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Support Group

Will daycare help protect your eczema child from allergy and asthma?

Allergic March – Starting with Eczema

I believe all parents with eczema children struggled with sending their children to daycare. I know I did, when I sent my baby girl Marcie to daycare when she’s 11 months old. Apart from worrying that daycare teachers can’t take care of her, given the constant scratching and attention required, I also worry that she will fall sick more often, resulting in asthma. Are these worries valid?

There is no conclusive research on daycare’s protection against nor causing allergy and asthma. As far as I gather, various studies’ conclusion are mixed as below:

1. A German study reviewed 3,097 children from birth to 6 years old and noted that children who attended daycare in the first two years also had more chances of eczema. This was from tracking children in East versus West Germany, as 52% of children attended daycare in the East versus only 6% in the West.

2. Another study showed that children who attended daycare early (between 6 to 12 months) had lower allergy antibodies, meaning less likely to develop food or nasal allergy. However, there was a higher incidence of respiratory tract infection, i.e. more wheezing.

3. Another study showed that children who attended daycare early were 75% less likely to develop asthma by 5 years old. However, if daycare was started after the child turned 2 years old, there were 3 times more allergy problems.

4. Another study showed that by 8 years old, daycare or no daycare had no impact on allergy/asthma.

How do we decide on daycare’s impact on allergic march when we still don’t know the cause? Based on the 4-part series, you’ll see that there is no one clear cause of eczema. If it’s the skin barrier, then you may decide to take care of your child yourself to make 100% sure that her skin is protected by moisturizing. If it’s the immune system, you may hope that sending your child to daycare will strengthen her immunity (though as you see above, there’s no conclusion). Moreover, eczema is a skin condition with multiple factors influencing the outcome, so it is hard to isolate a single cause to focus on.

So what do you base the daycare decision on? Personally, I don’t base it on impact on allergy/asthma. I base it on other factors, like whether she’s taken care of at the daycare, whether they pay attention to moisturizing and disinfecting her skin, whether I want or need to go back to work. The allergic march, which is the progression from eczema, to allergy and asthma, is also dependent on the severity of eczema (the more severe, the more likely to have allergy/asthma) and the whether the child has both eczema and allergy (then more likely to have asthma).

I know.. tough letting someone else take care of our eczema children, wondering if she scratches more, stresses more (which trigger more scratching) because someone else is taking care of them.

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101 things that Mothers with Eczema Child do Differently

13 of the 101 things that Moms with Eczema Child do Differently – Challenging Bedtime

I actually wish morning will come sooner…

This is the thirteenth 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.

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Support Group

Weaning off Eczema Baby from Co-Sleeping

Baby Marcie thought the cot is a fun place to walk around -> Baby Marcie found out that she’s staying in the cot for the night

 2 hours later, at 1 a.m.

My hubby was comforting Marcie, while I pretended to be dead -> Finally, out of exhaustion, everyone’s asleep

Hi! Last night was such a major milestone that I had to update you all; my baby Marcie spent the first night sleeping by herself in her cot! If you’ve seen my previous posts (here and here), you’d know that I’ve been co-sleeping with my baby. But for the past month, I’ve had a bad cough and Marcie sleeping on me made it worse. Last night, we cleared the clutter in her cot, vacuumed her mattress and resolved to regain our bodies (and sanity) at night.

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Other treatments

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%. Learn more about bleach bath and its effect on skin pH in interview with dermatologist Cheryl Lee MD

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 octenisan (2018 update: a more moisturizing antiseptic wash alternative chlorhexidine), which also serve to remove the staph bacteria).

2014 update: Read my interview with Dr Cheryl Lee on eczema skin and pH (including a Q&A on bleach bath)

2015 update: Read my interview with Dr Lawrence F Eichenfield (in collaboration with American Academy of Dermatology) on eczema bleach bath

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!

