Skin Care World

Imagine you’re a GP. This week you will see two hundred patients. How many will have a skin complaint?

Now you’re a teacher in a typical junior school. There are thirty, nine-year-old pupils in front of you. How many of them will have atopic eczema?

As a GP, you would see thirty patients with skin complaints. That’s 15% of your consultations.(1) In fact, up to 3% of the adult population suffer from atopic eczema.(2)

And in the classroom? Six children will have atopic eczema. That’s because 15-20% of children suffer from eczema at any one time.(3)

And atopic eczema isn’t just dry, itchy skin. It can be a debilitating condition that affects the whole family and can ruin a child’s education. As such, it’s more than just a medical problem, or something families have to cope with. It’s a community problem that needs to be tackled at a community level.

WHAT IS ATOPIC ECZEMA?

From a healthcare point of view, the most frustrating things about atopic eczema are its predictability and its relative simplicity. Predictable in that it’s hereditary – if parents, grandparents or siblings suffer from eczema, asthma or hay fever, chances are the child will develop atopic eczema.(4) And once it appears (usually as early as five years of age) it’s unlikely to go until they become teenagers.

As for its simplicity, although the exact causes are unknown, a lack of natural oils in the skin is acknowledged as a major factor.(5) Sufferers can be susceptible to allergies such as pet hair, dust, pollen and certain foods. Temperature extremes also make the condition worse, as can certain clothing, such as woolly jumpers and non-cotton items.(6) The problem is also exacerbated by the use of soap, shampoo and by exposure to detergents. The result? Dry, scaly, itchy skin.

The natural reaction is to scratch the skin to relieve the itch, but this can become a vicious cycle, worsening the condition and, in some cases, leading to infection. Breaking this cycle is not easy, but understanding the external triggers can aid in the management of the condition.

REPERCUSSIONS

Eczema is still seen as being a minor problem. For children, this can go beyond discomfort. In schools, it can be a source of bullying, as the children with the ‘scabby skin’ are picked on. This in itself would be problem enough, but the symptoms of atopic eczema can also lead to loss of sleep, which in turn means a lack of concentration and irritability at school. All because of dry skin.

TREATMENTS

A variety of treatments are available, including the use of steroids for more serious conditions, and moisturisers that can be used as soap and bath oil substitutes. The efficacy of these is enhanced by Wet Wrapping with tubular bandages such as Tubifast, which keep the moisturiser in contact with the skin. By cooling and soothing the skin, Wet Wrapping also helps interrupt the itch-scratch cycle (1) and has proved to be a valuable aid in improving sleep patterns and reducing hospital admissions.(7,8) Whilst treatments will vary depending on trust protocols and the needs of the individual patient, the widespread ignorance about the condition requires education at all levels.

THE NEED FOR EDUCATION

One route is the Internet. There are several websites that provide valuable information about eczema and its treatment (several are listed at the end of this article), but these will only be consulted by those who know someone with eczema.

This is why the National Eczema Society is seeking to tackle this ignorance at its roots by providing information packs and educational material for schools.

More children suffer from atopic eczema than adults, and the Society has produced educational packs aimed at providing teachers and pupils with a comprehensive insight into atopic eczema, its causes and consequences.

The pack is available for three school groups: Foundation to Year 3, Years 4-7, and Years 8-11.

Accompanying each pack is a teacher’s guide, showing how best to explain eczema to children. The exercises themselves range from word squares, puzzles, quizzes and role-playing to writing newspaper articles, group discussions and reprinted articles for children to take home. The aim is to engage children’s minds and make them appreciate what it must feel like to have eczema, and how they should treat classmates who have the condition.

It prompts them to understand the triggers that can make eczema worse, and so explain special dietary requirements, why pupils are excused from sports or why they might be tired in class. It also makes the important point that however unpleasant a case of eczema may appear, it isn’t contagious and, with the right treatment and understanding, children can lead relatively normal lives.

SPREADING THE WORD

What is the National Eczema Society School’s Pack? The National Eczema Society is launching the first ever in-school charity information initiative to educate children about eczema. The aim of the project, which is supported by an educational grant from Mölnlycke Health Care, is to encourage teachers to promote understanding and empathy amongst school children and to combat some of the prejudices faced by children with eczema, that can lead to bullying.

Who receives the pack? The Pack is predominantly aimed at children via their teachers, giving them issues to identify with while raising awareness of the condition and the National Eczema Society.

Targeted at primary, junior and secondary school teachers, school nurses and Local Education Authorities, it provides guidelines, articles and activities to help teachers learn about eczema and bring the issues into the classroom in a challenging and interesting forum.

Where was it trialled?

The School’s Pack has been trialled by Warrington schools Culcheth High, Twiss Green Community Primary and Gorse Covert Community Primary. Each sampled a pack for a specific age group and offered advice to ensure the information was appropriate and suitable for the classroom.

What feedback was received?

There has been a great response from everyone, particularly as this kind of educational and supportive material has been requested before by teachers to assist in GCSE work and by parents whose children suffer from eczema.

When will it be available?

The Packs were launched in June 2003.