date make-up.