The following brochure is personally written by my daughter’s allergy specialist. My daughter severely suffered though eczema for almost 10 years. Then, by Allah’s Mercy, I found this doctor for her. Alhamdullilah, Allah has blessed him with much knowledge and experience in his field. He is the head of the research department of Allergy and Immunology at Alferd I. Dupont Hospital for Children. This brochure is very very useful for all those who know the pain of eczema, both for the child and the parents!
ATOPIC DERMATITIS
What is it?
Atopic dermatitis is a chronic skin disease. It is not contagious, and cannot be passed from one person to another. “Atopic” refers to a group of diseases where one has an inherited tendency to develop allergic conditions, such as asthma or hay fever. “Dermatitis” means inflammation of the skin.
Eczema is a general term used to describe inflammation of the skin. Atopic dermatitis is the most common type of eczema. In atopic dermatitis, the skin becomes extremely itchy. Scratching leads to redness, swelling, cracking and weeping of clear fluid from the area. The skin ultimately crusts and scales.
What can you expect in future?
In most cases, there are periods of time when the disease is worse (called exacerbations of flares) followed by periods when the skin improves or clears up entirely (called remissions).
As some children with atopic dermatitis grow older, their skin disease improves or disappears altogether, but their skin may remain dry or easily irritated. In other children, atopic dermatitis continues to be a significant problem into adulthood.
How can we treat atopic Dermatitis?
There are two major goals in atopic dermatitis management:
1. Prevention of inflammation
2. Treatment of inflammation
PREVENTION OF SKIN INFLAMMATION:
We need to prevent factors that lead to skin inflammation such as:
- Strictly avoid any food to which you child is allergic. Also avoid any airborne allergen (pollen, dust) that he/she is allergic to.
- Avoid a smoking environment.
- Prevent skin dryness (see instructions below)
- Prevent or immediately treat skin and other infections. Use bactroban on any broken skin, under the nails and around nostrils.
- Avoid extreme hot or cold temperature, especially overheating since this causes sweating and may make the AD worse. (See Table 1)
- Avoid flare-ups of asthma and seasonal allergies.
- Prevent scratching (see Table 2)
TABLE 1: How to Avoid Overheating
- Wear 1-2 thin layers of clothing only.
- Try to wear summer clothing throughout the year.
- Keep bed covers to a minimum (one sheet in summer, an extra cotton blanket in winter)
- Avoid heaters in the bedroom and keep the house cool (around 68 F)
TABLE 2: How to Prevent Scratching:
-
- Be aware of the scratching. Keep a record in a diary/calendar of times and situations when this is the worst. Try to limit your exposure to such situations.
- Change clothes as quickly as possible.
- Control itching without damaging the skin by teaching your child to press a finger or thumb into the skin.
- Keep their hands occupied while they are watching TV or changing clothes.
- Never leave the child unsupervised in the first 4 days of a flare-up.
- Remember to reward your child by praising him/her for not scratching their skin.
- Never say “stop scratching”. All interventions should be positive.
- If your child starts to scratch, try to actively distract him/her by talking and playing. This is most important after applying medicated creams. Play with you child intensively for next 10 minutes.
- Night time scratching diminishes as scratching stops during the day.
Why skin dries so badly in Atopic Dermatitis?
Children with atopic dermatitis have increased water loss and decreased ability to bind water in their skin. This leads to skin stretching, which makes children want to scratch. Scratching causes further itching, dryness & damage to the skin.
How can we Prevent Dry Skin?
The goal is to restore the water content of the skin and prevent further water loss.
- This is achieved by:
Daily lukewarm bath for 10-15 minutes (cleanses & moisturizes the skin). - Add 8 teaspoons of salt, baking soda or aveeno to the bath water. Keep the water out of the eyes.
- Use mild, low acidity cleansers (like Cetaphil). Do not use cleansers or moisturizers with alcohol.
