This is a 4-part (a little more technical) series inspired by a review article “Features of childhood atopic dermatitis” by Hugo Van Bever and Genevieve Illanora. The article summarizes 4 players involved in atopic dermatitis, and I’ve tried to understand whatever I could from the article and other research papers published online and hopefully digested the information accurately for you to read.
What is Staph?
Staph is short for staphylococcus aureus, a very resilient bacteria found on the skin that can cause infection if it penetrates the skin. More than 90% of the people with eczema has staph versus less than 10% of people without eczema. Read more about staph bacteria on eczema skin in this interview with Dr Clay Cockerell, former president of American Academy of Dermatology.
One more reason not to scratch
Scratching gives a feel-good feeling to your child as written in this post, but it’s really bad. Scratching damages the skin barrier and makes it very easy for staph to penetrate. As written in the article “Features of childhood atopic dermatitis”, staph increases IgE production, activate native T-cells by its superantigens and damage skin by its proteases.
IgE are antibodies that catalyzed the protective cells of the immune system to lock on to the antigen, see this post on immune system). Superantigens are toxins released by staph, that causes skin inflammation. Staph also results in less protein that is used to fight infection.
How do you know if your child has Staph?
Children with eczema are prone to staph bacteria, so chances are very likely there is staph on the skin but it may or may not be visible in the form of skin inflammation. If there is honey-colored crusts, pus-filled blisters, red scaly patches, swelling that is warm to the touch or fever, it’s likely that staph has already caused skin infection.
So, how to get rid of the Staph bacteria?
Marcie’s doctor Prof Hugo Van Bever recommended using chlorhexidine before applying steroid cream for Marcie. I told him during the consultation that I only use chlorhexidine (antiseptic solution) when Marcie’s rashes is persistent and red (like in the picture). However, he said that the bacteria is not visible to human eye thus it’s a good practice to clean the skin before applying steroid.
I also read that some paediatrician recommended diluted bleach bath as the bleach can remove the bacteria from the skin. Prof Hugo recommended swimming for Marcie. The idea is that people with eczema typically suffers from bacteria colonization, so remove the bacteria first and if need be, apply steroid which is more effective without the bacteria (of course, moisturizing is a must).
For previous posts in this series, see
Update 2018: New antiseptic wash products such as Octenisan are now in the market, providing a more moisturizing wash option compared to chlorhexidine gluconate (which is drying).