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Support Group

Join me for Coffee Club Breakfast on 19 Nov, 10am

Coffee Club, Raffles Place branch

It’s time for our 2nd support group meeting and it’s scheduled on 19 Nov 2011 (Saturday), 10-11am at Coffee Club, Raffles Place branch (see pictures on left). I’ll be there with my hubby and baby and I’ll have 10 sticker packs to giveaway for the first 10 families who turn up. Appreciate if you RSVP by 17 Nov to mommarcie[at]gmail.com, so that I can make reservation and we can sit together. See you!

Coffee Club Breakfast Meeting:

Date – 19 Nov (Saturday); Time – 10 to 11am (breakfast ends at 11am)

Venue – No. 7 Raffles Place, Singapore (If you’re taking MRT, just exit to the ground level and find the stand-alone coffee club outlet, next to The Arcade.)

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101 things that Mothers with Eczema Child do Differently

12 of the 101 things that Moms with Eczema Child do Differently – Beach Dreaming

The Sun, the Sea…places where eczema child may be sensitive to

p.s. noticed that in my dream, I’m slim and wearing shades – both which I’m not and can’t in reality. Reality – Co-sleeping with my child, getting fat.

This is the twelveth 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.

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Eczema Facts

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. 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

Defective Skin Barrier

Allergy

Auto-Immunity

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).

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101 things that Mothers with Eczema Child do Differently

11 of the 101 things that Moms with Eczema Child do Differently – Most Common Question

It is NOT “Honey, Do You Love Me?”

This is the eleventh 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.

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Guest Interview

ScratchMeNot – A PTPA Winning Product for Eczema Children

Andrea Thomas, the mom behind the company Short Stacks that makes the PTPA (parent tested, parent approved) winning product, ScratchMeNot, talks to Marcie Mom at eczemablues.com about her passion and mompreneur journey. ScratchMeNot is an eczema clothing innovation that Andrea created to help prevent her daughter from scratching, and has since grown into a thriving business.

Marcie Mom: Hi Andrea, we know that you first created ScratchMeNot to prevent your daughter who has eczema from scratching. What motivated you to decide to make ScratchMeNot for sale?
Andrea: Yes, I first created ScratchMeNots for my daughter who was scratching non-stop! Before she was born, I knew very little about eczema so I was blindly searching for anything to help her. There seemed to be an endless supply of creams and ointments available, however I needed something for the immediate act of scratching. I went to brick and mortar stores & I googled like CRAZY to find anything to stop the itching. I tried the tradition baby mittens, but they did not solve the problem, as my daughter would rub or pull them off. Not being able to find a product out there to fit our needs, I decided to create my own, that would help my daughter immediately. Since I had such a hard time finding the right product, I thought maybe other parents were too. ScratchMeNots followed soon after, a product that is an all day solution for a scratching child’s needs.

Marcie Mom: Tell us more about your passion. Were you already into sewing before making ScratchMeNot?
Andrea: To be honest, the most experience I had in sewing, before ScratchMeNots were a pillow and a pot holder! Thankfully, I knew a friend who had the time, energy, and great skills to help me bring my visions to life. She taught me how to sew beyond pot holders. It was exciting to go from a thought to a finished product. It’s amazing how much parents can learn, when the driving force is meeting a need that allows their children to feel better, and helps other parents at the same time.

Marcie Mom: How do you find time to make the product, sell the product, manage a business and parent your children?
Andrea: Thankfully, we have a manufacturer that I work closely with to create our ScratchMeNot inventory. This is a great help to free up more time for me to focus on managing Short Stacks, family, and parenting! It is not easy to balance working from home, while my little one is here with me needing my attention. I’ve learned to plan ahead, to create a schedule, and to stick to it. Each portion of my day is dedicated to specific tasks, learning and/or quality time. I’m still trying to master our routine! A lot of work usually occurs early in the morning and late at night. It is challenging, but it’s worth every moment. I have learned to accept that everything I planned to do might not get done, and that’s okay. I also have come to understand the importance of networking with other companies that have an expertise in areas that I don’t. Especially with other moms, it helps all of our companies succeed!

