Eczema a real problem for many Bermudians
Have you experienced a nagging itch that won’t go away? One that gets worse the more you scratch or rub it? If you have, chances are you’ve experienced eczema.
The term eczema is a very general one according to local dermatologist Alexander Romeo, who says it is not a diagnosis but rather a symptom.
In this article Body & Soul is describing atopic dermatitis, the condition most often referred to as eczema.
It is a common skin ailment in Bermuda. No local statistics on the condition have been taken but paediatrician Ryan Bates said he estimates between ten and 20 percent of his patients are affected. That figure dovetails with US national statistics where a 2003 survey the most recent one published showed 10.7 percent of Americans under the age of 18 as having eczema. In some states the prevalence was as high as 18 percent.
Dr Romeo, who has practised here and in the US, said he saw about the same amount of sufferers in both locales.
The condition is most often characterised by dry, scaly itchy skin and is very common in children.
“It feels like bugs are crawling around under your skin, and it won’t stop itching so you scratch or rub it and that makes it worse, so it is a hard cycle to break,” said local dermatologist Deborah Daly.
“It takes a lot of conscious effort to not scratch and this is very difficult for children, especially young children, she added. “Even adults find it difficult and have to tell themselves: ‘OK I am not going to scratch, I am not going to scratch. I am going to rub slow circles with the prescription cream.”
Atopic eczema is akin to an allergic reaction. It is a hypersensitivity reaction of the skin and leads to long-term inflammation.
“It’s in that allergic triad family with hay fever and asthma,” said Dr Daly. “We see a lot of all of them in Bermuda as we have a lot of pollen, dust and other allergens that trigger them.”
Added Dr Romeo: “It’s a very common problem. It’s environmental and people who have it usually go on to develop asthma. Most adults I see with it, had it as children.”
In fact it’s been his experience that severity is linked to the age at which the person first had eczema. His most severe adult cases were those where the patient had the condition from infancy.
Paediatric nurse Liz Boden, who is also an asthma specialist, said the number of babies with eczema and those with asthma, have been on the rise in Bermuda for the past 20 years.
She gives parents advice on how to control and prevent eczema in babies and young children. She’s created an information flyer that she gives clients as a handy reference tool (see the Body & Soul section of
The Royal Gazette online).
“I want to make them aware of things they can do to prevent and control rather than just think of steroid creams. These creams, if overused, can make the skin thin and the whole situation worse,” she said.
Ms Boden said many doctors simply prescribe hydrocortisone cream with no education about prevention.
“Many years ago I heard a presentation on eczema at an asthma conference from a doctor from Norway,” she said. “He believed that babies exposed to baby products [powders, bubble baths, wipes, lotions etc and even the latex gloves in the labour room] may be the reason eczema is on the rise in developed countries. So that is why I try to get parents to use no products except water and plain Vaseline for their babies.”
And preventing a child from getting eczema is more than simply shielding them from the physical discomfort of an itchy rash. According to Dr Romeo, many adults who suffered with the condition from infancy have a “certain psychological profile”.
“They differ from the adults that present with it as adults,” he said.
“There is a certain psychological profile of someone who has had it since birth. They don’t know any other way, their skin has always itched, they’ve always felt discomfort, they’ve always had an inability to sleep because of it.”
Recognising the extreme discomfort, isolation and even stigma children with eczema experience growing up, the National Eczema Association in the US is working to make the lives of eczema suffers more manageable and bearable.
The association has produced a guide for parents, and one for teachers, with advice that includes discussing the condition with the sufferer and also with peers of the child so that they understand why the child with eczema is scratching and why that child’s skin looks so dry and scaly.