- DO NOT allow the skin to become dry after bathing. Pat the skin lightly and gently with a towel. While the skin is still DAMP, immediately apply the moisturizer to avoid water loss. Aquaphor or Crisco are good initial choices.
How do I Apply the Moisturizer or Prescription Creams?
LIGHTLY: pressure or rubbing can stimulate further inflammation.
GENTLY: reddened, cracked skin is brittle and dry- DO NOT RUB.
THINLY: a thick layer can trap heat and cause inflammation
FREQUENTLY: emollients prevent dryness, not treat dryness.
Remember: apply medicated cream BEFORE the moisturizer (to seal the skin with the medicated cream)
How often should my child be bathed?
DAILY!!
Bathing, followed immediately by applying moisturizers, not only helps reduce skin dryness, but also lowers the level of germs in the rash area. Bathing also allows you as a parent or caregiver to take a little time out from a busy day to inspect your child’s skin. Not to mention that bath time is a fun time to interact with your child. It may take some time to settle on a bathing routine that fits in with your schedule and to determine which moisturizers and medications work best. Be patient.
Remember, when you control the itch, it makes the eczema so much easier to manage!
What else should I Remember about Skin Care?
- Avoid large containers of moisturizers. They can eventually harbor bacteria.
- Use unscented, mild, liquid laundry detergent. Avoid ALL types of fabric softeners.
- Rinse clothing and bedding twice to remove detergent residue.
- Wash new clothes/beddings prior to using
- Avoid irritants, such as smoke or heavy perfumes
- Keep well hydrated- your child should drink water during the day, especially before and after exercise, or when experiencing a fever.
- Use air conditioning in hot weather and keep your child indoors as much as possible to prevent sweating and the itchiness it causes.
- Use sun screen
- Avoid skin contact with rough materials such as wool and sand. The skin is very sensitive and reactive to these. Your child should wear soft, thin cotton materials. Do not wear wool if you are holding your child. Place a cotton diaper over your shoulder. You may notice that your child itches more after crawling around on a wool rug.
- Saliva is the main irritant in childhood eczema. To avoid this irritation, regularly apply a thick moisturizer such as soft and liquid paraffin, especially before eating food.
TREATMENT OF SKIN INFLAMMATION:
1. Stop the Itch:
-
- Itching is a vicious cycle that must be broken.
- Scratching stimulates a type of cell in the skin called “Keratinocytes” that produces chemicals that causes FURTHER itching and inflammation. To break the cycle, skin must be restored to the texture of normal skin. (PREVENTION IS THE KEY!)
- Anti-itch medication by mouth also help, like Atarax, Peractin or Benadryl.
- Medications sometimes loose their effectiveness after 6-12 weeks of usage. If this occurs, rotate the medications for maximum benefit.
- Medicated Creams:
Method of medicated cream application: Steroid creams should not be applied more than twice daily (only once a day for the newer preparations). Cover the area of eczema evenly with a fine film of ointment so that the surface of the skin glistens in the light. The amount to apply is in ‘fingertip units’. The amount of strong topical steroid applied on a small child should nto be more than 20g in a wekk. If more is used, the natural steroid production in the body will be suppressed.
ATOPOIC DERMATITIS FLARE:
How is this treated?
3 level treatment:
1. Skin care as described above
2. Use of antibiotics by mouth or applied to the skin, as prescribed by the doctor.
3. Use of steroids prescribed by the doctor.
What About Follow-ups?
- After the acute flare-up completely stops, continue with regular skin care measures along with low potency anti-inflammatory medication cream for some time.
- Beware of relapses.
- Recently healed chronic eczema remains unstable for several weeks.
- Therefore, look at and feel the skin daily for
Itchiness
Dryness
Redness
Broken skin
- When an acute flare-up is identified, consult doctor and treat IMMEDIATELY.
- The sooner you begin aggressive treatment, the sooner the skin will heal and less steroid will be required.
- As time progresses the skin becomes more stable.
Jazakallah, Umm Reem, for sharing that.
