Jako dítě jsem měla atopický ekzém, který mě trápil od prvních narozenin zhruba do puberty. Musím říct, že jsem tím trpěla nejen fyzicky (ekzém opravdu hodně svědí), ale hlavně psychicky (mít ekzém v obličeji není pro holku žádná slast) a doufala jsem, že se toto zánětlivé onemocnění kůže mým dětem vyhne. Bohužel se tak ale nestalo a oba ho po určitou dobu měli a teď v zimě se jim opět vrátil, i když v mírnější formě.
Ale popořádku. Jisté náznaky, že bude mí Samík citlivější kůži, tu byly již od jeho narození, kdy měl dětskou kopřivku (tehdy pomohly obklady z černého čaje) a později měl téměř vždy kožní reakci po očkování (proto jsme pak oddalovali celý očkovací cyklus). Samíkovi se ekzém objevil kolem šestého měsíce, kdy byl ještě plně kojený (u nekojených dětí se doporučuje při ekzému hypoalergenní UM). Ekzém se mu během 4 dnů udělal úplně po celém tělíčku a já jsem plakala při každém přebalování, kdy jsem ho viděla nahého. Nejprve jsem udělala tu největší chybu, jakou jsem mohla a zasedla jsem k počítači a podle diskuzních fór jsem zkoušela Samíka mazat vším možným (od indulony po masti na zadeček) a když mu to hned ten den nepomohlo, přešla jsem na jiný krém. To bylo samozřejmě to nejhorší, co jsem tehdy pro jeho kůži mohla udělat, ale byla jsem opravdu zoufalá a rady ostatních maminek byly tak přesvědčivé. Jenže forem ekzému je spousta (od suché šupinaté kůže po mokvající ložiska) a každému pomáhá něco jiného. Poté jsme tedy raději navštívili pediatra, který nám doporučil produkty, které Samíkovi ale nepomohly a spíš stav pokožky zhoršily. Našli jsme si tedy dětskou kožní lékařku a vydali se k ní. Ta nám potvrdila atopický ekzém, doporučila krémy na promazávání (o mazadlech se rozepíšu dále) a dala nám řadu doporučení, kterých by se rodiče atopických dětí měli držet.
Co se koupání atopických dětí týče, tak zde platí zásada „čím méně, tím lépe“. Nám kožařka doporučila koupání jednou za 3 dny a dodržovat pravidlo 5 minut – 5 minut koupel a do 5 minut namazat – to jsme striktně dodržovali do roka, kdy byl ekzém nejhorší. Když měl Samík červená ložiska, používali jsme sprchový gel Bioderma, který potlačuje rozmnožování mikroorganismů a dráždivých látek zhoršujících suchost pokožky. Když měl Samík naopak kůži suchou až šupinatou, používali jsme sprchový olej od stejné značky, který pokožku vyživuje, zvláčňuje a zmírňuje pocity pnutí. Děti umývám obyčejnými mycími houbami z Lidlu, protože jsou levné a můžu je tak často měnit. Když Samíka hodně trápilo svědění, dělávali jsme mu také ovesnou koupel z DM drogerie (vyrobit si ji můžete i doma – použít se dají také otruby, řapík nebo bramborový škrob). Důležité je také nedřít pokožku ručníkem, spíš ho jen tak přitiskávat k pokožce.
Kvůli ekzému jsme neabsolvovali ani tolik oblíbené kojenecké plavání. Existují sice bazény se slanou vodou, ale atopické pokožce nedělá dobře nejen kontakt s vodou, ale také teplo a vlhko, takže jsme si tuto činnost na radu lékařky raději odpustili. Jinak co se moře týče, tak když byl Samíkovi rok, vydali jsme se s ním na 13 dní do Řecka a moc mu to pomohlo – na 2,5 měsíce jsme měli od ekzému úplný klid (kdyby to šlo, jezdívala bych s ním k moři pravidelně).
Další, co by asi každá maminka měla u atopických dětí řešit je oblečení a péče o něj. Ideální je oblékat děti do bavlny, která pokožku nedráždí. Naopak vyhýbat byste se měli vlně a to i na svém oblečení, pokud miminko nosíte. Samíkovi vadilo i jakékoliv oblečení s „delším“ chlupem, fleecové oblečení, různé plyšákové overaly apod. Co se péče o oblečení týče, tak já jsem na začátku zkoušela různé baby formy známých pracích prášků, ale když měl Samík ekzém opravdu ošklivý, tak jsem mohla používat jedině 100% přírodní prací prášek Ma-la-ma, který obsahuje jen kokosový a olivový olej a mořskou sůl. Skvrny jsem předeprala pomocí žlučového mýdla a se zbytkem si poradil tento prášek. Ideální je, když dáte jedno extra máchání navíc, abyste prádlo dokonale zbavili zbytků pracího prášku. A je opravdu velmi důležité úplně vynechat aviváž. U oblečení také stříhejte etikety a lístečky, protože ty děti s ekzémem hodně dráždí. Na noc existují i různá speciální pyžamka pro atopické děti, ale nám stačila pyžamka, u kterých se daly založit ručičky tak, aby se Samík neškrábal. S oblečením také souvisí to, že v ideálním případě by se pokožka dětí s ekzémem neměla zapotit, protože ve vlhku se bakteriím daří. Je tedy dobré děti oblékat do prodyšného oblečení jako cibuli (tedy do více vrstev), abyste ho mohli postupně svlékat, když přijdete např. z venku do tepla.
