How Does Eczema Affect My Child’s Growth & Emotion?
Dr Vivian Thong (Consultant Paediatrician) is here to share
Eczema, also known as atopic dermatitis, is a chronic inflammation of the skin which is typically present with recurrent redness, itch and dryness and usually takes place during early childhood. We frequently see infants who were brought into the doctor’s office diagnosed with not only rashes, but crankiness, feeding refusal, and are often labelled as “difficult babies”. On the other hand, there were also toddlers coming in with infected extremities, raw scratching marks, yellow crusted induration (hardening of soft tissue) and sometimes fever or limited mobility due to pain. All these are the common presentations for eczema cases running in clinics or even emergency departments. What about the impact of eczema on children’s growth and emotion?
Understanding the emotional impact of eczema
When the recurrence of skin redness, itch and dryness is frequent, the children might struggle
emotionally, and even worse when there are associated episodes of infection which lead to hospitalisation. For those non-verbal groups, they might just exhibit their distress by showing lack of appetite, sleep disturbance or just acting up and being cranky. Kids might have frequent mood swings, showing heightened irritability or anger, anxiety, and clinginess. Some will face social withdrawal through self-isolation, loss of interest in favourite food, activities or objects. All these may contribute to low self-esteem, inattentiveness, poor socialisation skills, adjustment disorder and increased risk of developing psychosocial or mental comorbidities (simultaneous presence of two or more diseases).
What causes stunted growth?
Zooming in the growth aspect, we observe stunted growth especially among kids with uncontrolled eczema. The possible causes are highly related to psychosomatic (stress-related) behaviour and emotional instability. Just imagine, as they scratch their bodies and cry because of the soreness, the quality of life will definitely be affected. Some of them might have con-current food allergy, dietary restriction or sometimes overzealous control of their food intake may also lead to malnutrition or failure to thrive, commonly seen with higher allergenic food group i.e.; protein (egg, fish, chicken, and seafood) and dairy (cow’s milk and cheese). There should be a balance between “disease control” VS “balanced diet and appropriate growth”.
Managing the emotional distress
We shall never underestimate the emotional distress that their parents or caretakers are facing, from feeling distraught or despair whenever they witness their beloved one suffering from acute flare of eczema to spending sleepless nights cuddling their kids to comfort and ease their pain. Studies show that atopic dermatitis/eczema has the greatest negative impact on overall quality of life of the child and also their caretaker, among chronic skin diseases in children (urticaria, acne, alopecia, atopic dermatitis). Taking extra precautions on the daily routine including feeding, skincare, and dietary preparation will also keep the caretaker busy. Whenever there is a sibling rivalry, they need to handle it with extra patience without jeopardising the whole family dynamics.
In conclusion, we understand uncontrolled eczema will not only cause physical discomfort but also lead to emotional burden not only to the kids but also the guardian, and not to forget, causing growth impairment too. With better understanding of the child’s skin condition, we might be able to control it better. Please consult your paediatrician whenever there is doubt or concern pertaining to your little one’s skin condition.
Dr Thong Siew Peng
M.D. MRCPCH (UK)
The content of this article is for educational purposes only. Seek the advice of your medical provider regarding any questions or concerns you have about your baby’s specific skin condition.