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Health: Families who are itching for a remedy: Chinese medicine is offering hope to children with eczema and their parents, says Bernardine Coverley

Bernardine Coverley
Monday 22 August 1994 23:02 BST

A row of little cotton gloves is drying in the bathroom. Every night at bedtime Caroline Austin covers two-year-old Daniel with moisturiser and wet-wrap bandages. Then come pyjamas and, finally, the gloves. Daniel has eczema, and eczema is itchy. On hot nights the itch is aggravated by sweat and by myriads of the unseen irritant, house dust mites.

'It crept up on us. At eight months he started getting skin rashes but it wasn't until it was covering his cheeks that I thought something was really wrong. It took me a long time to learn how many things affect eczema - wind chill, soap powder, food, bedding. Now I am so fine-tuned I know exactly what tips the balance.'

Most of his body is affected by eczema except his 'hands, feet and nappy area where the skin is like silk', explains his mother.

Summer brings its own problems: sun and sea are good only if skin is well protected with creams. Sand is bad. Nevertheless Daniel's skin improves at this time of the year. Unhappily, this is attended by an increased susceptibility to asthma. He spent two days in hospital recently, joining a ward full of small children breathing into their nebulisers.

The National Eczema Society's deputy director, Graham Ball, reckons that one in eight children suffer from atopic eczema - atopic meaning genetic predisposition to eczema, asthma or hay fever. 'What is alarming is the dramatic increase. The numbers have doubled over the last 10 years.'

All parents want their children's lives to be as normal and happy as possible, but without first-hand experience no one can imagine the constant vigilance that goes into protecting a child's skin.

The illness is so individual that it is hard to tell which out of several environmental factors triggers a reaction and which remedy will soothe the escalating cycle of itch, scratch and rash which can lead to sores and infection. What works for one child doesn't for another. Each family, with medical support, must work out a tailored programme of control. And because this involves so much practical work - checking for anything that could irritate, foods that could cause a reaction, cooling, moisturising and, not least with a young child, making all this fun - it places great demands on the family.

Ms Austin has cultivated the gentle skills necessary to persuade Daniel that greasy arms are a good thing and oatcakes are better than chocolate cake. She reads the letters page of the eczema society's magazine, Exchange. It is full of tips from other parents, especially aids to encourage peaceful nights such as putting on a story or song tape to distract a wakeful child. Daniel is about to test-run another suggestion, long cotton socks up to his shoulders instead of gloves (covered hands prevent too much damage from scratching).

Virtually the only time Ms Austin has for doing anything without her son is the brief time between his bedtime and hers. She graphically describes the disturbed nights: 'I know why sleep deprivation is used as a torture. And I never go away and stay overnight because Daniel can wake up four or five times. Friends aren't used to that. I can't leave him in a creche or with a babysitter because it is so distressing for people to see rub, rub and even bleeding.'

It is easy to see why some families are eligible for the disability living allowance. The absence of certain levels of sleep is such a worrying feature that the society is funding a research project on its impact.

Traditional Chinese medicine is one area that parents are particularly interested in. Practitioners prescribe up to 15 different herbs in mixtures designed for each patient. This is increasingly earning orthodox respect. The Chi Skin Clinic in Putney, south-west London, advocates a combined approach: antibiotics for infection and herbs for the long term. It is involved in research with Dr David Atherton, consultant dermatologist at Great Ormond Street Hospital and a specialist in childhood eczema. He is testing the power of the Chinese remedy from a fixed prescription, giving the same herbs to each child rather than individual ones. 'We need to satisfy licensing authorities who struggle with the idea of 10 herbs, even in mini-pill form. The purpose is to produce something that can be handled by pharmacists and could be prescribed around the country,' he says.

The apparently miraculous effect of Chinese herbs has been well reported and has proved irresistible to many people. As one father puts it: 'They just had to notice the queues round the block for a consultation in Chinatown.' His son is nine and consulted Dr Ding Hui Luo in Soho. After the original consultation and treatment his eczema has been successfully controlled, and he returns to Dr Luo for his individually designed mix of herbs - indescribably bitter - only when the now minimal rash and itch become bothersome again. He is also old enough to give an impressive explanation of the rash to any 'ugh-factor' curiosity at school.

The traditional scepticism of Western doctors towards complementary medicines is breaking down, if slowly. In China, doctors are trained in traditional and 'modern' medicine. In Britain the two paths tend to remain distinct. Dr Malcolm Rustin, consultant dermatologist at the Royal Free Hospital in north London, has been researching these remedies since 1988. Collaboration between Eastern and Western approaches is indeed still rare here, he says. 'We have had some very good results with Chinese herbs in the form of freeze-dried granules, coated so they're tasteless, and the number of pills reduced while their effect is maintained. What we want is to provide a Chinese herbalist to treat patients on the NHS, and we've set up a charity, Dermatrust, to raise money to do this.'

But Chinese medicine is not a quick fix. It is complicated, time- consuming and unpleasant. Preparing the decoction is quite a ritual and the resulting liquid looks like brown river water and tastes foul. Remedies are made up to suit the person, the current state of the illness and even the weather. Consultation and herbs can cost as much as pounds 60.

Money can be a problem for parents seeking conventional solutions as well. So many creams and lotions are needed, not all available on prescription.

''I have to test them out to find the ones that work for Daniel. That's why I call eczema capricious: it's so different for each person,' Caroline Austin says.

Daniel is barely old enough for Chinese medicine, which is not recommended until a child is at least two. But his wet-wrap bandages have improved his skin greatly and his parents hope for continued improvement.

Almost all children grow out of eczema by puberty. Perhaps this explains why, as Dr Atherton says, it is 'a very under-appreciated disease by the public and medical profession', and even that 'children with eczema and their parents are regarded as a nuisance, as the treatment is so time-consuming'.

But even when the skin is clear, the condition is merely dormant. There is no cure - only control.

'Where cat?' asks Daniel, ready for bed at last. Surprisingly, mother and child rummage among the frozen peas. The cuddly toy is retrieved, free of dust mites, after its weekly 12-hour stint in the freezer.

National Eczema Society, 4 Tavistock Place, London WC1H 9RA. Chi Skin Clinic, Riverbank House, Putney Bridge Approach, London SW6 3JD; helpline (071-371 9717). 'Eczema in Childhood: the facts' by David Atherton, OUP, pounds 9.99.

(Photograph omitted)

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