Marcie Mom: Thanks Andrea, and we certainly look forward to more products from your store! p.s. To readers of eczemablues.com, I asked Andrea for the interview because some of you have feedback to me that ScratchMeNot works for your child. I did not receive any money from Andrea or Short Stacks for this interview.

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Eczema Facts

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

How the Immune System works

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.

Attacking the Organ to Protect

Another possible cause of eczema is that the immune system has wrongly identified the organ it is meant to protect as an enemy to attack. Here are the basic steps on how the immune system works:

1st: The foreign substance (antigen) that invades the body is detected by a group of cells known as the B lymphocytes. B cells are specialized proteins that lock onto the antigen (but cannot destroy them).

2nd: The B cells continue to exist in the body, which helps to prevent the body from being invaded by the same antigen.

3rd: T lymphocytes are also produced to destroy the antigen, that have been locked by the B cells.

Higher level of antibodies have been found where the eczema is more severe. It is possible that scratching aggravates the immune response by stimulating a greater release of proteins (specifically the IL-21 protein that regulates the T cells) which scientists have found to be present in inflamed skin. Thus, scientists are exploring whether by manipulating the IL-21 protein, the amount of T cells can be regulated so that the immune system will not attack the skin incorrectly (click here to read more).

But why is the immune system not working as it should?

There is no answer yet, though the hygiene hypothesis is that our environment being too cleaned now (with everyone using anti-bacterial wipes and cleaning much more with chemicals) has deprived our immune system of the chance to practice working on the antigens, leading it to work on harmless substance. However, if your child is already known to be allergic to say dust mites, then the accepted action is to minimize the dust mites rather than purposely not cleaning your home.

Update on 10 Dec 2016: Came across this study by the bioengineering team at Imperial College:

The team’s model showed that repeated flare-ups of AD trigger an immune system overreaction in the body, and when triggered this can’t be reversed. This creates a cycle where the threshold for triggering further AD outbreaks becomes lower, the flare-ups are more severe, and the condition progresses to becoming long-term. Severe flare-ups happen as a result of the complex interactions between the body’s immune system, the skin’s protective barrier, and environmental factors such as stress.

The press release of the study by Imperial College here.

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101 things that Mothers with Eczema Child do Differently

10 of the 101 things that Moms with Eczema Child do Differently – No Time for Affection

Something I never do, but wish I do more often

I’m guilty of this – Not having the time, not having the mood, getting too pre-occupied with my baby and her eczema and the housework to display affection to my hubby. I created this design for my friend for her marriage vow and this picture of enjoying a drink with my hubby and soaking in his love suddenly hit me today, because I never do it. Parents with eczema children have a tougher time, I’ve even written a post on it here, but maybe you shouldn’t read but take the few seconds to give your spouse a hug!

This is the tenth 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.

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Eczema Facts

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

Role of allergens according to age and severity of AD (taken from Table 3 of article “Features of childhood atopic dermatitus”

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 hopefully digested the information accurately for you to read.

Does Allergy Cause Eczema?

The answer is we don’t know. If you refer to the first part of this series, allergy is hypothesized to be caused by eczema (rather than causing eczema). What has been observed is that the more severe eczema is, the higher the chances of allergies (as shown in table above). Allergies can be to food (which in the article “Features of childhood atopic dermatitis” summarized that it can be from direct eating/drinking, breast milk, placenta, inhaling and even kissing!), to house dust mites, dander and a whole lot of others (I’ve freaked myself out when researching what my baby girl Marcie could be allergic to).

Marcie’s Allergy

As it turned out, Marcie is not allergic to anything! She had a skin prick test done, something which I always recommend other parents to do because it takes a lot of guess work out. True that skin prick test is not 100% fail-proof, but it’s better than going mad worrying about everything cos if you google, you will most surely find something written or a post by someone that their child is allergic to something.

Here are some previous posts on skin prick test and eczema triggers that may interest you:

Taking the fear out of skin prick test

What triggers itch?

