Pediatric Eczema / Atopic Dermatitis in Children / Infantile Eczema

Atopic Dermatitis in Children./ Pediatric Eczema

                               Chronic Relapsing dermatitis

Atopic dermatitis is a long-term (chronic) skin condition. It causes dry, itchy skin. It's a very common condition in babies and children.

Introduction

Atopic Dermatitis or pediatric eczema often begins in infancy, affecting about 15-20% of children. It usually improves as the child grows older and may resolve by school age or puberty. Some children with atopic dermatitis may have more chronic disease.

Causes

Children with atopic dermatitis have a form of  'sensitive skin' that may be more easily irritated by sweating, heat, rough, clothing and some detergents, soaps and some cleansers. Children with atopic dermatitis  may have allergies to foods pets or foods or other animals, dust mites, tree pollens and grasses. Although it is not clear that these allergies actually "cause" the eczema in most children.

In most cases, identifying these allergies does not help the condition. Rarely some children with atopic dermatitis may develop allergies to chemicals in their moisturizers, other skin care products, clothing and topical medications.

Symptoms

Children with atopic dermatitis develop red, dry ,itchy patches on the skin that results from inflammation. Itching may be severe and constant. With frequent scratching, the skin may develop blisters, oozing, crusting,  or sores from infection. Sometimes, if the child scratches for many weeks to months. the skin may start to become very rough, leathery and darker in color.

In infants this condition commonly affects the face, scalp, arm and legs. In older children atopic dermatitis may involve only the inside of the elbows and back of the knees. Some children with severe atopic dermatitis may have involvement of their entire body, which is very itchy.

According to Ayurveda

Atopic dermatitis or Charmadala is charecterized by itching, reddish discoloration of skin, peeling of skin, dryness and papule. formation. Charmadala  affects only to the children who are affected due to consumption of vitiated milk. Its incidence id very less in children, whose main diet is cereal.  

                        "More than just an itch Atopic dermatitis in Children."

What cause atopic dermatitis in children and infant ?

In Ayurveda infancy is a Kapha prominent age with vata energy. Infants and children tends to consume a higher proportion of sweet, creamy and dairy products according to the need of their bodies. Such foods can tend produce  an excess of  "AMA" or toxins. If the digestive fire (or digestive enzymes) is  not strong enough. This ama is responsible for atopic dermatis in infants and children. It is preventable and easy to eliminate.

In fact the best tool available to mothers is nutrition. Ayurveda focus on taste heating and cooling qualities of the food, the post digestive effects of food in the body. and its effects on the individuals constitution or "Doshas" In this way the imbalances causing excess toxins to be produces can be corrected. 

To help prevent  or reduce the condition, it is recommended that the children's  dairy intake is moderated or that they are fed dairy products with  less lactose content. Avoid raw fruits or vegetables (especially sour and tropical fruits). Also avoid yeast containing foods such as bread, artificial additives and preservatives, junk foods and sweets and fizzy drinks, at least while the digestive enzyme are being rebuilt.

Avoid excessasive  exposure to cold, damp weather and wrap up warm during the winter months. Children can eat  warm, cooked food such as soups, khichdi and rice. Pitta -Kapha aggravation foods like sesame seeds, jaggery, eggs, Curd, cheese, Paneer, Cashew (all nuts in general) trigger Pitta. 

In the event that the child does experience eczema, using effective herbal tropical creams will help to  draw out the heat from the affected area, soothe and heal the inflamed skin.

Treatment

Allopathic

Stop using soap and other irritant products to avoid further progress

Use non perfumed Moisturizers : Moisturizing cream (Cetaphil). The Moisturizers should be applied twice a day, immediately after bathing (and before the skin is completely dry).

When used in conjunction with topical steroids moisturizer should be applied after the steroid.

1% Coltar lotion.

Avoid contact of skin with woolen apparel. Use moisturizing soap for bathing.

Anti biotic if required

Managing of allergy

Counselling and psychotherapy.

Steroids used locally 

Evening Prime Rose oil2 cap BD in children, adults 4 cap

Betamethasone valerate clobetasol propionate gradually decrease the potency.

Tacrolimus ointment (macrolactam immuno modulator) 0.03% in children and 0.1% in adult BD. Application can cause erythema and burning sensation

Betnovate S ointment

Zovate S Ointment for two weeks

For resistance cases

Dipsalic ointment

Tenovate ointment Apply twice a day for two weeks.

Antihistamine syrup  to avoid scratching eczema 

Ayurvedic

Herbs induced showers soaks lepas, oils and washing powders that depends on skin well being improving herbs to oversee Atopic dermatitis and eczema.

Panchkarma treatment to address unsettled kapha and Pitta are additionally prescribed to address the dosha imbalance in the body.

Aside from this , as a high level of Atopic Dermatitis is connected to ecological allergens and food allergens, fundamental changes are encouraged to ensure exposure of these allergens is limited.

The selection of herb will rely on the age of the patient, season and symptoms. For instances, if the introduction includes more of  Pitta based response like redness, irritation consuming sensation, warmth, Pitta adjusting spices should be picked over different spices like Nimba, Khadira, and so on.

If the emergence is forces on kapha such as scaling, thickening, or overflowing, Kapha should be selected to modify spices such as Kushta, Haridra, Daruharidra, and so on . Such cases may also benefit from the drying up of the region by using herb based dusting powders.

So while treating Charmadala (dermatitis) the drugs alleviation Vata, Pitta Kapha doshas (body humours) 

• Which are having Kandughna
• Kushtaghna
• Raktashodhaka

As well possessing bitter taste Tikta , Pungent taste Katu, taste rasa should be selected.. As tridoshas (three body humours) are involved in dermatitis charmadala the drug chosen should be balancing tridoshas (three body humours).

The treatment should be aimed at reducing dryness and pruritis which causes much of the discomfort to patients So shveta kutaja with coconut oil for local application is selected in disease with predominance of vata (vata dosha pradhana Vyadhi). Due to its Pacifying vata nature (vatashamana). The main content of Panchtikta Ghrita drug are Panchtikta dravya and ghee. All contents of Panchtikta ghrita have tikta rasa, laghu and ruksh guna, so they act as anti-itching agent.

Neem has an anti- inflammatory  activity and significant anti-ulcer effect.

Guduchi act as an anti-oxidant and immunomodulator thus cell layers during disease pathology are improved by this drug.

Vasa and Patola have anti histaminic and Anti oxidant property

Kamdudha ras is cooling food that has sheeta virya so it is very useful in Pitta roga.

Pravalapanchamrita balances Pitta dosha. Altogether the synergistic action of medical preparations help in reduction of dryness, scales and excoriation marks over face, back, trunk, upper and lower extremities in a span of less than three months.

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