Co vám může také pomoci, to jezápisník, kam si budete zaznamenávat, kdy se ekzém vašeho dítěte zhoršuje a v závislosti na čem to je. Kromě potravin to může být také změna prostředí, rostoucí zuby, stres (i ten pozitivní – např. čekání na Ježíška), očkování, nemoci, změny počasí… Samostatnou kapitolou je pak jídelníček. Mnoho lidí přisuzuje jídlu hlavní příčinu vzniku ekzému. U mě osobně se to nikdy neprojevilo, ale věděla jsem, že když sním např. hodně čokolády, citrusy nebo kořeněné jídlo, bude to horší. Ale neznamenalo to, že když tyto potraviny vynechám, budu bez ekzému. U Samíka se projevil ekzém, když byl ještě plně kojený, takže jsme s příkrmy začínali velmi pomalu. Každou novou potravinu jsem zaváděla 3-4 dny a až pak jsem zkoušela další druhy, případně jejich kombinace. Samík naštěstí žádnou alergii na jídlo nikdy neměl, ale nedělalo mu dobře kyselé ovoce, citrusy a rajčata. Dále bývá u ekzematiků hůře snášen česnek, cibule a koření. Některé děti mohou mít zase ekzém spojený s alergií na bílkovinu kravského mléka. Často se v souvislosti s potravinami doporučují eliminační nebo histaminové diety (viz google), aby se zjistilo, co případně ekzém vyvolává nebo ho zhoršuje. Alternativou těchto diet jsou testy na alergologii, ale náš pediatr i kožní lékařka nám je vymlouvali, protože do 3 let věku se imunitní systém dětí vyvíjí, což znamená, že výsledky testů mohou být zavádějící. Samík byl navíc do 17 měsíců kojený, takže měl v sobě protilátky z mateřského mléka a to by mohlo výsledky testů zkreslit. My jsme nakonec na testy šli, když mu byly asi dva roky a všechno vyšlo negativně. Co se týče doplňků stravy, tak my jsme Samíkovi pravidelně dávali probiotika, která mohou stav pokožky také zlepšovat.
Co se týče přizpůsobení domácnosti atopikům, tak já osobně nejsem zastáncem úplně sterilně čistých domovů. Nicméně nepoužíváme žádné závěsy a záclony, máme jen kusové koberce, které lze snadno vyprat (kvůli roztočům), častěji pereme dětem ložní prádlo (na kterém ulpívají zbytky kůže), snažíme se v bytě udržovat nižší vlhkost i teplotu (méně topit, více větrat) a samozřejmostí je nekuřácké prostředí. Skvělé také je, pokud eliminujete škodlivé chemikálie v domácnosti a vydáte se směrem k tzv. „non toxic“ domácnosti. V dnešní době už je to velice snadné, protože eko přípravky jsou dostupné v běžných drogériích.
A teď tedy k samotným mazadlům, kterým budete věnovat s atopickým dítětem celkem dost času, ale je to velice důležité. Na promazávání se používají tzv. emoliencia, která se aplikují na celé tělo, aby pokožku hydratovala a obnovovala kožní bariéru. U těchto mazadel je nejdůležitější mazat, mazat a mazat. A to doslova. V období nejhoršího stavu Samíkovy pokožky jsem ho promazávala minimálně 5krát denně – skvělou příležitostí k promazání je např. přebalování. Potom jsem četnost promazávání přizpůsobovala aktuálnímu stavu pokožky, ale min. jednou denně jsem mazala vždy. Emoliencia jsou běžně dostupná v lékárně a nepotřebujete na ně lékařský předpis. Předtím, než se rozhodnete pro používání určité řady krémů, bylo by dobré, abyste si v lékárně vyžádali vzoreček a po dobu 5 dnů ho testovali na malém úseku kůže (občas se stane, že daný krém dítěti opravdu nesedne). My jsme u Samíka a později i u Sárinky používali řadu Atoderm od Biodermy pro velmi suchou až atopickou pokožku a konkrétně k promazávání jsme používali krém Intensive baume, který zklidňuje podráždění a svědění a posiluje kožní bariéru.