If your child has eczema, can you have a pet dog?

Is partially hydrolysed milk worth the money?

What and how much Detergent to Use?

Is it what you ate? How pregnancy diet affect eczema in baby

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101 things that Mothers with Eczema Child do Differently

9 of the 101 things that Moms with Eczema Child do Differently – Ice Breaker

Ice Breaker Line

This is the ninth 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.

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Eczema Facts

4-part series on What Causes Your Child’s Eczema – Defective Skin Barrier

Restoring Defective Skin Barrier (taken from nationaleczema.org, article by Peter Elias M.D.)

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.

Why does my baby get eczema?

I’ve asked the same question countless times and I know it’s something to do with the genes (if you read my family tree post here); but exactly what causes eczema? Medical professionals are still trying to find the answer as finding the right answer can help them to find the right way to prevent/treat eczema. Apparently, it has all along been thought that eczema has something to do with a hyperactive immune system, which being too sensitive has wrongly thought that matters not harmful to the skin/body are harmful. Now, there’s a new outside-in hypothesis that it is the defective skin barrier that leads to more irritant and allergen penetrating the skin, inducing the immune system to increase production of IgE (that work as antibody). Too much IgE will lead to skin inflammation, asthma, hayfever and food allergy.

But why is the skin barrier defective?

This is caused by a few types of proteins, the most commonly cited one being the filaggrin (FLG), which serves to produce and protect the skin barrier. In people with eczema, there is lower level of FLG, resulting in flatter skin surface cells, disrupted protective fatty layer, reducing the moisturizing function of the skin and increasing water loss from the skin. Reduced FLG also increases the skin pH and leads to increased skin inflammation. The FLG does not explain all cases, because there are people without defective FLG but still has eczema and people with eczema, but no defective FLG. (Thus, it’s currently accepted as a few possible factors such as the gene, environment, allergy reacting together, in some way that we don’t know yet)

The Implication

In the table above, there are some current ways to restore our baby’s skin barrier mainly by moisturizing, FROM DAY ONE. This is because if the outside-in hypothesis is true, then the stronger the skin barrier, the less chances of allergen/irritant penetrating the body to cause the body to react hypersensitively. There is a chance then for us to stop the allergic march in our children, where eczema is replaced by asthma and rhinitis. Humidifier also helps to ensure that the environment is not too dry for the skin, especially during winter or if your air-con is on.

If you are interested in reading the research paper details, click here. To learn more about skin pH, read this very informative interview with dermatologist Dr Cheryl Lee where we break down for you the what is the normal skin pH, eczema skin pH (more alkaline), why it is important to get our skin to be slightly acidic and how much harm alkaline skincare products can do to our skin.

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Support Group

Poem for my Eczema Baby – Till You Fall Asleep

This is a poem which I submitted for the love poem contest organized by Singapore’s Writer’s Festival and Timbre Music Academy; my poem didn’t get shortlisted but hey… I still love it.

Till You Fall Asleep

Every night
I hold your hands
Every night
Sweet dreams I send
Every night
I’ll sing to you
Every night
I’ll pray for you
For you to sleep

But you can’t, you don’t
You hardly fall asleep
You scratch, you cry
You barely can sleep

Till you fall asleep
I will say the same prayer
Till you fall asleep
I will sing the same songs
Till you fall asleep
I will hold your hands
Till I fall asleep
I will do all that I can

With a picture of my girl sleeping that I absolutely love!

Eczema Baby Poem

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101 things that Mothers with Eczema Child do Differently

8 of the 101 things that Moms with Eczema Child do Differently – Looking at Babies

Admiring Baby’s Skin!

This is the eighth 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.

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Guest Interview

Mom with Eczema Child sets up Online Store, The Eczema Company

Jennifer and her children

Jennifer Roberge, who has a child with eczema, shares why she decided to set up an online store EczemaCompany.com. Her online store offering products for children with eczema has recently launched, with products such as clothing from Kumfy Cotton and ScratchMeNot, creams, soaps and bath oils.

