A TEACHER'S GUIDE TO ECZEMA
This is a publication of the now defunct Allergy/Asthma Association of Alberta. It was prepared in cooperation with the Alberta Children's Hospital, Calgary and funded by the Wild Rose Foundation, An Alberta Government Lottery funded Foundation.
What is Eczema?Eczema is a collective term for many different types of skin disorders which affect the top two layers of the skin. Numerous types of eczema exist, and their general symptoms are similar. Eczema may be chronic or acute in nature, and the child may never 'outgrow' the condition.
The most common form of childhood eczema is atopic eczema. With this form, the child has symptoms with environmental irritants as well as allergic responses. Contact dermatitis is another term for eczema. Both describe the same condition.
Signs and SymptomsThe symptoms listed here are common to all forms of eczema:
- an intense itch
- dry scaly skin
- a rash which can vary greatly in size of patches and extent of bodily coverage
- redness of the skin
- scratching to the point of breaking the skin
- weeping and crusting of skin areas, due either to scratching or skin condition or both
- difficulty in sitting still
- poor sleep, especially during the times when the eczema has flared up
Potential Irritants or AllergensPossible irritants or allergens in the classroom include such things as:
- play dough
- animal dander (dried skin particles)
- felt pens
Extreme heat or cold, sweating and emotional tension can all serve to aggravate an existing condition.
Though these treatments are done under a doctor's care, it is important to recognise that the condition and its symptoms can be so intense, and the anxiety produced so great, the the parents may seek all information on the condition and may even try unorthodox, non-medical treatments. This is done in the search for a 'cure' and everything may be tried in the hope of finding this magical solution.
- Eczema should be diagnosed and treated by a doctor. Generally speaking, the symptoms are treated rather than the condition itself.
- Various ointments and creams, including topical steroids, are employed to reduce the inflammation, itching and dryness, and to improve the general health of the skin. The latter is important because a healthy, supple skin is less likely to break down, or to break down as badly, when confronted with an allergen or irritant.
- Antihistamines are also used to reduce itching.
- Allergens and items to which the child is sensitive should be avoided whenever possible. If the itch becomes unbearable, mild tranquillizer may be employed to allow for some form of relief and some sleep.
- Antibiotics come into the picture only when an infection occurs, which can happen frequently if eczema is severe.
Implications in the ClassroomAs a teacher, you are responsible for your classroom and for attempting to maximize each student's learning potential. A student with skin allergies such as eczema can pose a challenge; however, this can be overcome through knowledge, prevention, and a good working relationship with the parents.
Here are some suggestions:
- Discuss the child's condition fully with the parents before school starts.
- Have the parents look through the classroom in order to identify potential problems.
- Consult with the parents before new activities occur in the classroom. With proper thought and preventative measures, even activities such as swimming are possible.
- If the child's learning ability is being impaired by the eczema, or if the child's behaviour is affecting the class, the parents should be consulted. It may be possible for the doctor to devise an alternate treatment program that eliminates this problem.
Points to Remember
It is understandable that the child's self-esteem may be quite fragile, especially if the child has had or does have severe eczema. Children learn to be quite self-conscious of their appearance and of your reaction and their classmates' reactions to it. Your reaction and how you discuss eczema with the class can make or break the situation and the child.
- The child is NOT contagious. Neither is the skin condition.
- The allergies, sensitivities and the skin condition are real and not imaginary. Their effects can be serious.
- The child may not be able to sit still because of the intense, constant itch.
- The child may not be aware that he or she is scratching. Asking the child to stop could be futile.
- Drowsiness and poor concentration may be caused either by poor sleep or by medications.
- A particular treatment which works for one child at one time may not help another child or even the same child at another time.
- When a child's skin does clear up, it may be due to or in spite of a particular treatment program.
- Anxiety and emotional stress do play a role in eczema, but their role is not fully understood. The relationship may be reciprocal, with stress possible causing eczema, and vice versa.
- The child may have to take or apply medication during the day, and may require some assistance.
- The parents are your best source of information about each child. Make use of their knowledge; together, you will form an effective team in providing a safe and rewarding school experience.
- Let the parents know that you will follow their instructions exactly.
- Don't allow the skin condition to make you lose sight of the fact that the child with eczema is still a child with special needs and strengths.
Knowledge, understanding and a good working relationship with the child and the parents will go a long way in making this situation a positive one. You can help the child to manage and deal with his or her condition and to maintain a high self-esteem. Knowledge, team work and understanding are the keys to a successful school experience.