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News & Research

Eczema News – Child car seats – Home for House Dust Mites

House dust mites in child car seatsHouse dust mites is one of the most common allergen triggering eczema in older children. We often think of house dust mites residing on the bed sheets, pillows and mattresses. One often overlooked area is the child car seat. This team of researchers from Ireland studied the type and amount of allergens in the child car seats and (oops, add one more thing to your to-do chores) it turned out child car seats are quite loaded with dust mites and allergens. Here’s a quick look at the study.

Sample: Dust samples collected from 106 child car seats and driver seats

Results: 12 species of mites, of which nine are known to produce harmful allergens, were recorded from 212 dust samples. Over 80% of drivers’ seats and over 77% of child car seats had house dust mites and its allergens. Over 12% of driver seats and 15% of child car seats contained house dust mite levels sufficient to be risk factors for sensitization and allergic reactions. From the samples examined, the house dust mites were breeding (not dead).

What it means: For those with eczema, asthma and rhinitis, you’d have to add car seats to your list of items to clean. Especially if you spend long hours in the car, even more critical to vacuum your car seats regularly. Plus it is compulsory for your child to be in a child car seat for safety.

Why dust mites love car seats: The researchers pointed out that the materials of the car seats, being made of polyester and/or cotton, trap shed human skin and other organic matter (like food) that are the food sources of house dust mites.

Read also these posts for more on:

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News & Research

Eczema Research Focus Month – House Dust Mite

Removing House Dust Mite even when there's no sensitization improves eczema
Removing House Dust Mite even when there’s no sensitization improves eczema

The above is a cartoon from Life of Eczema Girl. In the cartoon, I shared that there is no need to do crazy cleaning if the child does not have an allergy to house dust mite. Now, I’m not sure if I have to take back my words as I’ve come across this study that concluded that higher indoor house dust mite worsens the skin of eczema children, whether or not they are sensitized to house dust mite. The main points of the study are:

1. 95 patients of average 23 month old

2. Indoor house dust mite levels associated with the severity of skin symptoms, especially in eczema children who are not sensitized to dust mite

3. Possibly due to house dust mite being an irritant instead of an allergen

4. Practical implication to reduce house dust mite levels

How often is your cleaning? Did more measures to reduce house dust mite improve your child’s eczema? Do comment!

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Guest Interview

Improving our Homes for Eczema Children – Minimizing Indoor Allergens (House Dust Mites, Mold, Cockroach)

Celia Imrey is an architect and co-founder of SpaceKit; she graduated from Yale University (Masters of Architecture) and Brown University (Bachelor of Art and Semiotics, Magna Cum Laude). She is an Associate at the American Institute of Architects and is a LEED (Leadership in Energy and Environmental Design Accredited Professional) Accredited Professional. She has taught architecture and art courses at Yale, Brown, Columbia/Barnard and NYU.

This was originally a two-part series combined into one informative post.

For parents with eczema children, it is very likely you’ve ‘scanned’ your homes looking for possible triggers of eczema flare-ups (I know I did!). Whilst most of us think about our bed sheets, our laundry and carpets, we may not think about the layout and materials of our homes.

MarcieMom: Hi Celia, it’s so good to have you share with us on improving our homes. It’s also the first time I’ve an architect as featured guest, so I’m excited for the fresh perspective your interview will give to readers of this blog.

Common Indoor Allergens

The common indoor allergens are dust mites, mold, pet dander and cockroaches (droppings). We will consider how we can improve our home environment to minimize indoor allergen. Let’s start with the dreaded, all pervasive dust mites!

Dust Mites – Eczema Trigger for Children

Dust mite is a very common trigger of eczema for children, and more of it can be read in this post. They thrive in room temperature, humid environment and feeds on our dead skin. There are different allergens within the dust mite dropping, and they vary in particle size which renders some airborne while others tend to stay on surfaces. It may trigger different allergic conditions and symptoms for different ones in your family, depending in part, whether their airways or their skin is sensitized to the allergen.

