Asthma & Eczema

Asthma & Eczema

Asthma

Asthma is a medical condition characterized by the transient narrowing of the bronchioles also known as the small pipes in the lungs due to inflammation caused by triggering factors. Common triggers of an asthma attack are cold, pollen, smoke, dust, viral illness etc . It is important to take note of these triggers early enough so as to avoid them. 

Asthma is a very common condition in children and vital to manage as it can be life threatening. In most cases there is a family history of Asthma and atopies.

Signs and symptoms

  • Feeling out of breath or difficulty in breathing.
  • Wheezing.
  • Coughing especially in cold weather.

When these symptoms progressively get worse with respiratory distress, it is important that you call an ambulance immediately!

Other warning signs are:

  • If the child goes drowsy or unresponsive.
  • Confused, agitated or unable to complete a sentence.
  • Use of accessory muscles to breathe, including sucking in of muscles at the neck or chest ribs.

Asthma severity

  • Mild – No shortness of breath (SOB) at rest, can talk normally, wheezes are mild or cannot be heard, mild SOB with walking.
  • Moderate – SOB at rest, speaks in phrases, wants to sit and is unable to lie down flat and wheezing can be heard, there are retractions (ribs pull in with each breath).
  • Severe – Severe SOB at rest, can only speak in single words, wheezing is rather loud; it is however important to note that wheezing may also be absent in severe cases, severe retractions are present.

Treatment of asthma

Asthma is typically treated by bronchodilator, an example being Ventolin. These are drugs that enable the airspaces to widen allowing for proper breathing and circulation. The doctor may give you an inhaler which should be used to relieve mild episodes of asthma. It is important that the inhaler is given as a start dose as per medical advice followed by a review by the medical practitioner. In the event of an attack, sit the child comfortably and preferably upright, shake the Ventolin and give 6 -12 puffs according to their age and ask the child to breathe in after each puff. Monitor progress every 20 minutes up to 3 hours. If there is no improvement after puffs, call an ambulance immediately.

The doctor may also prescribe prednisone, a type of steroid that helps to prevent swelling or restricting of the airways. It also helps to make the tubes more responsive to the bronchodilators.

These two types of medication are ideally relievers and work to mitigate an attack already in place. 

The other type of medication is a preventer which is taken every day to prevent the attacks from recurring, example is Flixotide, Singular etc. Ensure that the doctor regularly checks the efficacy of these drugs which are taken daily.  In addition, controllers such as Seretide and Formoterol are taken daily and are long acting versions of the relievers. 

Most children eventually outgrow their asthma. It is however important that preventer medicine is taken every day and that these children need to see their doctors regularly. 

Call us for an appointment with our Paediatricians at Kids Health Space.

Eczema

Eczema is a skin condition that presents with itchiness, dryness and redness of the skin in children less than six years. Eczema is fairly common in children and presents before the age of one although it may also present later. 

  • Eczema is not contagious.
  • There is no cure for eczema but it can be controlled and managed effectively.
  • Eczema is itchy, if it’s not itchy, it is not eczema.

Triggers of eczema flare-ups

  • Foods— If certain foods are associated with severe itching, avoid them.
  • Animals— Certain animals including pets may make the rash worse especially if the animal sheds dander, you may have to take the animal away for a certain period.
  • Woollen clothes— Clothes made of or containing woollen fibres are very likely to cause a worsening of eczema flare up. As often as you can, avoid dressing your child in woollen clothes.
  • Dry air— The use of a humidifier in your home will go a long way in reducing the rash from eczema.
  • Herpes virus infection - This is by far the worst trigger. Do not allow your child to be in contact with anyone having herpes. It is advisable that small children should avoid being kissed on the mouth or face for their health and safety.

Signs and symptoms

A dry red rash that commonly begins on the face before spreading to the body, the arms and the scalp.

There is a variation in eczema rash often with certain times being mild and other times being severe.  The causes of eczema are not well defined but there is a genetic predisposition. There is a tendency for eczema to co-occur with asthma or even hay fever. There are various triggers for eczema with the most common being overheating, dryness. Certain soaps and detergents especially fabric softeners. Food allergies, toothpastes and pollen. 

Eczema itching scale

  • Mild – Does not cause interference with normal activities.
  • Moderate – Interferes with child school, sleep and normal activities.
  • Severe – Constant itching cannot be controlled.

Control of eczema

  • Moisturizing is your friend. Invest in a good fragrance-free moisturizer that should be applied as often as possible. Avoid bubble baths as they are a common trigger.
  • Keep your child cool.
  • Control the itching as it worsens the disease. Examples of ways to control itching are a cold towel to the affected area, wet dressings at home, distractions and well-trimmed fingernails.
  • Check to see if food may be a trigger and, if it is, avoid it.

When should you see our doctor?

  • If after two days of treatment, there is no improvement.
  • If your child shows signs of infection which are: weepy broken crusted areas of eczema.
  • If as a parent, you feel like a doctor should see your child.

Treatment of eczema

Cortisone is the treatment modality of choice, apply it to all exposed areas and monitor for response. It is important to note that while there are many over the counter cortisone treatments, our doctor will guide you on what is best for your child.  There are a lot of questions on the use of cortisone in children but there has been considerable rationale for its use in eczema. 

Apparent use of moisturizers / emollients.

Your child can still have their regular vaccinations as well as recreational activities such as swimming without fear. 

Contact local Emergency Department if:

  • The eczema is painful to touch.
  • There appears to be active infection without a fever.
  • The itching is still severe even after using a steroid cream.

Call us for an appointment with our Paediatricians at Kids Health Space for the right choice of management of Eczema.