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I, my son and the rest of our household have been bothered by the worsening skin condition of my son since signs of inflammation started manifesting on his skin around late July of this year. The entire family suffered from a strong strain of flu around that time, and he was specifically put on antibiotics as a result. I recall now that his symptoms of skin asthma started manifesting after his recovery.
Since then, we’ve tried every possible remedy — from virgin coconut oil and Tamanu oil to corticosteroids and anti-fungal creams. The symptoms persisted. Five months and three doctors later, I watch my son, teary-eyed, about his worsening skin condition, and I feel helpless that all I can do is to comfort him and to assure him that all will be well soon. But, it’s been five long months!
This morning, we met with a new dermatologist who told us (she’s the second dermatologist to tell us so, the third one is a critical care paediatrician) that my son has atopic dermatitis, in layman’s terms, skin asthma. She explains that it’s genetic and it’s been inside my son’s body. Something, perhaps the episode I just narrated, triggered it to manifest.
What causes atopic dermatitis?
The root cause of this skin condition is unknown. According to the American Academy of Allergy Asthma and Immunology, severe cases of atopic dermatitis are due to filaggrin, a faulty gene that affects the expression of skin. The condition tends to be passed among generations of family members.
Although the underlying causes are unknown, the manifestation of atopic dermatitis is frequently triggered by the following:
- chronic lack of sufficient sleep
- food allergies
- certain medications
- frequent soaking, swimming and bathing in chlorinated water
- bathing with water that is too hot or too cold
- excessive sweating
- certain textiles like wool
- harsh soaps and detergents
- dusty and polluted environments
- extreme changes in weather conditions
- generally dry climate
- dusty and polluted environments
People who have atopic dermatitis have trouble repairing the barrier in the skin matrix. So, once the condition has been diagnosed, patients notice that the condition can worsen easily because the skin is open and therefore, more prone to infections.
Based on my son’s lifestyle, it appears the culprit could be his sweat. My heart broke when the dermatologist said that my son can only play moderate sports (my son loves basketball), at least for the time being. She explained that his sweat is acidic and that, in turn, makes him feel so much more itchy. So, to manage my son’s skin condition, most especially the itching part, she said that we’ll have to manage his sweating.
How to manage atopic dermatitis in children?
While I wish I was the one who developed the condition instead of my son, we now have to live and deal with the fact that he has to face it and that he needs my support. Here’s the game plan:
First, we have to accept the diagnosis and recognize that it is generally harder to manage atopic dermatitis among children. They will be scratching and itching a lot and wouldn’t be able to help it.
Second, we have to be aware of the symptoms:
- redness, itchiness and scaling around the joints
- reddening or darkening of skin
- intense itching
- thickening skin
Third, we have to be aware of the triggers (see list above). Triggers can differ among patients so we will have to take note of what could be causing his skin asthma to manifest. This early, we know it’s sweat but, there could be others.
Fourth, we will keep seeking professional help. While it’s true that we’re now on our third doctor, atopic dermatitis is simply not a condition that we can manage on our own. For one, there are medications that can only be accessed with prescription, most especially the corticosteroid topical applications.
We were just prescribed with Betamethasone valerate (Brand Name: Betnovate, from GlaxoSmithKline) which should relieve intense itching but only available with prescription. When it comes to treatments like this, I take notes of the doctor’s instructions and read the inset as well because these products are steroidal and can cause side effects most especially among children when application instructions are not followed thoroughly. I will be praying that my son won’t need a stronger formulation.
Fifth, we will deal with the triggers right now. The sooner we can control the inflammation, the sooner we can deal with the scars. So, this is what we’ll do everyday:
- Take two baths daily using only lukewarm water
- Use the gentlest skin cleanser and moisturizer. Remember, skin barrier is already a problem. We don’t want to damage it further nor further strip it off of natural moisture. My son’s dermatologist prescribed Cetaphil Gentle Skin Cleanser and Cetaphil Restoraderm.
- Control the itching with antihistamine. He’s been prescribed with Levocetirizine diHCL (Brand Name: Xyzal).
- Control the itching by eliminating certain foods in his diet. These are the foods commonly known as “malansa”. So, sorry, son, no chicken, chocolates, processed meats and eggs.
- Revamp his diet, to include more foods with Omega 3 fatty acids, and more fresh fruits and veggies.
- Wipe and moisturize frequently in-between baths.
Sixth, keep learning about atopic dermatitis. One of the most detailed, most helpful information I have come across with so far is an article published on the online edition of The Philippine Star, “How to handle skin asthma” (accessed 21 Dec 2016). Still, it will be helpful to learn from moms who have dealt with this condition already and were successful in doing so.
Seventh, we will keep our eyes on the prize: my son’s condition will get better soon. If the statistics helps, most children who have atopic dermatitis outgrow it as they get older.