Druhou skupinou mazadel jsou bílé (někdy jinak barevné) pasty – patří sem např. zinková mast nebo Holtova mast, které se používají lokálně na ložiska (zčervenalá místa). Aplikují se většinou na noc, protože barví a trošku zapáchají a nenanáší se na celé tělo, ale opravdu jen na ložiska.
Poslední skupina mazadel je trošku kontroverznější a jsou to lokální kortikoidy. Já nejsem odpůrcem, ani zastáncem kortikoidů (sama si pamatuju, jak jsem o ně mamku vždy prosila, protože jsem věděla, že mi pomohou), ale je nutné používat je s rozumem, lokálně a opravdu jen v nejnutnějších případech dle pokynů lékaře (jsou na předpis). Kortikoidy neléčí příčinu ekzému, léčí jeho následky. U Samíka jsme v nejnutnějších případech, kdy nepomáhaly pasty z předchozí skupiny mazadel, používali Locoid – mazali jsme na postižená místa max. 2-3 dny (což vždy bohatě stačilo). Poté se doporučuje min. 2krát tak dlouho kortikoidy nepoužívat (když tedy mažete 3 dny, měla by pak být pauza min. 6 dní). My jsme je naštěstí používali vždy max. 3 dny v měsíci.
Mimo mazadla ještě dětem mohou ulevit různé obklady. Používají se ve chvíli, kdy kůže mokvá. Asi nejznámější je Jarischův roztok. Pomoci může ale také černý čaj nebo řapík. Obklad by se měl připravovat čerstvý, z teplé vody (ne horké) – ideální je, namáčet do něj gázu a tu přikládat na postižená místa. Jedno místo by se takto mělo ošetřovat minimálně 10 minut, přičemž každé 2 minuty byste měli obklad vyměnit.
Poslední, co bych zde chtěla zmínit je něco, co nám velmi pomohlo v noci a jsou to antihistaminika, což jsou léky, které zmírňují svědění. Nám doporučil pediatr i kožní lékařka Fenistil kapky. V návodu se píše dávkování 3krát denně, ale když nedáváte přes den, můžete dát o to víc kapiček na noc.
Ekzém je běh na dlouhou trať, ale Samík se ho naštěstí zbavil chvilku před třetími narozeninami. Teď v zimě má zase pokožku citlivější, ale už nám stačí jen promazávat krémem Intensive baume. Co se týče Sárinky, tak tu jsem po předchozích zkušenostech již od narození mazala krémem Atoderm préventive, který zamezuje zhoršení suchosti pokožky a omezuje přilnavost a šíření zlatého stafylokoka. U Sárinky se pak ekzém sice objevil, ale měla ho jen 3 měsíce a pak úplně zmizel.
Doufám, že vám tento článek alespoň trochu pomohl a přeji vám, aby vaše děti ekzém moc dlouho netrápil.
Super článek 😊 my máme ekzém v té horší podobě od 6 týdnů. Teď jsou synovi 13 měsíců a je to konečně lepší, ale u nás to hodně souvisí s potravinovou alergií (na bílkovinu kravského mléka, vejce, lepek a sóju). Bez rukavic nedáme ani ránu a když byl menší byla potřeba i kukla. Proto ještě doporučím web proalergiky.cz , kde kupuju oblečení.
Byli jsme i hospitalizovaní v nemocnici a tam nás naučili praktikovat zábaly, které dost pomohly. Vlhkou pokožku namazat chladivým syndermanem v obrovském množství. Takže je pak kůže úplně bílá. Miminko oblečeme do mokrého pyžamka, pak do suchého a zabalíme do peřinky. A vydržet nejlépe hodinku. Ale realita je samozřejmě taková, že když miminko začne být více pohyblivé, už v tom nevydrží.
To me moc mrzi, ze mate s ekzemem takove trapeni 🙂 Preji at uz se to jen zlepsuje.
Clanek zajimavy. Skoda tech nefunkcnich odkazu na produktyod Biodermy.
Moc dekuji za upozorneni, nevim, co jsem udelala spatne, ale jiz jsem to opravila.
Milá Lucie,
ačkoliv jsem byla k Biodermě trochu skeptická – mně osobně totiž nevyhovuje, po přečtení Vašeho článku – ve kterém jsem se trochu našla, a to zejména ve střídání produktů, v netrpělivosti, a v určitém zoufalství jak synovi pomoci od ekzému – hlavně co nejrychleji, což byla samozřejmě chyba, jsem nakonec Biodermu objednala, jednak Atoderm Intensive Gel moussant a k němu navazující Atoderm Intensive Baume…A jako panebože!!!! Okamžité zlepšení o 100 %…Doslova jsem valila oči jak tahle kombinace okamžitě zafungovala, navíc má syn kůži krásně vláčnou, a je patrné, že se na ní vytvoří jako kdyby ochranný film..Takže Vám děkuji jednak za typ na Biodermu :), ale i za ostatní rady, a za to, že jste to tak pěkně a jasně sepsala, a člověk má hned ucelený obrázek..
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