I do tend to stick to most of, or should I say, all of :), the advice that you posted. It is helpful to revise what one is doing from time to time, as, with chronic illnesses, sometimes one or the other thing can slip from the routine.
I was going through this post as a checklist and mentally assessing and reassesing our management of Bubbu.
Alhamdulillah, at this stage she is far better. The description I wrote on my blog was her condition about 1 year ago. At that time, all the measures we took did not seem to benefit her.
My impression was she had developed a reaction to a preservative in the moisturising cream, which was perhaps worsening her condition, and so I switched to a cream with a very simple formula and with the minimum ingredients. I think this has made a difference.
Ultimately, the one measure that gives me most hope is ‘dua’. Many doctors think atopic eczema gets better as the child grows older; yet there are many children who continue to suffer with it.
My own dua’ is that may Allah Taala cure your daughter, and inshaAllah, mine as well, of this troublesome condition Ameen.
Salam mummyjaan,
wa iyyaki.
I was unaware of most of these preventions! And now my younger one has it too on her legs but alhamdullialh i am using these tips and it is very well under control, alhamdullialh. I regret not taking good care of Reem…
In any case, once my friend tried this on Reem and it seemed to work…you may feel awkward but I used to put honey on her hands, twice a week and leave it on her hands for one hour then let her wash her hands. It worked very well. However, the condition was that honey has to be “pure” (not one of these store honeys…although it says pure on it but we know it has tons of sugar added with all other ingredients!)
So when I ran out of that honey (which was imported) I had to stop this treatment 😦
But you are absolutely right about du’a. May Allah cure your daughter and mine, amin!
Assalaam alaikum,
Alhamdullilah, I have found pure honey at the farmers market here. I am sure you can too whereever you live. Its raw and unfiltered. Anybody who has tried it says this is definately pure and when I am coming down with a cold I take some honey and it really goes away. Alhamdullilah,
Secondly I have also been using Homeopathy for cold and cough and it works excellently. I don’t have to ever worry about the kids when they get a cold. ALPHA CF by Highlands in the childrens medicine section at Whole Foods works wonders. No sideeffects, its natural and works fast. The reason why I am saying this is coz,Homeapathy is for a whole range of things. minor to severe. You may find something for eczema. A Family Guide to Homeopathy by Andrew Lockie and the advise of an Auntie who has been using it for her kids for 20 yrs has solved my families medical worries.
Hope that helps.
As Salaamu Alaikum All; (I recognize some names from ummadam’s blog). I have had eczema since I was 19, and am now in my late 40’s. In the past I’ve mainly used various creams containg varying amounts of cortisone. Back and forth results; sometimes I looked great, other times I thought I was turning into a snake.
What works best, for me, is actually limiting the amount of water for bathing. I take showers instead. When I have run a bath I’ve used Aveeno’s colloidal oatmeal bath and use jojoba oil immediately afterwards. I have had good results using homeopathy for other conditions, so I’m working with a homeopath/naturopath now. Homeopathy gets to the root of what is making the body respond by presenting as eczema. In addition, eczema is often tied to other allergies, both food and seasonal, as well as asthma. Work with a certified classical homeopath rather than picking remedies hit-or-miss yourself. They take an extensive history from you, both physical AND mental/emotional which aids them in pinpointing the right remedy for YOU.
Also, when you use moisturizers, try ones with only natural ingredients, the shorter the list, the better. Look for things like, joboba oil, honey, olive oil, shea butter, neem (plant from India), etc. LIMIT OR CUT OUT ALL REFINED SUGAR. Try a slow withdrawal rather than go cold-turkey. Replacements are succanat (evaporated pure cane juice with all the minerals still in it), agave nectar (from the agave cactus – taste like mild honey) raw honey. Also, try to get black seed oil to put on skin. Take pure fish oil a few times per day and drink LOTS OF WATER. (I have a hard time with this one; I just forget to drink.) Continue to make duah and ask Allah to lead you to the best substance/remedy/treatment for you. May Allah grant you the taufeeq. Amin.
jazakillah khair umm reem for this. I met your sister at the TDC last year (2007) and she told me of Reem’s eczema as my baby also has a terrible case, plus he has multiple allergies too.