Measures to reduce house dust mites are listed here, and they include removing carpets and stuff toys, washing in above 60 degC water and getting dust mite covers.

MarcieMom: Let’s suppose we are not changing where we live, but able to change our room layout and materials we use (ie major renovation):

Reducing Dust Mite through Home Design

Do the materials which we use for our floor, and for our walls, make a difference?

For instance, will certain wall materials or paint or finishing increase the surfaces for dust mites to live while others make it more difficult for them to thrive?

Celia: At Space Kit, we recommend using natural materials where possible, especially for carpets. Dust mites take refuge in carpets but can’t live on hard surfaces like wood floors or plastic. Wherever you have carpets or rugs, use wool. The natural lanolin in wool repels dust mites.  Paint does not affect dust mites that we know.

The natural lanolin in wool repels dust mites. 

How Home Design Affect Humidity & Dust Mite Growth

Is there a way to manage the humidity of our home?

Both in the overall sense, meaning to reduce trapping moisture in our home; and also particular to the child’s bedroom, should it be say further away from the bathroom or have windows positioned a certain area (or if windows can’t be moved, for the bed to be positioned differently)?

Celia: Proper natural and mechanical ventilation are essential for healthy living, especially in bathrooms, kitchens and laundry areas. A well designed home takes air circulation (and thus temperature and humidity) into account; there is directionality to air circulation, and Mechanical Spaces (where air handling equipment are) are designed in relation to the spaces they serve in order to maximize air circulation and minimize dead air pockets. Humid conditions can be countered using air conditioning and ensuring that windows are fully sealed when closed. Furniture placement near humid areas will encourage mites.

Humid conditions can be countered using air conditioning and ensuring that windows are fully sealed when closed.

Designing a Home to be Cool without Drying Child’s Skin

MarcieMom: For a child with eczema, like mine, needs to be kept cool and so sleeps in air-conditioned room. As the air-con dries the air, I actually have a humidifier on. The risk of a humidifier is of course it promotes the growth of dust mites and mold.

Do you have a solution to keeping the room cool, without making it dry or too moist?

Celia: You could cool the air before having your child sleep in the room. This will minimize the amount of time the child sleeps in dry air.  You could use the smaller, directional humidifiers to provide humid air only to the pillow area and then remove and treat the linens each day. It’s a lot of changing sheets but very hot water kills mites immediately, so regular laundering should be part of your solution if you use a humidifier.

Sunlight and Ventilation in Child’s Room Design

MarcieMom: Sunning and ventilation helps to remove dust mites.

What factors should we consider so that our bedroom can have sufficient sunlight and ventilation?

Celia: We love sunning and ventilation at Space Kit too! Light materials and paint colors help bounce light around. For bedrooms, use window treatment that provides sufficient privacy when open.  If you like sleeping in a dark space but have a privacy issue, you will need two kinds of window treatment, one for darkening the room and one for providing privacy while letting light (and some air) in.  Quality window treatment that is easy to use is critical.  You need to be able to operate it or pull back the curtains with a simple hook or tie.  Ease of use encourages you to use your windows to live in a healthier manner.

Mold, Another Common Eczema Trigger

Mold is another common indoor allergen and more of it can be read from CDC. Like house dust mite, they thrive in room temperature and humid environment. Their feeds include materials like wood, leather, dead skin and cotton and wool fibres. Mold spores are airborne and trigger symptoms and conditions such as watery eyes, sore throat, respiratory issues, nasal congestion, eczema and even asthma. Minimizing mold growth can be via control of temperature, control of humidity and reducing their food.

Choice of Home Materials on Mold

MarcieMom: As I’m preparing for this, I’m surprised to learn that many building materials are food sources for mold, including wallpaper glue, greases, paper, textiles and wood. 

Do you have suggested common materials to use for our walls and floors, and in our bathroom, so that there is less food for the mold?

Celia: Solutions that resist mold are a fundamental part of Space Kit’s designs. There are many design considerations to make with regard to moisture. Good designs don’t leak, cause condensation, or trap moisture. Some options include using good quality door seals and gaskets for shower doors. Usage of moisture and mold resistant backer boards and vapour barriers.

