Health Promotion Manager, Irish Skin Foundation
Emollient therapy plays a crucial role in protecting and restoring the skin barrier as part of the over-all management strategy to achieve long-term control.
Managing your child’s eczema
The main aim is to improve symptoms and achieve long-term control. In atopic eczema, the skin’s protective barrier is weakened, which allows moisture to be lost and irritants and allergens to pass through the skin more easily. Some common everyday substances, like soap, contribute to the weakening of the skin’s barrier and should be avoided.
It is important to remember that on-going (daily), frequent and generous use of emollients and the avoidance of trigger factors form the basis of eczema management. However, when your child’s eczema flares up, other treatments, such as topical steroids, are needed and are usually prescribed by your healthcare professional. If your child’s skin is not improving, see your doctor to establish if infection is present, which would need additional treatment.
The importance of emollient treatment
Emollients are an essential part of daily care, even when skin is clear. Emollients are moisturisers that are used in two ways – applied directly to the skin as a leave-on moisturiser, and as a soap substitute instead of soap or shower gel.
Used several times a day, emollients help to soothe dry, itchy skin and repair the skin’s barrier, thereby preventing entry of irritants and allergens, which can trigger eczema flares.
Remember no bubbles!
Choose soap substitutes/emollient wash products
Ordinary soaps, bubble baths and shower gels should be avoided as they dry out the skin by stripping away its natural oils. Instead, choose emollient wash products when bathing, which leave the skin coated with a protective film afterwards.
Choosing an emollient
Emollients come as lotions, creams and ointments. Finding the right emollient is often a matter of trial and error, but the best are ones that you (or your child) prefer to use and will continue to use every day. Remember, a higher price doesn’t necessarily indicate a better product – ask your healthcare professional for advice.
10 tips for emollient therapy
- Establish a good daily skin care routine and try to stick to it.
- Don’t stop moisturising when your child’s skin is clear.
- A child with atopic eczema often needs 250g of ‘leave-on’ emollient per week, minimum.
- Apply emollients in a smooth, downward motion, in the direction of the hair growth. Circular rubbing, particularly with heavy moisturisers, can block pores, especially in hot weather and cause acne-like spots, called folliculitis. If this happens, use the correct technique and a lighter moisturiser until they clear.
- Empower your children – teach them how to apply their emollients correctly from a young age.
- While heavier moisturiser can be very effective, some children don’t like the feel of it under clothing, so consider using a lighter moisturiser during the day and a heavier one at night.
- Remember – avoid soap, bubble bath and shower gel! Use soap-free products for bathing and specially-formulated shampoos.
- Bathwater should be a lukewarm temperature; five minutes with an emollient bath additive is sufficient.
- After bathing, gently pat skin dry. A great time to apply emollient all over is when the skin is still ‘slightly humid’.
- Change your tub of emollient at least every six weeks, as it can become contaminated, or use a pump dispenser. If using a tub rather than pump dispenser, remove what you need with a clean spoon to avoid contamination by hands.