THE CHILDREN'S eczema service in York has been nationally acclaimed for its excellence. Before National Eczema Week, CHARLOTTE PERCIVAL discovers how families can seek help to cope with the distressing condition.

ONE in five children now suffers the itch, pain and discomfort of eczema.

Cases have increased three-fold in the last 30 years and while eczema can be extremely distressing to the sufferer, the side effects can disrupt the whole family.

Now, the burden of eczema on family life is being thrown under the spotlight as part of National Eczema Week (September 17-24).

Margaret Cox, chief executive of the National Eczema Society, said 23 per cent of carers of children with eczema never got a good night's sleep while 15 per cent felt the whole household was disrupted.

"While the person with eczema can do nothing to stop themselves scratching and has to live everyday with painful, cracked and often bleeding skin, their carers can be left feeling helpless, guilty and exhausted through lack of sleep and worry," she said.

"When one person in a family has eczema, everyone can be affected.

"A child with eczema may waken several times a night because they've scratched so much they need bathing or because they need more cream putting on. This can really take its toll on parents.

"Siblings can feel left out because their parents' time is spent caring for and distracting the child with eczema. It's a very difficult balance to keep everybody happy."

In York, an eczema service was set up to help and support families with children who had mild to moderate eczema.

The team, made up of staff from York Hospital and Selby and York Primary Care Trust (PCT), piloted a health visitor clinic for under-fives and set up a steering group.

It recently won a Health & Social Care Awards regional Children's Care Award, scooping £1,000 to spend on service development and sharing good practice.

Gail Dunning, clinical nurse specialist in dermatology, said the project reduced visits to hospital.

She said: "Other benefits identified are the physical improvements in controlling children's eczema and preventing relapse as well as those of providing support to parents and helping them to develop their knowledge and skills and their own coping mechanisms."

For help and support coping with eczema, phone the National Eczema Society all 0207 281 3553 or visit www.eczema.org

A new introductory booklet on Childhood Atopic Eczema is available free during National Eczema Week by phoning the Society's helpline 0870 241 3604.

How allergies triggered distressing symptoms

AFTER years of suffering eczema herself, Amanda Cooper was quick to recognise it in her children.

Amanda, 39, of Wigginton, discovered that cow's milk triggered her eczema when she was 22.

When her son, Joshua, was born, she gave him goat's milk until a health visitor told her he should be drinking cow's milk.

"Within three hours of giving him cow's milk he had eczema all down his leg, it was terrible," said Amanda. "At the time I thought I was awful not giving him cow's milk but when I knew he had an allergy too I was very careful to avoid it."

Joshua and his sister, Emily, are both allergic to milk protein, unlike their little sister, Tanya, who is eczema free.

"At night time it can be very difficult for them and they become much more irritable," she said. "When I've put the cream on to make sure their skin's not itchy they get a bit hyper and can't settle. I can understand what it's like for them but if I didn't know I'd think they were misbehaving.

"They don't always realise they're scratching and they can do it in their sleep but then it can become so sore it bleeds and becomes infected."

Amanda said she occasionally had "slip-ups" and ate products containing milk.

"I have a tolerance level and can occasionally have a slice of cheese or a small piece of pizza but if I had just one Rollo it would be enough to wake me up scratching," she said.

"I'm very careful with the children when we're eating out or at parties because I know just how uncomfortable it can be for them.

"I'm lucky because I know what it is they're allergic to. If I didn't know I'd be giving them cows milk and custard and milk chocolate and cheese and they'd be in a terrible state."

Factfile

What is eczema?

In mild forms the skin is dry, hot and itchy, while more severe forms can result in broken, raw and bleeding skin.

With treatment the inflammation can be reduced, although the skin will always be sensitive to flare-ups and need extra care.

Who does it affect?

It can affect all ages.

What causes eczema?

The causes of eczema are many and varied and depend upon the particular type a person has.

Some are thought to be hereditary while others are caused by irritants such as chemicals and detergents, allergens and yeast growths. The causes of some forms remain unexplained. It is not contagious.

Treatment:

There is no cure, although over-the-counter and prescription treatments can ease the distress.

Some people find complementary therapies helpful while others minimize environmental allergens in the home or alter their diet.

Will I grow out of eczema?

While there are no guarantees, 60 to 70 per cent of children are virtually clear of eczema by their mid-teens.

Types of condition

Atopic eczema

The commonest form of eczema and closely linked with asthma and hayfever. It can affect both children and adults, usually running in families. One of the most common symptoms is its itchiness , which can be almost unbearable.

Allergic contact

dermatitis

Develops when the body's immune system reacts against a substance in contact with the skin. The allergic reaction often develops over a period of time through repeated contact with the substance.

Irritant contact dermatitis

A type of eczema caused by frequent contact with everyday substances such as detergents and chemicals. It most commonly occurs on the hands of adults and can be prevented by avoiding the irritants and keeping the skin moisturised.

Infantile seborrhoeic eczema

A common condition affecting babies under one year old, the exact cause of which is unknown. Also known as cradle cap, it usually starts on the scalp or the nappy area and quickly spreads. It is not sore or itchy and does not cause the baby to feel uncomfortable or unwell.

Using moisturising creams and bath oils can help.

Adult seborrhoeic eczema

Characteristically affects adults between the ages of 20 and 40. Usually seen on the scalp as mild dandruff but can spread to the face, ears and chest. The skin becomes red, inflamed and starts to flake. Believed to be caused by a yeast growth

Varicose eczema

Affects the lower legs of those in their middle to late years, being caused by poor circulation. Commonly the skin around the ankles is affected, becoming speckled, itchy and inflamed. Treatment is with emollients and steroid creams. If left untreated, the skin can break down, resulting in an ulcer.

Discoid eczema

Usually found in adults and appears suddenly as a few coin shaped areas of red skin, normally on the trunk or lower legs.

They become itchy and can weep fluid.

Updated: 10:02 Friday, September 02, 2005