Are there other areas in our home that traps moisture easily and what can we do about them (both during renovation and on maintenance basis)? 

I’ve read that certain paints, leaks, damp basements, poor drainage or plumping traps moisture, and also condensation on cool surfaces can increase mold.

Celia: Basically mold feeds on untreated, natural surfaces. Space Kit promotes the use of natural materials, like stone, ceramics, plaster and wood and we advocate finishing them properly. For example, wood is a beautiful home material, especially for floors, but it needs to be finished properly, so use varnishes, stains, paints, and fill all the cracks. In using any natural material, make sure all the surfaces are coated and maintained.  Wool carpets are dyed and the dye is bound with a sealer. If you keep carpets clean and off any floors that have moisture issues like concrete floors in a basement, they should not feed mold. Space Kit’s window treatments use materials that hinder mold, like synthetic materials. For bathrooms, we recommend tiling the full walls.

Note: be vigilant about spotting mold: undersides of tables, on ceilings, etc. and treat immediately before it spreads.

What about the selection of cabinets, walls, wall coverings, bookshelves and also the positioning of furniture? Do these affect mold growth?

Celia: None of these affect mold growth if there if proper air circulation.

Bathroom Design on Mold Growth

MarcieMom: My guess on the common area in our homes where mold thrive is the bathroom where it is often damp. 

What are your recommendations to minimize mold in bathroom?

Celia: Our designs are intended to minimize moisture retention, for example, we like glass shower doors (with systematic wipe-down after showering) instead of curtains. Proper ventilation for bathrooms and dryers is critical.

Cockroach – The Yucky Eczema Trigger

Cockroach, more precisely the allergens found in their droppings, saliva and bodies, is another common indoor allergen. From the AAFA website, it is mentioned that When one roach is seen in the basement or kitchen, it is safe to assume that at least 800 roaches are hidden under the kitchen sink, in closets and the like’.

Cockroaches thrive in warm and humid environment, and they feed on our food (thrash, scraps, starch) and water. The particle sizes of cockroach allergen are large and tend to settle on surfaces. They not only worsen allergic conditions, but carry bacteria.  Symptoms or conditions of allergy to cockroach may be itchy eyes, itchy skin, eczema rashes, nasal congestion, asthma and allergic rhinitis. Minimizing the growth of cockroach can be done by observing hygiene and minimizing their food source, water and shelter.

Prevalence of Cockroach Allergen in Dust

In a study published in the New England Journal of Medicine, of the children in the study, “36.8 percent were allergic to cockroach allergen, 34.9 percent to dust-mite allergen, and 22.7 percent to cat allergen. Among the children’s bedrooms, 50.2 percent had high levels of cockroach allergen in dust, 9.7 percent had high levels of dust-mite allergen, and 12.6 percent had high levels of cat allergen”.

I understand that cockroaches hide outside the home, what are the possible areas in our home to ‘seal off’ cockroaches?

Celia: Sealing the hole around the steam pipe and sealing the hole around all plumbing and electrical pipes. Also, you can utilize drain covers to prevent critters from entering up into your home through showers and sinks.

MarcieMom: Chemicals may trigger irritation either in airway or skin for young children. It is best, therefore, to use cockroach trap. This may sound strange, but is there a need to plan ahead where cockroach traps should be placed?

Celia: If proper preventive measures are appropriately taken such as sealing of holes and cracks, then there is no need to plan for precautions.

Safe Chemicals at Home for Children

MarcieMom: While we’re on the topic of chemicals, which are the materials you would commonly recommend that are safe for young children, and for how long would ‘airing’ be required before the family moves into the home?

Celia: Materials with zero or low VOC content are recommended for children and adults. It is best to move in after all the fumes from the paint have disappeared (i.e. that are no off gassing smells) and the home is dust free.

MarcieMom: Thank you so much Celia for helping us improve our homes and minimize the indoor allergens, right from the renovation stage!