Marcie Mom: Jennifer, it’s so good to see an entrepreneur mom, particularly when the business will help children with eczema. What gave you the idea to start EczemaCompany.com?

Jennifer: My son Tristan was diagnosed with eczema at three months old and it was progressively getting worse over the years (he’s now three years old). I was desperate to find anything and everything that would help to relieve his suffering, calm the itchiness, or prevent the horrible scratching that would keep our whole family up at night. We spent a lot of money and searched companies all over the world to discover the best natural products for him. It was very costly and time consuming finding the right products from so many different sources, so my idea was to gather our favorites and make them available in one online store for other families like us.

Marcie Mom: How do you think your products can help other parents with eczema children? Have they worked for your child?

Jennifer: I have chosen the products you’ll see on the website because either we use them on our son or we know other parents who have used them, both with great results. My son does not take a nap or night’s sleep without wearing his ScratchMeNot mittens and Kumfy Cotton clothing (tops with mittens and pants with feet) because without them he would scratch himself horribly.  All our creams, oils, and soaps are wonderful products with all natural ingredients that are gentle on delicate irritated skin, but not all of them will work for every child. Therefore, we offer a variety of products so parents can find something that will help their child with their particular case of eczema.

Marcie Mom: How do you find the time to parent two children and run the online store?

Jennifer: Multi-tasking, isn’t that what moms do best?! I’m sure all the mompreneurs will say the same. It’s also finding the right balance of time management and structure. I have the passion to help families living with the daily challenges of eczema, so that’s a big motivator for me.  We do plan to keep to our regular family time though – dinner together, weekends biking or going to the park. Family is incredibly important, so our time together will remain a priority in our lives.

Marcie Mom: Thanks Jennifer, all the best for your online store.
p.s. To readers of eczemablues.com, I did not receive any money from Jennifer or EczemaCompany.com for this interview.

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Eczema Tips

What and how much detergent to use when you have a child with Eczema?

My washing machine

When you are a first-time mom, you get lots of advice; if you are a first-time mom of an eczema child, you get even more advice on everything from everyone, and sometimes they get contentious. Detergent is one of the issues where opinions differ – some say no detergent, some say little detergent, some say organic detergent and most of the time, it brings about frustration. So what is right?

Unfortunately, yet again, there is no clear cut answer. Detergents are everywhere, from laundry, to residue on our clothes (supposedly up to 2% of the fabric weight), towels, dishes, food containers, bedding, bathroom, floor, furniture, hair, skin (ours that come into contact with our children) and lint. There are parents who believe in cutting out all sources of detergent but given the prevalence of detergent even in dust, it is difficult to cut everything.

Below are some of what I’ve found out, from various research papers and online.

1. Increase in eczema is linked to increased usage of soap and detergent personal wash products in children (taken from review article Features of childhood atopic dermatitus by Hugo Van Bever and Genevieve Illanora, who in turn quoted Dr Michael Cork’s 2002 article)

Dr Michael Cork’s article in Dermatology in Practice published that eczema in british children increased from 3% in 1950s to more than 20%; during this time, the sales of detergent increased from 76m pounds in 1981 to 453m pounds in 2001. There is also an increase in central heating, carpeting, double glazing/wall insulation that promotes the environment for dust mite to thrive.

2. Is detergent bad?

Apparently, yes. Detergent strips the protective fats of our skin barrier, making it easier for irritant and allergen to penetrate. Eczema skin is dry, and thus more suspectible to cracks in the skin, making it even more vulnerable. The ingredients which are bad in detergent include sodium lauryl sulfate, triclosan, formaldehyde, sodium hydroxide, linalool and sodium flouride. These chemicals are not only used in detergent (including some hypoallergenic detergent), but also fabric softener, bubble bath, insect repellent, air freshener, toothpaste, bleach, liquid soap and baby wipes!

