Dr SEARS L.E.A.N. Series: Raising Healthy Kids through Healthy Lifestyle

Image from www.haydairies.com.sg – A Goat Farm in Singapore that Marcie loves to visit!

This is a fortnightly series focused on raising healthy children, following the advice on DrSearsLean.com. Marcie Mom came across Dr Sears’ Lifestyle-Exercise-Attitude-Nutrition approach for healthy families and found it to be practical and fun to follow. However, parents of eczema children may have reservation on certain healthy tips such as bringing their child for swimming (‘Lifestyle’) or eating fruits and vegetables (‘Nutrition’). This series examine if there’s truly a need to restrict eczema children from following the LEAN tips and take note of DrSearsLEAN’s recommendation at the end of each post!

Museums, Factory Tours, Animal Farms but Swimming?

There are many fun activities to do as a family and some of the Lifestyle tips on DrSearsLean.com are playing ‘I Spy’ in a museum, learning how things are made in a factory tour and visiting an ‘exotic animal farm’. Swimming is also listed and that includes having fun with balls and slides in water parks or leisure pools.  But many parents are worried about bringing their child with eczema to the pool, fearing that the chlorine in the swimming pool water may worsen the eczema. On the contrary, my baby’s doctor actually advised swimming three times a week but not more than 10 minutes each time. Of course, there are some do’s and don’ts to follow and particular to eczema children, be sure to shower them immediately and apply generous amount of moisturizer.

Swimming – A fun way to reduce bacteria on the skin

According to a factsheet from the National Eczema Society, chlorine is generally the least likely to cause skin irritation. In another of their factsheet, it is suggested that re-creating chlorinated swimming pool with a bleach bath can have positive anti-septic effects on the skin. In particular, eczema skin is susceptible to colonization of staphylococcus aureus bacteria that can cause infection if it penetrates the skin. More than 90% of the people with eczema have staph versus less than 10% of people without eczema. Swimming is therefore a fun way to reduce this bacteria and applying steroid will then be more effective (of course, moisturizing is a must).

DrSearsLEAN’s recommendation

Chlorine and other chemicals in water can sometimes be the cause of skin irritation and contribute to eczema in a small percentage of kids. Always bathe your child in clean fresh water after swimming and avoid using regular soap. Most regular soap, whether liquid or bar soap can cause dryness. A natural soap mixed with moisturizing lotion and free of perfumes will enhance skin moisture. These can be found in any drugstore or supermarket. Also avoid scented lotions and use PABA-free suntan lotion to protect their skin. Be sure to use a generous amount of moisturizer after bathing your child. The lotion helps seal in all the moisture gained from the bath to help control your child’s eczema.

Overall, swimming is a fun way to get your kids moving more! Plus, they are learning a life-long tool. It’s much easier to learn to swim when your child is young. Getting them used to the water helps them overcome fears and could be a life-saving tool  someday! When you take your children to the pool, remember to follow some safety tips to ensure a fun trip for both you and your child. Read more at http://www.drsearslean.com/resources/healthy-tips/drsearstips/summer-safety/#Pool%20Safety

MarcieMom: Thank you Dr. Sears for your recommendation. Next interview, we’ll continue to explore more Exercise Tips!

Do you dare to let your eczema child try a bleach bath?

A very cute winnie the pooh bathtub (from summerinfant.com)

Published in May 2009 Pediatrics Journal was the findings of a bleach bath study conducted on 31 children, aged 6 to 17 months, with moderate to severe eczema. The children had staph (see this post to learn about staph), which is a very resilient bacteria on the skin that can cause infection. Half the children were soaked 5 to 10 minutes in a bleach bath twice a week, while the other half in a placebo bath. The children who were soaked in the bleach bath showed decreased severity of eczema within 3 months. The diluted bleach bath act like a antiseptic, which can remove the bacteria. Before trying this on your own, do check with your baby’s doctor and also note the following:

1.      Dilute the bleach and don’t apply bleach directly onto skin. Bleach is an irritant to the skin, so do check with your doctor on the preparation of the bath. For the above study, it’s ¼ cup bleach diluted with 40 gallons of lukewarm water. The concentration of sodium hydrochlorite in the bleach should not be more than 6%.

2.      Rinse off the bleach, pat dry and moisturize generously within 3 minutes of the bath.

3.      The neck and head was not in the water for the study. It was published online though that the doctor of this study, Dr Amy Paller, suggested closing eyes and submerging head into the bath to clear the bacteria. I’m not sure about this as my baby Marcie keeps drinking her current oatmeal bath!

4.      A 14-day oral antibiotic was given at the same time during the study, and moisturizing too. This meant that bleach bath is not a standalone treatment (in fact, bleach can dry/irritate the skin, so do dilute and moisturize a lot).

5.      Bleach bath should not be used for cracked skin, and consult your doctor first (I know my baby’s doctor recommended swimming and chlorhexidine, which also serve to remove the staph bacteria).

My take is I don’t dare and won’t try bleach bath, since chlorhexidine (antiseptic) had worked for my baby. Swimming had also worked for her, even when we only brought her weekly (as opposed to her doctor’s advice to bring her 3 times/week). Do you dare to try the bleach bath on your child? If you have, do let us know how it went, thanks!

4-part series on What Causes Your Child’s Eczema – Staph

Eczema on neck – Bacteria colonization?

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.

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

Defective Skin Barrier

Allergy

Auto-Immunity

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