Hidden toll of eczema

It’s incredibly common and has no cure, but people still don’t know much about eczema and the impact it can have on children and their families.

RCH nurse practitioner Emma King works with patients suffering extreme eczema. She says research shows eczema negatively affects quality of life more than asthma and insulin dependent diabetes. The itch, she says, would in some cases be ‘dementing’.

“A child can be covered in eczema from top to toe – they are infected, crusted and waking every half to an hour overnight,” she says, and because of this lack of sleep, families are often not coping at home.

RCH leading the way

Current research tells us that eczema affects 30 per cent of children in Victoria. To meet this demand, Emma and fellow nurse practitioner Liz Leins set up the RCH’s nurse-led eczema clinics, which are the only ones like them in the world and recently won a Public Healthcare Award.

The clinics allow the nurses to treat patients in a really effective way – patients and families get one-on-one consultations, which mean they benefit from individual education and demonstration.

By taking a good history of each patient, Emma says they can look at development, growth, and diet, which helps to rule out allergies.

Empowering families

Both nurses agree that eczema is not difficult to treat, rather it is just poorly managed. Cortisone (steroids) in the form of a topical cream should be used, however Emma says often the cream is too weak, meaning the eczema can’t get better.

“A lot of dermatologists or GPs will just give families a script,” Emma says.

“We get them to put [the cream] on in front of us and we’ll see that they’re not putting it on properly.”

Treating eczema as soon as it appears has shown to be the best way to stay on top of the terrible itch.

“Even if they’ve got the right treatment, they don’t know how to put it on, or they put it on the wrong way, or there isn’t enough,” Liz says.  “So a lot of what we do is showing them how to do it properly.”

Life-changing treatment

Treating eczema from a young age and with the right plan is important for a child’s ability to thrive. Emma says eczema is more than just a skin condition. Left untreated, it may affect growth and development, and brain function as well.

“The latest research is showing that if you control the eczema early, there’s less chance of developing asthma, allergic rhinitis and food allergy,” she says.

“If you get the skin right, then there’s less chance of these other conditions forming.”

If you think your child has eczema, it’s good to identify things that irritate your child’s skin. A GP can help you with a treatment plan or referral. Visit Kids Health Info for more eczema information.

20 comments for “Hidden toll of eczema”

  1. Kate Currell

    I was wondering how I go about getting an appointment with a nurse practitioner?

    • Lauren

      Kate, you need a referral from your GP, but if you ring the team at MACCS and speak to the receptionist they should be able to point you in the right direction. Good luck.

    • Media team

      Hi Kate, to make an appointment to the workshop you will need to get a referral from your GP, attention it to Eczema Workshop and then email it to clinics@rch.org.au

  2. Tracy

    Emma King treated my son. It has changed his life. He has very little irritation and when he does we know to go back to basics. With out emma my son woyld have had no quality of life.

    Thanks emma

  3. Therese Quinlan

    I shared this post on Facebook, where it’s attracting a lot of interest. Well done, Emma King and RCH!

  4. Meaghan Tranquille

    Can you post a video on how to apply creams properly?

  5. Emily Tannock

    I would also love to see a video or how to apply the steroid and moisturizing cream on properly

  6. Georgia

    Hello, I was wondering if ezcema can be due to a delayed igg food allergy? I have had skin prick testing with no known food allergies, so I’m not sure how to find out if there’s anything else I’m allergic/intolerant to. Thanks in advance, Georgia

    • Media team

      Hi Georgia, There are many things that can trigger eczema. First line management always starts with optimal skin care. Allergies can be an aggravator of eczema and can be immediate or delayed reactions. If you are concerned about allergies you should see an allergist. Good luck, Liz Leins

  7. Mauro Morganti

    Eczema is a sign that the body is exposed to a stressor, again steroids and the like is a band aid approacho thr to the issue at hand. Look for the root cause rather than a symptomatic approach eczema management. I am sure that all eczema sufferers and families would agree

    • Rebecca Evans

      I cannot recommend the eczema nurse specialists at RCH highly enough. Steroids certainly have their role in treatment of eczema. It frustrates me reading ill-informed opinions.

      See the specialists. Get the right treatment plan.

      Wet dressings, bleach baths, steroid ointment and lots of moisturizer cream we’re all part of the management plan which turned my son’s severe eczema around (80% better in 3 days). Thanks Emma.

    • Donna

      I agree with Mauro. Yes steroids are important in treating flare-ups etc. But the long term management should be focused on the cause of eczema. Why is eczema so prevalent? What’s the u deleting cause? How do we cure eczema, rather than simply treat the symptoms ongoing. It’s fantastic that there are some wonderful management strategies available now! But this still isn’t helping long term.
      I took my daughter to a Paediatric Dermatologist (an Associate Professor in his field) and he simply told me to use steroid creams and other useful management strategies (basically the same as RCH), yet NOTHING on how to prevent it ever coming back. My DD would have flare ups and we were able to settle it down with our “tool kit” of strategies, but she’d still have flare-ups. I then took her to a Paediatric Naturopath and Nutritionist, we had some tests done and made some dietary changes, and it’s been a HUGE difference. I haven’t had to use steroid creams at all in a number of months. This can’t be a coincidence.

    • Rebecca Evans

      Dear moderator, could you please remove “dairy” from the statement where it reads dairy, egg, nut etc – it should read just egg and nut.
      Unfortunately cannot edit own posts.

  8. Denise

    So how DOES one put on the cream correctly? Would love to know. Am an Aussie living overseas at the moment and our little one has a mild case of ezcema. We have the cream but I just want to make sure that I am putting it on properly.

  9. Sally

    Is there a problem with using steroid creams too much? Can the skin thin or discolour? I’m sure I’m underusing creams on my son because I’m worried about using them too much.

    • Media team

      Hi Sally, Topical cortisones are the main treatment for inflamed skin, however they are often under used. They are very safe when used as directed by your doctor or nurse practitioner. Liz Leins

  10. Melissa

    Emma and Liz, well done on such a progressive, preventative approach to eczema. I am a practice nurse in rural Vic and would be very interested to “sit in” on a clinic to gain practical knowledge to bring home and share with patients and their families. Is this a possibility?

  11. Steph

    Hi. Both my girls have eczema but very different types. My four year olds is in the usual spots behind Knees and elbows and very dry skin during winter and manageable with creams and if necessary topical steroid creams. However, on my six year old the steroid creams seem to make it worse. Is there an explanation for this? Have you heard of tsa? Topical steroid addiction?

  12. Lyndall

    I wish this service was available when I was a kid. I’ve had eczema my whole life, I’m now in my late 30’s. I inherited it from my grandfather. My parents, who have normal skin, didn’t know what to do to help me. I agree that there are some environmental factors that some people might be able to avois to reduce the effects of eczema (eg. Soaps, perfumes, detergents). However there are some factors that flare up eczema that are impossible to avoid eg. My eczema flares up when the seasons change (hot to cold, cold to hot), when I’m stressed or sick, and when I get wet & don’t put moisturiser on straight after.

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