(A Sweden study showed that 5–7% of 3,000 eczema patients patch tested positive to linalool, which is found in 60-80% of perfumed hygiene products and detergent liquid. Linalool is a fragrance ingredient found naturally in lavender and mint, and when oxidised, can cause contact allergy).

3. So what to use and how to use?

Mild, fragrance-free, dye-free, lubricant-free, phosphate-free, brightener-free products suited for sensitive skin. (many webpages recommend puraderm). Recommended to use liquid detergent, instead of solid and to use 1/8 to 1/2 of the recommended dosage (supposedly washing machines are more water-efficient now while detergents have gone more concentrated). Using more detergent than necessary does not make your clothes cleaner but instead creates a build-up of residue which you can tell if your clothes get stiff when dried.

4. So how far should you go in cutting down detergent?

Personally, I used as little detergent as I can pour out and I invested in a washing machine with allergy care function which supposedly washes away chemicals, which I think it does as each cycle is 2 hours! I clean my floor with water only and that’s about all the measures I take. I find cutting all traces of detergent to be too exhausting and so far it hasn’t seem necessary from observing my baby’s skin reaction. What’s your take on this? Do drop me a comment!

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101 things that Mothers with Eczema Child do Differently

7 of the 101 things that Moms with Eczema Child do Differently – Detergent Decision

Detergent Decisions

I remembered that detergent was one area which I received lots of ‘advice’ on, especially when Marcie’s skin was very bad about 7 months old. It’s frustrating, and that’s one of the reason I’ve set up the support group because only parents with eczema children go through all the other stuff that comes with eczema flares.

This is the seventh 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.

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Eczema Tips

How much Moisturizing is Enough?

More Moisturizing helps

One thing that my husband and I can’t quite agree on is how much to moisturize – I like to slather huge amounts (think pressing the bottle pump vigorously, and just applying VERY liberally) while my husband prefers to pump with measured control as he feels that too much moisturizer get wasted on the clothing and when my baby hides under the blanket to escape from us). So how much is enough? And when to moisturize?

Let’s first establish that moisturizing is a must; it’s the one advice that I had from Marcie’s doctor Prof Hugo Van Bever, and in his words “You Can’t Moisturize Enough”. In a later follow-up consultation even after Marcie’s eczema is under control, his advice is still to continue moisturizing.Moisturizing helps to restore the skin barrier which is typically broken/thin in eczema skin, and that allows irritants and allergens to penetrate the skin. Moisturizer helps to trap water (after a bath) and also retain moisture in the skin. As you can see in the chart, people who moisturize more had to pay less visits to the doctor. I also read that the more moisturizer one uses, the less severe the eczema is. 

So, how much to Moisturize? From what I’ve read is 400-500 grams per week, that’s one bottle of QV 500ml lotion or 2 bottles of Physiogel lotion, which is also the amount that I’ve been applying for Marcie. If you read my budgeting post, you will know how much it cost. 

Steroid first or Moisturizer first? That’s another item that my hubby and I can’t agree on, but I think he’s right. Steroid first, then moisturizer. 

When to Moisturize? Immediately after shower, and roughly at every diaper change/ 2-3 times per day. Moisturize even when the eczema is under control and for whole body, not just the rash area. 

What Moisturizer to choose? I’ve tried to decipher the ingredients with not much success, but have posted here on what to generally look out for.I’ve later read that silicone is to protect the skin, butylene to re-hydrate and prolipids to restore. I know that propylene glycol and sodium lauryl sulfate may irritate the skin. You can also refer to this link for more on the ingredients (I didn’t summarize them ‘cos I’d tried for 2 days to compare ingredients across brands and they just don’t label them the same way…)Whatever it is, don’t give up on moisturizing! Anyone has any brands that worked for your child? Do post in the comments, thanks!

Update on:

How Much to Moisturize – read this Q&A with dermatologist Dr Jeff Benabio here

On Steroid or Moisturizer first – read this Q&A with Dr Bridgett here

On which ingredients to avoid in skincare production – read this Q&A with Dr Verallo-Rowell here