Doctors Answer Parents’ Burning Questions About Eczema and Children

WORDS LIM TECK CHOON

FEATURED EXPERT
DR MELANIE MAJAHAM
Consultant Paediatrician
Sunway Medical Centre Velocity

WHY DOES MY CHILD HAVE ECZEMA?
Dr Melanie Majaham explains that:

  • Eczema usually happens in a child that already has a tendency for dry skin.
  • The child’s skin becomes inflamed and very itchy when they are exposed to triggers such as chemicals, sweat and heat.
  • Red, dry, itchy patches form on the skin as a result of the inflammation.
  • Because of the itch, the child will constantly scratch their skin, which can lead to further damage to the skin. Blisters, oozing, crusting, and sores are some possible consequences from the constant scratching.
  • Such damaged skin leaves the child vulnerable to bacterial, viral and fungal infections.
HOW IS ECZEMA TREATED?

Dr Melanie says that treatment options will depend on which phase the eczema is in.

Active flare-ups
  • In active flare-ups, the child may need steroid-based creams to reduce the inflammation and break the itch cycle. These steroid creams are safe and will not cause long-term complications when used correctly over a short duration.
  • If the skin is infected, antibiotics and antiviral medications may be needed. Parents should be reassured that steroid creams prescribed correctly and in short duration will not lead to long term complications.
Subacute or chronic case (the skin is merely dry; no active inflammation present)
  • Maintenance therapy is important to prevent flare-ups.
  • Such therapy include intensive moisturizer creams that are free from fragrance and certain chemicals.
  • The child will also need to bathe with soap-free solutions to prevent excessive drying of the skin.
  • While bathing, make sure the water is not too warm. Dr Melanie nots that water that is too warm tend to worsen one’s eczema.
  • Wet skin should be pat dried gently with a towel.
FEATURED EXPERT
DR JUANI HAYYAN ABDUL KARAF
Consultant Ear, Nose & Throat (ENT) and Head & Neck Surgeon
Sunway Medical Centre Velocity
WILL IMMUNOTHERAPY HELP MY CHILD?

Dr Juani Hayyan Abdul Karaf explains that immunotherapy—in the form of shots—is available to treat allergies, but this is specific for certain allergens such as house dust mites.

WILL MY CHILD CONTINUE TO HAVE ECZEMA WHEN THEY ARE AN ADULT?

Children with eczema can develop food allergy, allergic rhinitis, and asthma—a natural progression from infancy to adulthood known as the atopic march.

Dr Juani shares that the atopic march happens when children continue to develop inter-related allergies into childhood that can begin with eczema.

“It can start with a skin condition as it’s the first body barrier that can be breached. The body’s response can continue and manifest later as food allergies, allergic rhinitis, and asthma,” she elaborates.

More than 50% of children with eczema develop asthma later in life, with a further 33% developing food allergies, as well as an increased risk of developing allergic rhinitis .

CLOSING ADVICE FROM THE EXPERTS
  • “Parents should ensure the child is kept cool as heat can aggravate eczema,” Dr Melanie points out. “Constant round-the-clock moisturizing also does wonders in keeping the child comfortable.”
  • Dr Melanie also discourages the use of antiseptic soaps, as these soaps are harsh and can worsen eczema. “Some parents think eczema is caused by poor hygiene and tend to use antiseptic soaps. However, the more appropriate bathing solution would be something soap-free and fragrance-free and rich in emollients.”
  • Dr Juani advises parents to encourage their child to exercise regularly and spend time outdoors to soak up vitamin D.

Not Sure What Immunotherapy Is? Get Your Answers From an Oncologist!

WORDS LIM TECK CHOON

FEATURED EXPERT
DR HAFIZAH ZAHARAH AHMAD
Consultant Clinical Oncologist
Sunway Medical Centre Velocity
IMMUNOTHERAPY IS A NEWER APPROACH TO TREAT CANCER, BUT WHAT EXACTLY IS IT?

According to Dr Hafizah Zaharah, immunotherapy is a pretty unique way to treat cancer, in that it uses the body’s own immune system to attack cancer cells.

“The immune system is like the police force of our bodies,” she says. “It is designed to protect the body against infections, illnesses, and diseases.”

The cells that make up our immune system. Click on the image for a larger, clearer version.

When it comes to faulty or mutated cells in our body, the immune system identifies and eliminates these cells before these cells become a significant threat to our healty.

However, the cells of our immune system may not be strong enough to kill cancer cells, according to Dr Hafizah. Sometimes, the cancer cells are able to fool our immune system by resembling normal cells or hiding themselves.

THIS IS WHERE IMMUNOTHERAPY COMES INTO THE PICTURE

“Immunotherapy can boost or change how the immune system works, so it can recognize and kill cancer cells,” explains Dr Hafizah.

For example, cancer cells originate from normal cells, so the immune system may still mistake them for normal cells.

“These cancer cells can push a ‘brake’ button on the immune cells, so the immune system would not attack them,” Dr Hafizah adds.

Now, a type of immunotherapy called checkpoint inhibitors can take the ‘brakes’ off the immune system, allowing it to now recognize and attack the cancer cells!

There are other types of immunotherapy, of course, and these treatments can be used for various cancers.

CANCERS THAT CAN RESPOND TO IMMUNOTHERAPY
  • Non-small cell lung cancer
  • Triple negative breast cancer
  • Head and neck cancer
  • Cervical cancer
  • Gastric cancer
  • Oesophageal cancer
  • Bladder cancer
  • Melanoma
  • Liver cancer
  • Renal cell carcinoma
  • Endometrial cancer
  • Colon cancer
WHAT IS IMMUNOTHERAPY LIKE?

According to Dr Hafizah, various immunotherapy agents are given as an infusion into a vein (a drip) typically once every few weeks.

These immunotherapy agents can be given to the patient all by itself, or in combination with targeted therapy or chemotherapy.

“For advanced stage cancer, immunotherapy treatment generally is given for 2 years, alongside close monitoring,” Dr Hafizah further says.

IS IT EFFECTIVE, THOUGH?

Although immunotherapy seems like the answer every person with cancer is looking for, Dr Hafizah warns that not all types of cancers will respond well to the treatment.

This is why, before embarking on immunotherapy, one will first undergo a specific biomarker test, such as the PD-L1 test, which will be carried out on a cancer specimen to ensure that the person will respond to the treatment.

ARE THERE ANY SIDE EFFECTS TO BE CONCERNED ABOUT?

“Generally, the treatment is well tolerated,” Dr Hafizah assures us.

However, just like with most types of treatments, side effects are possible. These include:

  • Feeling tired, skin rash, or muscle or joint pain
  • Rare side effects include allergic reactions such as dizziness, fast heart rate, face swelling, or breathing problems
  • Autoimmune reactions, which can lead to serious problems in the lungs, intestines, liver, hormone-making glands, kidneys, skin, etc