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Doctor Q&A Support Group

Sharing Treatment for Eczema Children

Eczema Treatment for Children Dr Lynn Chiam dermatologist Singapore
Elomet ointment

Last Friday’s eczema support group session with Dr Lynn Chiam was a fruitful one – the topic was Treatment for Kids’ Eczema and we had pizza and chicken wings for lunch at the National Skin Centre Singapore!
Dr Lynn is a consultant dermatologist who subspecializes in paediatric skin conditions at Mount Elizabeth Novena Specialist Medical Centre, Children & Adult Skin Hair Laser Clinic, Singapore.

Eczema Tips for Children

1. Moisturizing within 3 Minutes After Shower

This is inline with Dr Jennifer Shu’s tip here, so it appears that it’s an international recommended practice. Dr Lynn shared that should it be difficult to do so, or if skin is still dry, wet wrap can be implemented. For practical purpose, should the child not be able to tolerate wet wrap overnight, instead implement at least an hour, 5 times a week. Even a dry wrap will retain moisturizer better for the skin.

2. Removing House Dust Mite (if it is an allergen for your child)

Dust mite can be killed either by extreme cold or heat – so wash bedsheet in at least 60 deg C water (read this post) and for stuff toys, freezing them may help decrease the amount of dust mite as they are affected by extremes of temperature. Dr Lynn recommended sunning mattresses and changing mattress once per year, i.e. don’t get a thick and very expensive one. Remove carpets.

3. Use of Topical Steroid – Don’t be Steroid-Phobia

I shared that there is a lot of fear out there among parents on using even the mildest steroid cream, and I’ve heard of increasing number of children hospitalized for infections due to fear of using steroid. Read more here on ‘Is Steroid Cream Safe?’. Dr Lynn explained 4 side effects of topical steroid (i) skin thinning (ii) easy bruising, (iii) fragile blood vessels and (iv) excessive hair growth. However, these can be avoided if patients ensure they use (1) the right steroid (2) at the right part of skin and (3) for the right amount of time. 

Topical Corticosteroid Withdrawal Children

Read this interview with Professor Hugo where we go through the review paper conducted by National Eczema Association on Topical Corticosteroid Withdrawal

For anyone who emailed me (and we’re talking many!) who ask if steroid cream is safe because they’ve read about the side effects (which further reinforces FEAR spread like FIRE), you know my reply is the side effects of MISUSE should not be confused with Right Use. There are also many who have an agenda for propagating fear – to sell a steroid-alternative. Again, there is no need to use one and not the other. You can use steroid safely to treat flare-ups and skin inflammation, while at the same time, moisturize, wet wrap, have healthy diet, healthy lifestyle, distract your child, protect their skin, covering their fingers..


Side effects of MISUSE should not be confused with Right Use

Dr Lynn shared that steroid treatment should be used pro-actively, to treat skin inflammation even after the rash disappear, and this is also consistent with what Dr Bridgett shared in this post. Protopic can be used for maintenance, and I’ve clarified with Dr Lynn that the stinging sensation that some experienced with Protopic will not be manifest as rashes. For more on Protopic, see here.

4. On Oral Steroid

This is usually a treatment for severe active cases, not lightly prescribed due to its side effects of osteoporosis, stunting growth and increased vulnerability to infection. Tomorrow’s post is on prednisolone, and you can also refer to previous post on cyclosporine.

5. This is my afterthought – Don’t Jump from Fear to Fire

I’ve shared earlier that Fears spreads like Fire, and I like to remind parents not to jump from fear into fire – for instance:

Is someone telling you not to use steroid but something natural? If so, do ask them and search Pubmed for studies. I’m not against natural and I’m not against any parent wanting to try something natural. Do check 1. It’s safe to consume/apply, 2. Keep up the standard treatment.

Is someone telling you that a steroid cream is not working and that the flare is caused by it? Think back – did your child have rashes before the steroid? and Dr Lynn shared that each steroid cream has its own molecular structure, suited for different purpose. You may wish to work with your doctor on another cream.

