New research from Trinity College Dublin (TCD) has found that severe eczema can be associated with significant growth restriction in children. But importantly, the study suggests that effectively treating the condition may help children catch up on their growth. Eczema is very common in children, wi…
New research from Trinity College Dublin (TCD) has found that severe eczema can be associated with significant growth restriction in children.
But importantly, the study suggests that effectively treating the condition may help children catch up on their growth.
Eczema is very common in children, with one in five children in Ireland affected. For most, it means an itchy or painful rash. But for those with severe cases, the impact can go far beyond that.
Alan Irvine, Professor of Dermatology at TCD who led the research said that most instances of eczema, formally atopic dermatitis, are mild and are treated by GPs.
Speaking on RTÉ's Today with David McCullagh he said there are hundreds of children who live with severe eczema "who do live with very impacted lives".
"It affects their ability to sleep. It's intensely itchy. They require a lot of treatment to manage it and it does have an impact beyond the skin. It's got lots of other things it's associated with, like food allergies and risks of asthma," he said.
"But even just the inflammation in the skin itself can have quite a profound effect on the child's health, their ability to sleep, their ability to grow and their comfort levels."
Prof Irvine said that epidemiological studies show that children "have a shorter height attainment, lower growth rates, lower levels of what are called bone biomarkers".
He said that the research that he was working on was on how to reverse these impacts and was based on treatment trials.
"When I was looking at their data, I noticed that this marker, alkaline phosphatase, had gone up in the kids who were treated. And there was a concern that that was maybe a safety thing with the drug, but I thought it probably wasn't. I thought it was probably a really positive thing," he said.
So, he went back to the results and reanalysed all the data.
The original trials on the treatment were completely blind, so nobody involved, researchers or children, knew who had been treated, or who had got a placebo, a saline injection.
"The kids at the start of the study who had eczema were considerably shorter than their peers who didn't have severe eczema. And there's ways that we can measure how you should grow on a percentile curve, essentially," he said.
"At sixteen weeks, the kids who got the treatment had had really shot up and achieved much greater growth, even in that sixteen-week period."
Prof Irvine said the result was "remarkable" and as the study continued to a full year, the results continued.
Findings 'really robust'
Children with eczema who had been given a placebo originally, and who were switched to the treatment, also responded positively, which made the findings "really robust".
He said it appeared to be more effective when given earlier as children have more years of growth potential. Boys responded somewhat better than girls, again because they have more growth years.
There are some minor side effects such as red itchy eyes and joint stiffness.
"The growth effect is a genuinely new discovery. And it's just another thing for parents and people who provide care for their kids to think about, when parents are coming to consider, do they put their child on a drug for their skin condition?" he said.
On why eczema affects growth, Prof Irvine said there were two main theories.
One is that inflammation consumes a lot of calories that growing children then miss out on. A second theory is that eczema interrupts sleep and children grow in their sleep.
