Managing eczema at school
Eczema is an extremely common childhood condition, affecting one in five kids. This means that in every primary school class, it’s likely that several children will have eczema.
For the vast majority of kids with eczema, the condition develops in the first five years of life, and often in the first 12 months. Although 65% of children will outgrow eczema by the age of seven, many will start school with the condition.
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What are the symptoms of eczema?
The symptoms of atopic eczema include:
- Patches of skin that are dry, cracked, sore and red.
- Intense itching that may disturb sleep.
- Irritation particularly on the hands, fingers, elbow and knee creases, the face and scalp. Black and Asian children may have eczema in different areas, such as the front of the knees and outside of elbows.
- Periods when the symptoms are less noticeable, interspersed with periods when they are more intense, known as flare-ups, which can happen as often as two or three times a month.
Sometimes, eczema becomes infected. This can cause additional symptoms:
- Worsening eczema.
- Fluid oozing from patches of eczema.
- Yellow crusts on the skin or small yellowish spots.
- Swollen or sore skin.
- A high temperature and feeling generally unwell.
Treating eczema in children
Eczema in children is typically treated by using medical moisturisers called emollients every day. These are available in pharmacies or on prescription.
If your child has a flare-up, they may need topical steroid creams to reduce swelling and redness. If they develop an infection, they might be prescribed antibiotics.
Some children take antihistamines to help with the itching. If their eczema is severe, they may also need to wear bandages or bodysuits under their clothes to let their skin heal. They may also be referred to a dermatologist.
How eczema affects children at school
Eczema can have a big impact on children’s experience of school.
‘They sometimes struggle to sit still or concentrate because of the itching,’ explains Alice Lambert, spokesperson for the National Eczema Society.
‘This itchiness can continue late into the night, causing tiredness the next day.’
Children may need special accommodations to be able to take part in school activities.
‘They might need additional equipment, preparation or aftercare: for example, for messy or wet play, they might need to wear PVC gloves with a cotton lining, and moisturise their hands before and after,’ says Alice.
Your child might need to take precautions when participating in sports.
‘Sweat can trigger eczema, so they might need to apply emollient after PE, and take it easier when their eczema is flaring,’ Alice advises.
‘When they go swimming, they should apply emollient before entering the pool and after patting themselves dry following their post-swim shower.’
Eczema can have a social and psychological impact on your child, too.
‘They may feel frustrated and irritable as a result of their eczema, which might make it difficult for them to make friends,’ says Alice.
‘Children with eczema on visible areas such as the face and hands might feel self-conscious, so it’s important that other children in the class understand what eczema is, and that it’s not contagious.’
Supporting children with eczema at school
Children with eczema often need help with managing their condition at school. The most important thing that schools can do is support them in using their emollient: the foundation of treating eczema.
‘Some children will need to apply emollient during the school day, and it’s really important that they are given a clean, private room to do this: toilets aren’t an acceptable option due to the risk of infection,’ says Alice.
‘Teachers will need to remind younger children to apply their emollient, as they are likely to forget.’
Schools can also help by being aware of children’s triggers and trying to minimise exposure. For example, your child might need to stay indoors at breaktime when the pollen count is high to avoid irritation, or sit on a cotton mat during carpet time, as carpets harbour dustmites and their droppings, which can cause itching and chafing.
School uniform may need to be adapted, too, as some kids with eczema find their skin is irritated by wool and synthetic fabrics. They might, for instance, be allowed to wear a cotton jumper in the school colour rather than the official sweatshirt.
One important thing that schools can do to help children with eczema is ensure other kids in the class have an understanding of the condition.
‘They can work to increase awareness and understanding of eczema, to make school a happier and more accepting environment,’ Alice says.
The National Eczema Society has a series of lesson plans that schools can use to educate children about the condition.
Schools should also be accommodating if your child needs time off school for medical appointments or to recover from a flare-up.
How to help your child manage eczema at school
There’s plenty you can do to help your child manage their eczema at school.
‘We recommend that parents meet with their child’s teacher before the start of each new school year to discuss how their eczema can best be managed at school,’ says Alice.
The National Eczema Society provides a school information pack for parents and teachers, which includes a checklist of subjects to discuss at this meeting.
The school may suggest putting together an Individual Health Care Plan that sets out how your child’s condition affects them, and how it can be managed.
It’s important to teach your child to apply their own emollient. Providing their ointment in a pump dispenser may make it easier to apply.
Inform the school of any triggers that affect your child’s asthma, such as temperature extremes, particular foods and pollen, so they can help to minimise them.
If you can, try to arrange medical appointments out of school hours so their learning is disrupted as little as possible.
It’s also essential to look after your child’s mental health as well as their physical symptoms: give them chances to talk about how things are going at school and if they’re worried about anything like discomfort during certain activities or bullying, so you can raise these issues with their teacher.