Is someone telling you their skin recovers after doing a,b,c and d? Ask them, did they do a,b,c and d while applying the steroid?

Is your doctor (I really hope not) telling you that established clinically trialed cream is no good and their own concoction is better? I do not know if it is/not, how would anyone know if it’s kept a secret, even without a medical name. If it doesn’t work for your child, it’d be impossible for the next doctor to understand what your child has been prescribed and how the skin reacted.

This is a very long summary of the discussion. But as you can see, I’m really AGAINST people who spread fear of steroid – again, I’m not saying steroid is the only way, I’m saying it has its place and fear shouldn’t be propagated for personal means.

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Doctor Q&A

Friday Dr Q&A with Dr Liew – Managing Allergy & Eczema at Childcare

Dr Liew is a pediatrician who practices at the SBCC Baby & Child Clinic, Gleneagles Hospital Singapore and is also a visiting consultant to KK Hospital. He subspecialises in allergy, immunology and rheumatology. He was also awarded several research grants to pursue clinical research in paediatric anaphylaxis, drug allergy, primary immunodeficiencies and Kawasaki disease.

Managing Allergy for Eczema Kids Dr Liew Woei Kang

This was an original four posts of Friday Q&A, combined into one more informative post. MarcieMom contacted Dr Liew on setting up an eczema fund in Singapore and subsequently collaborated on this Q&A.

Childcare for Allergy Kids

MarcieMom: Suppose a child who has an allergy has to have alternative care-giver, say at child care centre.

What would you recommend a parent to share with the childcare?

Dr Liew: Your allergist should be able to advice what the caregivers be taught. Written action plans for eczema are useful for daily skin care instructions, whilst food allergy/anaphylaxis action plans provide information on treatment in emergencies. There is continued public education regarding allergic conditions via hospitals and societies like AAA.

Food Allergy in Childcare

How should a parent besides obviously telling the teachers/ care-givers of the allergy, help to make it easier for the school to prevent contact with the food? 

For instance, is there a need to warrant 0% contact, for instance, the whole school shouldn’t even bring the food in?

Dr Liew: After a diagnosis of food allergy, it would be important to relay the importance of food avoidance and emergency care plans with the care-givers. Written food allergy/anaphylaxis plans are useful. The degree of strict avoidance varies accordingly to the food allergen and severity of allergic reaction. It would be better to discuss specific advice with your allergist.

Non-Food Allergens

What are the common non-food allergens?

And if it’s dust mite, how can a parent tell the school to keep the dust mite level low since house dust mite is something that can’t be totally eliminated? And if it’s dog droppings allergy, should a parent not even sign up a child care centre where teachers or even classmates have dogs at home? For common skin allergen like soaps and detergents, should a parent go as far as to monitor what detergent the child care centre or caregiver is using? (And the bigger question is – how can a child care centre with 70+ kids cope with so ‘many requests’ of a parent?)

Dr Liew: The most common environmental allergen is house dust mites in Singapore. House dust mite avoidance measures are useful to reduce the levels of protein, but results variable. I would not recommend schools to implement house dust mite avoidance measures as they are time-consuming and difficult to implement in the long term. Dog sensitisation is usually to the hair epithelia, rather than poo, and is not common in Singapore. Irritants like harsh soaps and detergents should be avoided in children with eczema and dry skin. It may be helpful to provide the school with your child’s soap substitute and moisturisers, and get the teachers assistance for application.

Allergic Reactions in Kids

How can a parent recognize an allergic reaction and more importantly, which are the symptoms that are signs of serious reaction such as anaphylaxis?

Mild to moderate allergic reaction include:

• Swelling of lips, face, eyes

• Hives or welts

• Tingling mouth

• Abdominal pain, vomiting

Antihistamines usually suffice.

Severe allergic reaction (anaphylaxis) include:

• Difficult/noisy breathing

• Swelling of tongue

• Swelling/tightness in throat

• Difficulty talking and/or hoarse voice

• Wheeze or persistent cough

• Persistent dizziness or collapse

• Pale and floppy (young children)

Epi-pens at Childcare

When should a parent prepare an epi-pen and how can the parent teach the child and the alternative care-giver on when an epi-pen is to be used?

