Come for 30 Aug Wet Wrap Workshop

Wet Wrap session with Singapore Eczema Support Group

Wet Wrap session for kids with Singapore Eczema Support Group

Reminder of next Saturday 30 Aug’s workshop at National Skin Centre, Singapore by Tubifast for the Eczema Support Group. This session will be focused on wet wrap for younger kids. Wet wrapping is a worthwhile technique to learn esp given repeated studies proving its effectiveness, read more here.

30 August (Saturday) – Venue, National Skin Centre Singapore Room 401, 9.30 am to 11 am

The program:

1. 9.30 am to 9.45 am Breakfast and Kids have balloon sculpture and jigsaw puzzles to keep them occupied

2. 9.45 am – 10.45 am Tubifast team demonstration, it’s much easier if you bring your child along for them to demo on him/her!

3. 10.45 – 11am Q&A time

Same note: No doctor present, so don’t expect to ‘Ask the Doc’. Information shared is not medical advice, please still see a doc. No selling anything or pretending to be a parent of eczema child and the session is for parents with eczema kids. Information on my blog is not pre-approved by NSC.

4. YOU MUST RSVP – It will then be possible for us to prepare breakfast and for the Tubifast team to prepare the relevant product. If you’re coming, please email me ([email protected]) your name, mobile and email, number of adults & kids (and age, so the right size wrap can be prepared for presentation) coming.

One last thing, the session would be ending on-time, so please don’t come late and expect it to drag, it won’t – simply cos I have to run! Look forward to seeing you! Mei

Eczema Complications series – Eye and Eyelid

Eczema eyelid complications eyeThis is a 4-topic series focused on complications from eczema and mainly inspired because my daughter recently had impetigo. Moreover, the potential complications from bacterial, viral and fungal infection are not very often emphasized yet a child with eczema is often vulnerable to infections. So let’s explore!

Eyelid Functions and Skin

The eyelid very often present a very tricky and difficult to treat skin area for eczema sufferers. Moreover, the constant rubbing and scratching of the eczema at the eyelid can also lead to complications. Before we go into the complications, let’s first understand the basics of eyelid functions and the skin at this delicate area.

Functions of the Eyelid

  1. Protection from injury
  2. Regulation of light
  3. Maintenance and distribution of tear film/ flow

Eyelid Skin

The skin of the eyelid is characterized by:

  1. Thinnest skin are of our body – total less than 1mm, with both the epidermis and dermis being the thinnest
  2. Smoother skin due to finer hairs
  3. Oilier skin due to more oil glands

Common Eyelid Conditions

Being thinner oilier skin and on the face predispose the eyelid to various health conditions, such as:

  1. Atopic dermatitis (eczema), more common from adolescent age (read more from dermatologist Dr Lynn Chiam)
  2. Contact dermatitis, due to contact with chemicals used on the face/eyes and hair
  3. Seborrheic dermatitis, typically on the eyelid and eyebrow (read here for more on seborrheic dermatitis)
  4. Blepharitis, also known as eyelid inflammation
  5. Conjunctivitis – this refers to inflammation of the eyelid lining, accompanied by itching and eye watering
  6. Ptosis, known as droopy eyelids from prolonged contact lens use or aging
  7. Dermatochalasis, baggy eyes from aging
  8. Ectropion, eyelids that roll outwards usually from ageing or sun-damaged facial skin
  9. Entropion, eyelids that roll inwards, may also be complication of blepharitis
  10. Malignant eyelid tumors
  11. Chalazion, eyelid cyst swelling from obstruction of the meibomian (tear) gland, may also be complication of blepharitis
  12. Hordeolum, also known as a stye, lump from infection of the meibomian gland, may also be complication of blepharitis

Eczema and Eyelid Complications

Apart from atopic, contact and seborrheic dermatitis of the eyelid, there are also complications from having eczema at the eyelid. Complications usually occur in patients with severe atopic dermatitis where repeated scratching and rubbing, inflammation and infection of the eyelid cause other conditions. Let’s take a closer look at some of these eczema eyelid complications:

Blepharitis

This refers to inflammation of the eyelid, being accompanied by redness, sore eyes, itch, flakiness, burning, swelling, eye watering and mucous discharge. The eyelid margin may appear crusty, waxy or greasy. Blepharitis can be due to many reasons, including allergy, irritation and bacteria infection that causes the eyelids to become itchy. Blepharitis is associated with eczema, rosacea and acne patients.

