Dear Doctor,

I don’t have any kids but my sister has two and they were both born with eczema. I am not that familiar with the condition but I see wounds and painful blisters around their elbows and knees. I have also heard that the condition is also genetic. Does this mean even my future kids will have the condition?

Tracy

Dear Janet

Eczema is a condition of chronic inflammation of the skin, which occurs due to allergy. The body, when exposed to a substance, considers it to be foreign and antibodies build inside the body against it. On subsequent exposure, an antigen-antibody reaction sets in manifesting as chronic inflammation of the skin along with sores and blister.

About 15-20 per cent of children and 38 per cent of adults suffer from eczema. There are many causes for eczema, and it is inherited. One individual may develop eczema due to allergy to some environmental factors and this may be passed on genetically to the next generation. With one parent positive there is a 60 per cent risk of eczema, but the risk is enhanced if both parents have it.

Genetics increases one’s susceptibility to have allergy to something present in the atmosphere or consumed as food or drink or used as cosmetics.

Regarding food, mostly protein rich diets like meat, milk and milk products and soya products, can cause this condition. Chemicals used as food preservatives or flavouring agents are also implicated.

Among locally used substances, soaps, detergents, creams and lotions can cause eczema.

Eczema is also induced by nylon socks and clothes. The condition can be precipitated and aggravated by dryness, sweating, change of climate and stress, both physical and mental.

Eczema, asthma and allergic rhinitis (recurrent cold) are inter-related conditions having same underlying causes. One can have one or more of these conditions and all are inherited. Scalp, neck, armpits, groin, hands and feet are body parts which are commonly affected by eczema.

There are about 10 types of eczema with some variations in the clinical symptoms. The skin may become itchy with sores and rashes. There can be exudation. Scratching leads to red and brown patches. Secondary bacterial infection can result in boils. A baby can have inflamed angry looking red, brown patches.

Prevention consists of preventing dryness of skin by using a suitable moisturizing agent, avoiding food substances that can trigger eczema, avoiding nylon clothes, cosmetics that aggravate the condition. Regarding food substances, one can include and exclude a substance each day from his/her diet for some days and include it again. This will help to identify the allergy producing substance, which can be avoided.

Treatment consists of keeping skin moist, anti-allergy drugs like chlorphenaramine maleate and cetrizine among others are used to reduce the itching. Corticoids in tablet or ointment forms are used to treat the underlying inflammation.

It is advisable not to worry about the risk of children having eczema. If some other blood relative has eczema but both the parents are negative for it, the risk of baby acquiring the condition is less. Even if it is acquired by the baby, it can be managed very well.

Dr. Rachna is a specialist in internal medicine at Ruhengeri Hospital.