Epipen should be administered for severe reactions. A written anaphylaxis plan should be provided with pictorial reminders on how to administer an epipen.

Outdoor Allergens

What are some common outdoor allergens in Singapore?

For instance, to certain type of trees or to certain pollen? Pollen counts are usually higher in the morning and on a warm, windy day versus just after a rain. Many places in Singapore are air-conditioned, is this better or worse off for a child with dust mite, pollen or certain allergy?

Dr Liew: Outdoor aeroallergens include tree pollen (Oil palm tree pollen is commonest), grass pollen are common in temperate countries with seasons, but is uncommon in Singapore. Air-conditioning is better tolerated for eczema patients but can worsen an allergic rhinitis. The impact on specific allergens are not great except moulds, as they may grow in poorly maintained air-conditioning units.

Air-conditioning is better tolerated for eczema patients but can worsen an allergic rhinitis.

Mold & Indoor Allergens

MarcieMom: Mold is another allergen and lots seem to be growing in my home!

If a child is allergic to mold, what steps should a parent take?

Also, for allergies like cockroach droppings, does it mean that the parent must diligently hunt for all droppings in corners of the home and remove them?

Dr Liew: Steps to reduce mould in the environment include a well-ventilated room, and if air-conditioning is used, frequent maintenance of the AC unit. Pest control measures are best for cockcroach sensitisation, as cockroaches often “roam” around and leave traces of protein.

Vaccines and Allergy

MarcieMom: On vaccines, there is so much discussion out there where even doctors are coming out to say that vaccines are unnecessary and pharmaceutical companies are coming up with more and more vaccines that are unnecessary and even harmful for our children. Some parents may be opting their child out of vaccines due to egg protein included in some of the vaccines.

What’s your recommendation on this and when should a parent seriously questions a vaccine before letting his/her child have it?

Dr Liew: Vaccines are the one of the proven public health measures to reduce mortality from infectious diseases. Vaccines are produced for significant infectious diseases. There is no link between vaccination and allergies. Traces of egg proteins can be found in influenza vaccines and specialised vaccines like yellow fever. Egg allergic patients should discuss the risk benefit ratios of receiving these vaccines. MMR vaccines are safe for egg allergic patients.

Antibiotics

MarcieMom: On antibiotics, I’ve read online that antibiotics are mostly unnecessary since they are only effective against bacteria yet it is so common for general practitioners to prescribe antibiotics! (in fact, I always have to refuse the prescription because it’s just a common flu!) Antibiotics are also known to cause allergic reaction, what would be your recommendation?

Dr Liew: Antibiotics should only be prescribed for bacterial infections.

Cross-Reactions

MarcieMom: On cross-reaction, it’s commonly heard of when a child is allergic to birch pollen, he/she is also allergic to apple. Or a child who is allergic to latex is also allergic to kiwi.

Can such allergy be identified by allergy tests?

Also, what are some of the common allergies that you can point our parents to, so that they are aware if their child is allergic to one thing, they should probably avoid something else.

Dr Liew: Cross-reactive allergens occur due to the similarity of one protein to another, usually within the same botany taxonomy. They can be easily tested by skin prick test or blood IgE testing. A good example would be most cow’s milk allergic patients are allergic to goat’s milk as there is an approximately 95% similarity between the two.

MarcieMom: Thank you Dr Liew, it’s such a great pleasure to have you explaining all these allergy questions that many parents have, we are all so grateful!

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Eczema Facts

Should you be Worried about House Dust Mite (HDM) for your Eczema Child?