Relation of Blepharitis to eczema as follow:

a)     Staphylococcal blepharitis – patients with eczema have higher chance of staphylococcus bacteria colonization, leading to staph bacteria infection

b)    Seborrheic blepharitis – due to the malfunction of oil glands at the eyelid, affecting patients with seborrheic dermatitis. The excess oil production may be due to stress, hormonal changes or diet. A characteristic of seborrhea blepharitis is redness at the eyelid throughout the day and crusting at eyelid in the morning.

c)     Other eczema complications – Complications of eczema such as from herpes simplex or varicella zoster virus or molluscum contagiosum can also cause blepharitis.

Dennie-Morgan fold

This refers to a fold under the lower eyelid, typically due to excessive scratching/rubbing of the eye. The eyelid may also hyper-pigment or become red and swollen.

Allergic Contact Dermatitis

Ophthalmic corticosteroids may also product allergic contact dermatitis, due to allergy from certain ingredients of the corticosteroids.

Eyelid Erythema

This refers to redness of the eyelids and can be caused by eczema, contact dermatitis and blepharitis.

Cellulitis

This refers to bacterial infection of the eyelid and can also be caused by insect bite/ other skin injury. Preseptal cellulitis affects the eyelid and skin around the eye, but not the eye socket. Orbital Cellulitis is much more severe and affects the back of the eye, causing eye protrusion and double vision. The common bacteria causing cellulitis are Haemophilus influenzae, Staphylococcus and Streptococcus.

Neurodermatitis

Also known as lichen simplex chronicus, this refers to skin thickening, lichenification of the skin of the eyelid from habitual scratching.

Eczema and Eye Complications

There are also complications involving the eye, typically for prolonged eczema at the eyelid.

Keratoconus – This refers to the degeneration of cornea which pushes the eye outward, resulting in a cone shaped eyeball. There will be visual disturbance with this condition. This may be due to hard rubbing of the eye from the itch.

Scarring – This refers to scarring of the eye, mostly due to scratching or excessive rubbing.

Cataract – There is association between cataract and severe and chronic atopic dermatitis of more than 10 years, possibly due to overtime absorption of steroid cream applied on thin eyelid. One feature of cataracts associated with eczema is that the cataract affects both eyes.

Retinal detachment – This is very rare and associated with severe atopic dermatitis.

Complications from prescription creams seeping into the eyes, resulting in glaucoma

Certain eye-related conditions are not directly related to eczema, but related to allergy. For instance, conjunctival irritation

General Care for the Eyelid (Hygiene)

Top tips for general care of the eyelid:
1. Refrain from eye make-up
2. If wearing contact lens, always clean with disinfectant solution; in certain cases, refrain from using contact lens.
3. Apply warm (not hot) compress 4 times a day to clean and reduce discomfort (for blepharitis)
4. Clean eyelid with cotton swab with mild diluted baby shampoo/wash (read dermatologist Dr Jessica Krant’s tips for baby’s eyelid here)
5. Use artificial tears as blepharitis commonly occurs alongside dry eyes
6. An omega-3 supplement may be recommended to patients with blepharitis as small-scale study suggested anti-inflammatory effect of omega 3 benefit blepharitis patients. More on omega 3 and eczema here.

As you can see, there are quite a lot of health conditions affecting the eyelid and a few relating to eczema. Most of it has to do with bacteria and scratching, thus it is important to practice eyelid hygiene and treating conditions that create itch at the eye promptly.

note: if you’ve reached this far to the post, thank you! Took me a long time to do up a comprehensive post on eyelid complications from eczema and if you have any to share, kindly comment, will make my day!