JazakAllah khair Umm Atiyya for your input. Actually I have heard from quite a few people about homepath treatment for eczema, but never tried myself.
Nadia: hmm…my sister mentioned about meeting a couple of sister…do you live in houston?
Assalamu’alaykum Umm Reem
May Allah heals and make it easy on Reem’s bubbu. Make sure she is not anywhere near cats or go to people’s home with cats, dogs or birds. The cat’s dander in particular can be really bad for sensitive skin and asthma.
MashaAllah, the last time I met an adult college age sister. She has been suffering eczema all her life and she is allergic to almost everything including tap water, anything nuts, fruits and salad.
Water? Yes she cannot have shower because it can make her skin swells and burst as if in contact with acid.
She can only drink from a staw.
What about Wudoo and other personal stuff?
Aaah… Allah knows best how she copes.
Khawla: Oh, may Allah have mercy on the sister and ease her suffering, make it an expiation for her and replace it with what is better! There are skin cleansers that do not require the use of water, but if her skin is so supersensitive, then the ingredients might cause further suffering. If the sister’s skin is reacting like that to water, she may have an extremely rare condition called “aquagenic urticaria”. Less than 50 people in the world are known to have it. If you see her again urge her to ask her doctor to do some research into it. Make duah for the sister that Allah guide her to the best treatment for her.
ummreem, no, I’m from columbus OH. Your sister and I were in Dr Mamdouh’s lecture ..I was sitting next to her, and then we got to talking..she had asked me to stay with her bec after the lecture she wanted to ask Dr Mamdouh something, but I had to run and get my baby, and then we met up again outside the room and we talked about her kids, my kids, reem, eczema, treatments, before that she talked about colorado, saudi etc etc…lol
Nadia: Oh my sister did mentions about you…hmm…how did you find me?!! 🙂
MashaAllah Umm Atiyya
Jazzakillah for giving the name of this skin condition. I had no clue until I looked it up. This is the first time I heard about this. I will talk to the sister if she can use distilled water for washing or Wudoo, inshaAllah. I know she can only drink boiled lemonade made with fresh lemon and honey.
May Allah heal the sick for He is the best healer.
ummreem,
I don’t remember, but i actually found you a LONG time ago from bloghopping LOL..all those homeschooling blogs and maybe also from muslim blogs not necessarily related to homeschooling 🙂 love your posts by the way!
Assalamu aleikum
Jazaakillahu khayran for this post, excellent advice and a good reminder.
I’ve added you to my blogroll, by the way.
Nadia: JazakAllah khair 🙂
Khawla: Amin to your dua’s
Oum Anas: JazakAllah khair:)
The style of writing is very familiar to me. Have you written guest posts for other blogs?
I didn’t write this article…it is written by Dr. Yousuf Ejaz from DE.
I write for Muslimmatters.org though…
My daughter had Atopic Dermatitis, she is 6 year old, tried many creams, lotions but it give temporary relief after then its again come. on google search i found a forum thread, who offering free cream sample for Atopic dermatitis. I use that sample cream on my daughter skin …. ITS Amazing its miracle all eczema gone. i use that sample 3,4 times and it has guaranteed results. its super cream, now i order him large quantity. i recommend all Atopic dermatitis patients that use that cream.
God Bless this guy who help me… his forum address is http://atopicdermatitis.tk/forum
Dear friend, After suffering from horrendous, humiliating eczema for 37 long years… scratching myself to the point of bleeding while living in constant fear and paranoia of what others might think about the nasty red eruptions all over my skin…I accidentally stumbled upon 3 simple little steps that to my amazement:Read more here!
Dear friend, nice to share: http://eczemaebook.info/eczemacure/kill-your-eczema-1-rated-eczema-stopping-guide/
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