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Eczema Symptoms

   

Identify the Aggravating Factors

The first thing to determine is whether there are any obviousaggravating factors that the patient encounters.

Diet

Do particular foodstuffs make the condition worse? The argument about cow's milk has not been settled as yet but if either patient or parent is convinced that milk makes the condition worse then a trial should be made of a milk-exclusion diet.

The same is true of any other foodstuff that is accused. Some find that eggs or fruit bring on attacks or aggravate the condition. If strict avoidance of the suspected allergen does little for the disease then there is not much point in persisting, but it is certainly worth making the attempt at exclusion from the diet. If dietetic treatments are contemplated it is important to 'build in' as much objectivity and absence of bias into a preliminary trial as possible. An unequivocal negative is just as important as a positive. When suspected foodstuffs are subjected to trials which are evaluated critically it is quite uncommon for the suspicion to be sustained.

Clothing

Woolen clothes are tolerated badly by many atopies and now that there are cheap smooth synthetic garments there seems little point in persisting with the older fluffier ones.

Stress and anxiety

Although stress or anxiety does not cause the disease they certainly seem capable of making it worse. The accounts of children's dermatitis getting worse before examinations at school are too frequently heard to be ignored.

However, although recognition of this sort of problem is important, it is much more difficult to know what to do about it. The worsening of the dermatitis before exams or some other stressful event should be anticipated and if possible guarded against. If the worsening that stress produces cannot be prevented, it is probably better to put up with it than avoid the stress. A voidance of this type of stress inevitably generates other problems - and examinations are still important.

When children scratch their way through the night and cry with the discomfort it inevitably causes anxiety and guilt in the parents. Eventually this may lead to a very unpleasant atmosphere within the family where no-one sleeps and everyone is bad-tempered. In these circumstances a temporary separation of the affected child from the family may be the best answer. If necessary a few days of intensive treatment in hospital can be arranged.