Life of Eczema Girl – Sleep Rotation

Sleep, Co-sleeping in Marriage

Does Co-Sleeping change your Marriage *bedroom* dynamics?

Back by popular demand, this month’s cartoon all on sleep, co-sleep, suffering sleep, sacrificial sleep, whatever you call it! This is the 56th of my 2nd cartoon series, ‘LIFE OF AN ECZEMA GIRL’. For more cartoon in this series, check out hereIf you have a funny sleep story, drop me an email or a comment and I may just turn it into a cartoon!

Mom E-votional : Inconveniences

Eczema Devotional InconvenienceIt is one of those irritating things – the new ATM pin for one of those fancy chip replacement card just didn’t work. I then had to waste an hour queuing and re-queuing to try different pins without pissing the people in the queue behind me. When all fails, I had to queue at another bank’s ATM. It then hit me that in life, we have many inconveniences – falling sick, home appliances failing or train breakdown during office commuting hours! But what of our children? I ask myself if I have ever viewed my daughter or her eczema as an inconvenience. 

The answer is probably yes. Sometimes I want to finish my chores, but have to stop to take care of my daughter. Some days I want a long shower, but I have to shower with my daughter to make sure that her fungal shampoo and chlorhexidine shower foam are used correctly. I then remember Jesus, how he never viewed the children as a nuisance, for instance when children were brought to him for prayers (Matthew Chapter 19:13-14). He also stopped or detoured in his journey to talk, heal and help others, for instance he healed a little girl (Mark 5:23). It then occurred to me that maybe life is made up of inconveniences! At least for parents of eczema children, with so much time spent on skincare, we might as well use this time as family time rather than view it as an inconvenient time! I pray that all of us have the wisdom to parent our children, despite the inconveniences from eczema.

Bible verse:

Mark 19:13-15 Then children were brought to him that he might lay his hands on them and pray. The disciples rebuked the people, but Jesus said, “Let the little children come to me and do not hinder them, for to such belongs the kingdom of heaven.”

God, help me to be a good mom even when it comes with inconveniences

Help to be a good daughter when when it becomes inconvenient

Help to be your good child despite the inconveniences

With God, there is no inconvenience

Eczema Complications series – Folliculitis

Folliculitis_Eczema

Taken from http://health.howstuffworks.com (no direct permission obtained for use, but duly credited)
Link of picture directed to HowStuffWorks website

This is a 4-topic series focused on complications from eczema and mainly inspired because my daughter recently had impetigo. Moreover, the potential complications from bacterial, viral and fungal infection are not very often emphasized yet a child with eczema is often vulnerable to infections. So let’s explore!

Bacterial Infection

Last week, we covered viral infections – eczema herpeticum previously covered in this blog (here and here) and molluscum contagiosum. This week, our focus is on bacterial infection. The most common bacteria that colonizes eczema skin is staphylococcus aureus bacteria, which is the cause of common children skin infections like impetigo and folliculitis. Apart from impetigo and folliculitis, S. aureus also causes other secondary infection with presence of pus, fever, swollen lymph nodes and in severe cases, staphylococcal scalded skin syndrome, where the lesions rupture to give scalded appearance (see this interview with Dr Clay Cockerell on symptoms of S.aureus infection).

Other bacterial infection include boils and ecthyma, also from S. aureus. The other common bacteria that causes infection is streptococcus pyogenes, which can cause cellulitis and erysipelas. Untreated bacterial infection can cause fatal systemic toxaemia or septicaemia, which is blood poisoning. If strep infection is a topic you’re interested, comment/email me and I may start a series on it!

Folliculitis

Folliculitis is an inflammation at the hair follicle that can be due to numerous causes – a common one being from staph bacteria. A word about staph bacteria is that even if it doesn’t trigger secondary infection, its presence impedes the recovery of eczema rash via (i) toxins (enterotoxin) from the bacteria that can trigger hypersensitivity and (ii) existing inflammation from bacteria makes it harder to treat the eczema (more on staph bacteria here).