House Dust Mite (picture from dust-mite.net)

House dust mites are tiny insects, about 0.03mm long, look scary under a microscope but too small to be seen by us. They are definitely in our homes as house dust mites, or HDM, love room temperature (18 deg C to 26 deg C/65 to 80 deg F), humid (above 55%) homes where there are plenty of shed human skin for food. HDM feed on our dead skin, fingernails, hair, animal fur, bacteria, fungi and pollen. In your home, they are likely to be on the bed, mattress, carpets, upholstered furniture and curtains. There is no way to have zero dust mite in your home, but you can reduce their quantity by making the environment less favorable for them. It takes a lot of effort to keep the dust mites away, so we should understand a little bit more before killing ourselves with the cleaning.

How does house dust mite affect your eczema child?

First things first, get your child tested. A skin prick test will show if your child is allergic to the droppings of the house dust mite. It’s the protein in the droppings that is the allergen, and not every eczema child will be allergic to HDM (my baby Marcie isn’t) though patients with eczema could be more susceptible to dust mite allergy (taken from “Specific profiles of house dust mite sensitization in children with asthma and in children with eczema” article in Pediatric Allergy and Immunology 2010). It was also written in the same article that those with eczema by 3 months old is more likely to be sensitized to aeroallergen by 5 years old. Also, the more severe the eczema, the greater the sensitization to HDM. In the article, it is noted that the major HDM allergen for eczema patients is Der p1 of D.pteronyssinus, which is a large particle that don’t stay airborne but quickly land on surface, including on the skin. For eczema children with defective skin barrier, the allergen can penetrate the skin more easily to trigger itchiness.

How to reduce house dust mite?

If your child is tested allergic or get asthma attack from inhaling the HDM allergen, then there’s little choice but to get rid of as much dust (and the dust mite dropping trapped in the dust) as possible. Here’re a few ways to keep the dust mites away:

1.      Remove carpets, thick curtains, thick mattress, upholstered furniture (think plastic, wood, leather, vinyl).

2.      Get dust mite proof covers for the pillows and mattresses.

3.      Wash bed sheet, pillow cases weekly at temperature of above 60 deg C (you can see my washing machine here, I steam wash everything).

4.      Wipe your home with wet cloth, instead of dry dusting from one area to the air (finally, there’s some support for what I love to do, using a wet kitchen towel to clean everything).

5.      If vacuuming, get a vacuum cleaner with a good filter that does not release small particle in the exhaust; I borrow my friend’s $3000 vacuum cleaner twice a year to vacuum mattress; but if your child has asthma, then the mattress needs to be vacuum weekly. (Dust mite can burrow deep into the mattress and will be hard to vacuum away if the mattress is thick.)

6.      Ventilate room; this will reduce stale humid air trapped in the room, and let the sun in (think less cosy for the dust mite).

7.      No soft toys; if your child absolutely can’t do without them, try freezing the soft toys in plastic bag for 24 hours in the freezer to kill the dust mite, followed by washing away the dead mites and droppings in the washing machine.

8.      Reduce humidity, but too dry environment is bad for eczema, read this post on humidifier and air-con.

9.      Reduce ornaments, dried flowers, books, textured wallpapers; the less surface for dust to land on, the better.

Save your money on these:

1.      Don’t buy mite killing sprays which may be an irritant; likewise, for ionizers.

2.      Don’t buy air filters because the air filter may stir up air, making it longer for the dust to settle (which increases risk for asthma children as the HDM allergen stays airborne). Or air filter may end up filtering only the air near to the filter.

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101 things that Mothers with Eczema Child do Differently

5 of the 101 things that Moms with Eczema Child do Differently – Squeaky Cleaning

Cleaning and more cleaning!

A gentle note to all moms of eczema and allergy kids, especially those with an allergy to dust mites, don’t kill yourself over the cleaning… as advised by Prof Hugo Van Bever at sneezywheezy.com’s playgroup on Aug 24th, a thin bamboo mattress is best and sunning the pillows and mattress regularly helps to reduce dust mites. Don’t spend too much money on vacuum cleaners, make the home as less attractive for dust mite as possible by not having thick beds or thick curtains. Btw, construction dust is not dust mite as dust mite has to live around people.

This is the fifth of my “101 Things that Moms with Eczema Child Do Differently“, a tongue-in-cheek look at the many unique situations that we face. For more cartoons, click here to view.