eczema & hard water
Article on childhood eczema & hard water.
Published in the Healthy Times Oct/Nov 98
Published by Alliance UniChem Plc, Cox Lane, Chessington, Surrey. KT9
1SN
A recent study has found a link between hard water and childhood
eczema. Healthy Times explores the health issues behind the
headlines. Eczema affects around one in eight children in the UK. In
its mildest form, the condition causes a few patches of dry skin, but
in severe cases, it can affect the whole body, causing persistent
itching and extreme discomfort. Frequent washing is an essential part
of the daily management of eczema, as it keeps infections at bay. But
scientists at Nottingham University have discovered that in some
cases, washing can actually aggravate the condition. A recent study,
which was published in the medical journal The Lancet, found that
children who live in homes with hard tap water are more likely to
suffer from eczema than those Living in homes with soft water.
Although this doesn’t mean that hard water causes eczema, it may mean
that it plays a role in aggravating eczema flare-ups.
The hardness or softness of your domestic water supply depends on
where you live and the original source of the water. At present, hard
water is supplied to around 60% of households in England and Wales.
Hard water contains higher concentrations of calcium and magnesium
than soft water. It forms scale that clogs up pipes, blocks shower
fittings and reduces the life expectancy of household machines, such
as dishwashers. The scum produced by hard water leaves tidemarks that
are difficult to wash off baths and basins, and makes it difficult to
obtain a lather, so more soap or shampoo is needed for washing.
Families of eczema sufferers and some doctors have claimed for some
time that living in a hard water area can make eczema worse, but it’s
only now that there is scientific evidence to back up these claims.
It is thought that calcium and magnesium may directly irritate the
skin, or may modify the effects of other chemicals such as
soap. ”There are at least two possible ways in which hard water can
make eczema worse. First, the salts in hard water could be deposited
on the skin causing dryness and irritation. Second, it is possible
that using hard water simply means that we use more soaps and
shampoos, which we know can irritate the skin of eczema sufferers,”
explains Professor Hywel Williams of Queen’s Medical Centre in
Nottingham, who co-authored the study. In the study, primary school
children aged between 4 and 11 years - were more likely to be
affected than secondary school children, suggesting that the link is
age-related. It is possible that younger children have greater
exposure to hard water during supervised bathing, under the watchful
eye of parents, or that older children are not as exposed because
they spend less time at home or have less sensitive skin.
It is possible to artificially change the hardness of your domestic
water supply. Water softeners alter the chemical structure of water
by exchanging calcium and magnesium ions for sodium. Physical
conditioners are scale reducers only and do not affect calcium and
magnesium levels. According to British Water, it is estimated that an
ion-exchange water softener could save over £200 a year for an
average family of four through the amount of shampoo, soap and water
that you save with a softener.
However, water softeners vary in price and efficiency, so seek advice
before you buy. According to Peter Evans, British Water’s Quality
Water Group’s deputy chairman: "It is absolutely vital for any parent
of a childhood eczema sufferer who is considering softening their
water to deal with a reputable supplier who will provide them with
detailed information and advice on the various products available.’
It’s too early to say whether water softeners will benefit the health
of children with eczema, although some dermatologists do recommend
them to their parents. ‘It is important that other independent
scientists confirm our findings, and that we follow up our study to
see whether softening the water of eczema sufferers will improve
their condition,’ says Professor Williams.
If you do install a water softener, place it downstream to the
kitchen tap, as softened water isn’t good for you in large amounts
and shouldn’t be used in cooking or in drinks. There is some
statistical (but not clinical) evidence to show that softened water
is associated with an increased risk of heart disease. The reason for
this is unclear, despite much research. One theory is that the higher
Levels of sodium cause an increase in blood pressure - softened water
isn’t suitable for babies or for people on a Low-sodium (low-salt)
diet.
Because water itself has a drying effect on skin, washing with
softened water may also aggravate eczema in some people. But it’s
still important to wash frequently -just apply moisturising emollient
products when you do. "Washing keeps the skin’s surface germs down,
reducing the risk of infection," explains Dr Sue Lewis-Jones,
consultant dermatologist at the Wrexham-Maelor Hospital in North
Wales. Flare-ups have been linked to a build-up of Staphylococcus
aureus bacteria, which are present in a higher density than usual on
areas of skin affected by severe or inflamed eczema. To reduce the
drying effect of water, eczema sufferers should apply emollients to
all affected areas after bathing, or use a specially-formulated
product in the bath itself. "If you wash with a bath oil, aqueous
cream or soap substitute, you stop the water drying out your skin.
Emollients act as an inert barrier, stopping germs getting through,
and also pass into skin cells, where they restore the natural oils,’
stresses Dr Sue Lews Jones.
Using emollients can be very time-consuming, as the products need to
be applied regularly -every few hours if possible. This causes a lot
of distress to young sufferers and places a strain on the whole
family. In a study published in the British Journal of Dermatology,
researchers found that in families where at least one child suffers
from severe eczema, 66% of parents said that they did not lead
a ‘normal’ family life. Over 60% felt frustrated or exhausted as a
result of attending a child who delayed sleeping or woke at night
with itching or scratching. Over 60% of siblings were losing steep
too.
Now that researchers have found evidence of a strong link between
hard water and eczema, it may be possible to prevent a lot of this
distress. "The results of this study are exciting, because if it is
confirmed that hard water causes flare-ups in a significant number of
eczema sufferers, it may be possible to improve the lives of eczema
sufferers by changing the water hardness," concludes Professor
Williams.