So back to folliculitis – It appears as a small localized pus (on surface or deep) at the hair follicle, followed by red bump when the pus dried with surrounding inflamed skin that may itch. If the infection runs deep into the hair follicle, it can cause a boil which can be painful. The hair follicles on the chest, back, legs, face, neck, thighs and buttocks are more vulnerable to folliculitis. Folliculitis will not affect part of the body with no hair follicle such as the eye, mouth, palm and sole.

Multiple Causes of Folliculitis

Bacteria, from staphylococcus aureus is the most common cause.

Virus – Herpes simplex virus (that cause eczema herpeticum), herpes zoster (that cause shingles, read here of my daughter’s shingles experience) and molluscum contagiosum (covered last week) may also cause folliculitis.

Yeast – Folliculitis may also be from the yeast, Pityrosporum ovale (Malassezia) when it proliferates, usually on the trunk of young adults.

Fungi – Fungi such as tinea capitis (ringworm), Microsporum canis and Trichophyton tonsurans can cause folliculitis particularly on the scalp.

Parasite – Hair follicle mite (demodex) can affect the face or scalp of adults with compromised immune system or that of elderly. This is known as demodicosis. Scabies is another parasite that can trigger folliculitis.

Steroid – Systemically administered or topically applied steroids could result in facial folliculitis (perioral dermatitis) or steroid acne due to adverse reactions to long and significant doses of steroid.

Occlusion – Clothes with sweat, friction, thicker emollients, like paraffin-based ointment and adhesive plastic can break the skin and/or increase the penetration of bacteria into the hair follicle.

Chemicals – Some chemical like coal tar may cause irritant folliculitis.

Razor-burn folliculitis – This is due to frequent razor cuts creating opening on skin’s surface that allow bacteria to enter and cause inflammation at the hair follicle.  It is more common on women’s leg and men’s face and neck. Excessive close shaving creates trapped hair in the follicle, increasing inflammation.

Spa pool/ Hot tub folliculitis -  This is infection from inadequately chlorinated warm water, allowing the bacteria Pseudomonas aeruginosa to thrive. It is more common on the back and to prevent this, rinse/shower after a spa or hot tub.

Who is a Higher Risk of Folliculitis?

Skin conditions, such as acne, eczema and psoriasis patients

Diabetic patients

Obesity

Patients with lower immunity such as cancer, HIV, hepatitis or even chronic eczema patients who are on immunosuppressants may get eosinophilic folliculitis.

Occupations – Those that come into often contact with oil, tar or grease and sweat.

Warm and humid climate

Treatment of Folliculitis

The treatment will depend on the cause, as follow:

Bacteria – Antibacterial wash such as benzoyl peroxide, chlorhexidine or in certain case, antibiotics to kill the bacteria and clear the skin. There are increasing instances of methicillin-resistant Staph aureus bacteria, thus making it more difficult to treat such MRSA bacterial infection. Oral flucloxacillin is often prescribed and if there is penicillin resistance, erythromycin is prescribed. More on MRSA here.

Fungus and Yeast – Both fungus and yeast causing folliculitis can be treated using an antifungal shampoo or body wash such as ketoconazole (Nizoral shampoo) twice daily. Topical antifungal cream such as miconazole (Lotrimin) or terbinafine (Lamisil) and an antifungal medicine fluconazole (Diflucan) may be prescribed for more severe case.

Virus – Medication for virus, such as acyclovir for herpes simplex virus will help to resolve the folliculitis.

Razor folliculitis – Treatment includes antibacterial wash and topical antibiotics if not resolved on its own. Stopping to shave and using alternative hair removal techniques may help prevent future folliculitis from shaving repeatedly. Using a new razor and shaving in the direction of hair growth will help to prevent cuts. For men, antibacterial benzoyl peroxide shaving gel can be used. Permanent hair removal can also be attempted.

