After a long time we had a scratching attack last night. J. didn’t sleep well the last couple of nights, which might be because my husband was gone for a few days, which interrupted our sleeping routine. J. is scratching more these days, which might be due to my husband’s absence, the bad sleep, the birthday party where he ate a piece of cake, the absence due to sickness of his favorite educator at his daycare, the glass of goat milk he drank yesterday, everything together, or something entirely non-obvious to me. Oh, if I just knew what bothers him…. Or, he might just be getting sick. Since yesterday he has a bad flare-up of a bacterial infection at the back of his neck and is generally very tired. And it is very difficult to keep him from scratching his neck.
I keep reading about allergens that could potentially worsen eczema, and especially because J. doesn’t have a clear food allergy, I am starting to look more closely at potential external and airborne irritants. For long time already we are using only organic cleaning supplies, I stopped using perfumes, etc. and we are trying to keep the house as clean as possible, vacuuming and washing the floors every week. But I have not been militant about dust and dust mites. House dust mites seem to be a very prominent trigger for asthma (many children with eczema seem to develop later asthma as well) and according to the “Handbook of atopic eczema”  and references there in, they do play a role in eczema (chapter 3.8.8.):
House dust mite allergens have long been known as a provocation factor for atopic eczema […]. The efficacy of measures to reduce the allergen load of house dust mites was investigated in several randomized controlled trials focusing both on the allergen load and clinical endpoints. The majority of these studies indicate a beneficial effect, although some smaller studies were not able to confirm this […]. The clinical association between atopic eczema and a sensitization to house dust mites was shown in an epidemiological study in 2,201 school children. A significant linear association between the degree of sensitization (kU/l) to house dust mites and the severity of atopic eczema (intensity score) was reported […].
So, it might be worth to put a bit more effort into the fight against this tiny (ca. 1/3 mm) member of the spider family. As I understand, the problems are not the mites themselves but their droppings, so any fight should concentrate on eradicating the mites as well as washing out the droppings.
Mites live off tiny bits of organic tissue, in particular small scraps of skin. So, the bed of a person with eczema is heaven for them. They like even more the mold that grows on this tiny organic particles in a warm and moist environment – and pillows and fluffy toys which collect the warmth and moist of the breathing are the best places for this. On the other hand, mites don’t like (it kills them) temperatures above 60 °C (140 °F)or below freezing. Besides washing and freezing all bedding and toys regularly and keeping rooms well ventilated, pillows, mattresses and bedding can be covered with special mite prove micro-pore envelopes.
For a start I had all our pillows and blankets outside during the days when we had temperatures below freezing. But this doesn’t wash away the droppings and I have to think how I deal with this. This weekend we are planning to do a thorough cleanup of J.’s room, packing away all toys and books he doesn’t play with, so that we can easily clean all surfaces. And I will look for these mite prove envelopes. Maybe that will help J.’s eczema, or at least lowers the risk for him to develop asthma later.
 Ring J, Przybilla B and Ruzicka T (Eds.) (2006). Handbook of Atopic Eczema. Springer-Verlag Berlin Heidelberg. (available as electronic version online)