A teacher’s tips for managing eczema at school

I’ve had eczema from the day I was born. As a child, I was under the care of Great Ormond Street. My transition to adult dermatology was problematic in many ways and it took more than ten years to find a dermatologist who I trusted. I have tried everything, ranging from questionable, eye-wateringly expensive herbal remedies to immunosuppressant treatments.

While I was growing up, I tried to compartmentalise this part of my identity. Looking back, I can see how this made school difficult to navigate. There can be a lack of awareness about the condition, with many still wrongly believing eczema is ‘just a rash’.

This is something I certainly encountered. These memories, combined with my pastoral role within school, have helped me realise how important it is to acknowledge the needs of pupils with eczema and make adjustments for them. These tips may help.

Communication

It can be hard to know how much information to share with your child’s school. If your child’s eczema compromises their enjoyment and wellbeing, it’s important to explain this to the school, and their doctor or dermatologist, so a support plan can be put in place.

• Find a trusted adult at school for your child to speak to. This might be their class teacher, form tutor, head of year or school nurse. In secondary schools, a form tutor or head of year can help to share information with other staff.

• Be clear with medical professionals about difficulties your child faces at school. For example, if they say ‘You must apply moisturisers often during the day’ and the reality of school makes this impossible, let them know. Check timings for treatment plans against school demands, especially in examination years such as Year 11 or 13.

• Phototherapy or immunosuppressant treatments can involve frequent medical appointments. If you think this would improve wellbeing, ask for reduced homework or deadline extensions, or see if they can take fewer subjects. Some students find that knowing in advance what content they will miss does help them manage their studies.

• If your child is suffering from a flare-up, let teachers know so they can make temporary adjustments to your child’s workload.

• At its worst, eczema can impact on wellbeing – sometimes leading to anxiety, depression or low self-esteem. If you feel your child is struggling, contact the school mental health lead or wellbeing team (if you’re unsure who this is, ask your child’s teacher). If the school cannot offer support in house, they may be able to signpost you to external agencies and write supporting letters.

School trips

School trips are significant social and educational events but you or your child may worry about managing skincare or emollient routines away from home – particularly during overnight stays.

• Ask for the trip itinerary. The excitement and chaos may disrupt those all-important skincare routines. Tell teachers that your child may need to get ready for bed or wake up earlier to apply creams or take their medication. If your child is worried about privacy, find out in advance about access to bathrooms and sleeping arrangements.

• If you support your child with their routine at home, help them become independent with this before they leave so they can confidently maintain their skin while they are away.

• Find out who will be responsible for carrying and storing the medication.

• Prepare a written copy of your child’s skincare routine and perhaps a photocopy of prescriptions to help busy teachers be clear about what your child needs.

Uniform

People with eczema often become experts in covering up and wearing fabrics that minimise irritation, but the restrictive nature of uniforms can cause discomfort for some children. I recall my own experiences of weighing up whether to overheat in a scratchy school jumper or reveal my badly marked arms.

• Speak to your child’s head of year to ask if your child can wear a light natural-fibre undergarment under their uniform.

• Ask if your school can offer reasonable adjustments to the PE kits – for example, a long sleeved T-shirt and leggings or tracksuit bottoms in school colours, rather than Lycra – although your child might not want to look different to their friends.

• White shirts are very unforgiving of cream, ointment and blood stains, while dark jumpers and blazers show dry, flaked skin. If your child keeps a spare shirt or jumper in their locker, or with a trusted teacher, this can minimise their feelings of self-consciousness.

Lesson time

Tiredness caused by disrupted sleep patterns, missed lessons due to hospital treatments and temperature changes in classrooms are just some factors that may affect your child’s happiness and confidence in school.

• Chat to your child about where they sit in class. Ask the teacher if they can sit away from radiators and near an open door or window, as this may help. Don’t worry about drawing attention to your child. Teachers are skilled at making quick, discreet changes to seating plans.

• Discuss an exit strategy in case your child needs to leave class. Sometimes they may need a few minutes out of lessons to compose themselves and ‘check for damage’ if they are particularly itchy or uncomfortable.

• Materials used in subjects such as DT and art can trigger contact dermatitis, so it’s a good idea to check what is being used that term, to avoid issues.

• Eczema, especially if combined with allergies, can make aspects of school difficult. For example, grass, tree and pollen allergies can make outdoor PE or sports days unhappy experiences. Children can feel embarrassed about making a fuss but it’s important to make sure teachers are aware of the severity of the allergies, eczema and triggers.

• If your child has difficulty maintaining focus or gets tired, they may need extra time and/or rest breaks in assessments. Ask your school’s SENCO or head of year for advice. You will need robust medical evidence for this arrangement in public examinations, so keep professionals informed about the impact your child’s eczema has on their education.

Seeing pupils struggle does take me back to my childhood, including:

• The horrible: The physics teacher who refused to believe that the nausea and side effects from my twice-weekly hospital trips for PUVA treatment was a valid reason for not completing homework

• The helpful: The English teacher who suggested I sit away from a scalding hot radiator

• The absurd: Not being able to bend my legs when seated because of icthopaste bandages strategically concealed under winter tights.

I do notice pupils’ discomfort but I’m careful not to tell them to stop scratching. The last thing anyone with eczema wants is someone stating the obvious. If it feels appropriate, I will ask what their triggers are, though, and help them think through how they might make their life easier. Supporting pupils is rewarding – especially when adjustments make an improvement to their wellbeing.

A couple of years ago, I observed a lesson and noticed a pupil clearly struggling with their skin, so I gently suggested we chat. This discussion was worthwhile for both of us and led to many of the suggestions in this article. Eczema is a tricky condition to manage, and there aren’t always answers, but in my experience, good communication with the people around you always helps.

About the author: Ana-Maria Fernandes teaches religious studies at a mixed comprehensive secondary school in Hertfordshire, where she has worked for nearly ten years. For the past three, she has been head of year. A considerable part of this role is supporting pupils with various medical and wellbeing needs.

School Information Pack

Starting school or moving to a new school is an exciting yet anxious time for any parent and child. Families of children with eczema may have additional concerns about this new phase of life.

A child with eczema will, over time, need to learn how to be responsible for their own skin care during the school day. This is often a challenge and all school staff have an important role to play in supporting the child with aspects of their eczema which may affect their wellbeing at school, and in accommodating the child’s complex needs (especially when the eczema is moderate to severe).

We recognise that managing eczema at school can be daunting for everyone involved – children, parents/carers and school staff – and that’s why we’ve produced our School Information Pack.

Our School Information Pack is aimed at parents of primary-aged children, and primary school staff. It contains:

• Information about eczema, eczema triggers in a school context and eczema treatments

• Advice for supporting children with eczema at school

• A parent/carer – teacher meeting checklist to inform a discussion about a child’s eczema

• An eczema-planning checklist for a teacher/teaching assistant who has a child with eczema in their class

• Eczema-related lesson plans for different age groups covering ages 3 to 11, for teaching children about eczema

The School Information Pack can be downloaded below.