As the most likely factor is from bacterial infection, good hygiene measures such as hand-washing, not sharing towels/razors and showering after contact with likely bacteria surfaces helps prevent folliculitis. Not touching parts of body that have high staph bacteria such as the nose, armpit and perineum (area between anus and vulva/scrotum) can limit the spread of the bacteria to other parts of the body.

Folliculitis and Eczema

Children with eczema have a few factors to their disadvantage which make them more likely to get folliculitis. Of the causes of folliculitis, the one that most affect eczema patients is bacterial infection from staph bacteria.

  1. Eczema skin already have higher likelihood of bacterial colonization, of more than 50% chance.
  2. Most skin with staph bacteria won’t be harmed, however eczema skin is defective in its barrier protection, either from dry skin, ‘open’ skin from scratching and more permeable.
  3. Eczema patients are suspected to be less able to fight common bacteria, fungus, virus and yeast.
  4. The dry skin on eczema children is a more conducive environment for bacterial growth, compared to normal skin with natural oils.
  5. The toxin produced by Staph aureus bacteria worsens the eczema with triggering more hypersensitive reaction/inflammation.

It once again points to keeping bacteria count low, proper hygiene, keeping our children fresh and cool as preventive measures for our children. What is your experience? Do share in the comment!

Eczema Support Group – Wet Wrap for Kids

Wet Wrap session with Singapore Eczema Support Group

Wet Wrap session for kids with Singapore Eczema Support Group

Back by popular demand is another session on wet wrap, focusing on wet wrap for kids, including the younger ones. Another study had been released recently in July on the efficacy of wet wrap, citing a 71% reduction in symptoms out of the 72 children who took part in the study. Healthy skin is maintained one month after returning home with reduced reliance on medication. So the more reason to learn some wet wrap techniques!

30 August (Saturday) – Venue, National Skin Centre Singapore Room 401, 9.30 am to 11 am

The program:

1. 9.30 am to 9.45 am Introducing Ourselves over BREAKFAST – A warm-up for everyone, and food to get everyone awake. Feel free to bring your child, we have puzzles, coloring, balloon sculpture to keep your little ones occupied.

2. 9.45 am – 10.45 am Tubifast team will share on wet wraps for kids. They will give a presentation and have products available for you to see. From past sessions’ experience, it is not as easy to visualize your child and how to wrap, so you may just want to bring him/her along!

3. 10.45 – 11am Q&A time, so be prepared with your question!

Same note: No doctor present, so don’t expect to ‘Ask the Doc’. Information shared is not medical advice, please still see a doc. No selling anything or pretending to be a parent of eczema child and the session is for parents with eczema kids. Information on my blog is not pre-approved by NSC.

4. YOU MUST RSVP – It will then be possible for us to prepare breakfast and for the Tubifast team to prepare the relevant product. If you’re coming, please email me ([email protected]) your name, mobile and email, number of adults & kids (and age, so the right size wrap can be prepared for presentation) coming.

One last thing, the session would be ending on-time, so please don’t come late and expect it to drag, it won’t – simply cos I have to run! Look forward to seeing you! Mei

Life of Eczema Girl – Sleep is Married?

Sleep eczema co-sleeping and parenting!

I wonder if co-sleeping confuses kids!?!

Back by popular demand, this month’s cartoon all on sleep, co-sleep, suffering sleep, sacrificial sleep, whatever you call it! This is the 55th of my 2nd cartoon series, ‘LIFE OF AN ECZEMA GIRL’. For more cartoon in this series, check out hereIf you have a funny sleep story, drop me an email or a comment and I may just turn it into a cartoon!

Mom E-votional : Reset Button

cool seatIn life, there are certain moments when we Reset. For me, these are times when my daily routine is different, for instance, taking a long-haul flight where your morning and evening swap. Or being down with flu and having to rest at home. Typically, for these down times, I ask myself these few questions:

  1. Is all that I’m doing (the busyness, even fully justifiable and worthwhile activities) RIGHT?
  2. Do I need to change, add, reduce, refocus what I’ve been doing?
  3. Am I loving God, my family and my friends enough?
Taking care of an eczema child makes these questions even trickier. For one, we may be spending disproportionately amount of time doing any or all of the following:
  1. Monitoring + Saying + Shouting Stop Scratching
  2. Moisturizing
  3. Caring for Eczema Flare-ups

These are certainly things we have to do, but I think it’s not so much of the time and work involved but also the stress it creates. It may also prevent parents from evaluating their own life, their parenting and how they want family time to be different. Sadly, after spending so much time on skincare of eczema child + the stress that comes with it, parents are hardly in a ‘sane’ state of mind to reset. I pray that all parents get our down time and ‘me’ time to steer our life in the right direction.

Bible verse:

Psalm 25:5 Lead me in your truth and teach me, for you are the God of my salvation; for you I wait all the day long

God, every day our life as parent is very busy. Caring for eczema child comes with stress and lack of sleep. Help us to quieten our mind and lead us to grow and thrive in our life on earth.

Seek the Lord in our Resetting

Interview with Children Book authors of My Peace Place

My Peace Place's Book Tour Stop at EczemaBlues

My Peace Place’s Book Tour Stop at EczemaBlues

peace placeThis is a special interview with children book authors, Lori Bortnick and Mari Lumpkin, on their book My Peace Place. The book encourages children to find their ‘peace place’, especially in today’s high-strung world with busy schedules and much noise. I gladly agree to do a book review and interview Lori and Mari on EczemaBlues because eczema kids and parents have so much added stress in their life from managing eczema. Check out the book for tips on calming your child.

Mei’s Review of ‘My Peace Place’

The book is written by Lori Bortnick and Mari Lumpkin, illustrated by Natalia Buscaglia. The story itself fills up 15 pages of colored illustrations on various scenarios in a child’s life that create stress – for instance, being pushed in school or feeling ignored at home. The child then think of his peace place, where he can relax, breathe slowly and deeply and feel peaceful. The scenarios are realistic and thus offers parents a good chance to speak to the child on other similar stressors that may have happened in the day. It is easy to read for a preschooler who can definitely benefit from a parent’s participation in finding that peace place.

Apart from the story, the book also offers tips to parents as well as recommended yoga poses for the child. This is helpful as it further reinforces how stressful conditions are all around us and practical tips to calm ourselves. Overall, I enjoy the book and feel parents will find it helpful.

Interview with authors Lori and Mari

MarcieMom: Hi Lori and Mari, thanks for sharing with me your book. Can you share a little background on yourselves that lead you to focus on writing this book?

Lori: Thanks so much for having us and reviewing our book. I’m a preschool teacher and I love to help children think of ideas to have better lives. Lots of times, my children come to school sad about things they can’t control I think My Peace Place will help children gain a sense of control.

Mari: I’ve worked with children in many settings, usually as a literacy volunteer. I’m always amazed that people don’t see that much of the problem behavior we complain about our children exhibiting can be connected to their not having the tools to manage stress.

MarcieMom: At what age do you think children can benefit most from your book?

Lori: School aged children and kids in group situations.

Mari: I think children as young as three can benefit from the yoga poses and the deep breathing. I believe the ideas and techniques in the book could benefits everyone from age 3 to 103.

MarcieMom: If you were to write a follow-up to this book, what will you be focusing on?

Lori: How to bring peace to large groups. Once children learn to be peaceful in themselves, then they can learn to focus on reaching out and learn to find peaceful solutions in groups.

Mari: We’re also thinking of doing something about volunteering. That’s another healthy activity that releases people from their own worries and promotes peace.

Thank you both for sharing your book and this interview; it has been a pleasure and also a reminder to create peace in my home. One pet peeve that I believe in is de-cluttering the home because clutter equals noise in my mind!

Mari L Barnes writes for children under the pen name of Mari Lumpkin and for adults as ML Barnes. Her books, Parting River Jordan and Crossing River Jordan are proof that church can be funny. Mari’s company, Flying Turtle Publishing, specializes in books that families can share.

Lori Bortnick is an Illinois certified Early Educator with type 04 certification, a master’s degree in Teaching in Early Childhood and more 15 years of teaching experience in both private daycare and the public school system.

To see Flying Turtle Publishing’s Virtual Book Tour schedule and be entered to WIN a $10 Amazon Gift Card in our monthly drawing, click here.

Eczema Complications series – Molluscum Contagiosum

molluscum contagiosum eczema

Taken from cdc.gov (no direct permission obtained for use, but duly credited)
Link of picture directed to CDC website

This is a 4-topic series focused on complications from eczema and mainly inspired because my daughter recently had impetigo. Moreover, the potential complications from bacterial, viral and fungal infection are not very often emphasized yet a child with eczema is often vulnerable to infections. So let’s explore!

Molluscum Contagiosum (Virus)

Apart from molluscum contagiosum, the other common viral infection is eczema herpeticum. This eczema complications series will not include herpeticum because it has been covered in April 2012 post: Eczema Herpeticum – What is it and is it Dangerous? Eczema herpeticum is caused by the herpes simplex virus and eczema children’s skin (being defective) is more vulnerable to the penetration of the virus.

The other common viral infection in children is molluscum contagiosum, caused by the molluscum contagiosum virus, a family of the pox virus. It appears in clusters of small bumps (papules) in places such as armpit, face, neck, abdomen, groin, joints which are warm and moist. The papules may be pink, white or brown but often with a center hole and waxy/shiny look. The papules will later turn inflamed, crusted or into scabs. The extent of the molluscum varies – from mild with a few papules in most healthy children to extensive and last longer for children with eczema (study here) or low immunity (for instance, larger and more papules in HIV patients). In healthy children, the virus will stay on the skin and not circulate in the body therefore the virus leave the body with full resolution of the papules.

Spreading of Molluscum Contagiosum

Molluscum Contagiosum is spread by skin contact, for instance, taking shower or swim together (not clear whether the water spread the virus or contact with towels, surfaces at pool spread the virus). It can also be spread via bedding, toys, towels and clothes. In adults, it can be spread by sexual intercourse. Children (age 1-4, some reports show up to 12) living in tropical climate (warm, humid, crowded) have a higher risk of molluscum contatgiosum. The incubation period ranges from weeks to months. The recovery period on its own can take from 6 months to few years. It follows that if you are infected, to limit sharing of towels, toys and touching surfaces (bandaged the papules).

Treatment of Molluscum Contagiosum

Treatment can be hastened by pinching/ squeezing the molluscum lesions to express the soft white core. This is best done a few lesions at a time for children as it can be painful. The base is then treated with silver nitrate or mild sclerosing agent. Various medical treatment may include electrocautery, cryotherapy (freezing), curettage (cutting), laser, cantharidine, imiquimod cream or wart cream containing salicylic acid. There is no drug/ vaccine that kill the virus. Consultation for treatment should be about 3-4 weeks apart as certain molluscum may have been in incubation stage.

Although both the molluscum contagiosum and small pox are pox virus, they are distinctively different to our immune system and thus a smallpox vaccination does not prevent molluscum contagiosum.

Relationship with Eczema

It is almost like a double-whammy – children with eczema with defective skin barrier are more susceptible to molluscum contagiosum and after getting molluscum contagiosum, the eczema worsened PLUS the molluscum at the eczema area healed slower. Furthermore, molluscum contagiosum is likely to be more extensive in eczema children due to the scratching of the papules, followed by touching the rest of the body. There is also linkage between molluscum contagiosum and long-term use of glucocorticoids which are steroids such as prednisone, dexamethasone and hydrocortisone. Use of non-steroid cream such as topical immune-modulators (tacrolimus and pimecrolimus) have also been associated with molluscum contagiosum (here).

My take – a lot of the complications are possibly going to be linked to scratching, where infection and bacteria/virus spread from one part to another. Therefore, it always make sense to treat eczema and take steps to improve the skin barrier.

Have your child had molluscum contagiosum before? Share your experience and it may help another family, thanks!

 

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