Although house dust mites are not a common trigger for childhood eczema, for a number of children they can cause persistent flare ups which may not respond to treatment. Diagnosing a house dust mite allergy is best done through allergy testing as eliminating house dust mites is time-consuming and can be expensive. If a house dust mite allergy has been diagnosed, it can be a really tricky eczema trigger for parents to manage. We have house dust mite allergies in the family so have built up rather too much experience in dealing with the pests over the years…
House dust mites: know your enemy
House dust mites are scavengers that live in nest sites of warm blooded animals such as rats, birds and humans. Their favourite food source is discarded skin fragments although they will almost anything organic. House dust mites have evolved a clever way to extract the most out of the available food: the first time they eat something hard to digest it passes through the mite relatively untouched but it will have been covered in active digestive enzymes. These enzymes break down the hard to digest food, turning droppings into an easy meal. House dust mites can recycle their droppings 3-4 times in this way. The digestive enzymes are activated by moisture, so if house dust mite droppings come into contact with damp human skin, the enzymes will start working there too. It is these enzymes in the dropping, rather than the house dust mites themselves, that can result in allergic reactions including eczema, asthma and rhinitis.
Practical ways to control house dust mites
While it is impossible to completely eliminate house dust mites, it is possible to substantially reduce them and their droppings. Mites are most active and breed most successfully at temperatures above 20°C and in humidity above 50%. To control house dust mite levels you need to both keep your home dry and cool, and minimise food sources by removing house dust as soon as it appears.
How to keep house dust mites out of children’s beds
The biggest source of house dust mite allergy reactions come from bedding. As young children can be in their beds for up to 14 hours a day, controlling house dust mites in their bedding is often the key to managing house dust mite allergies.
The warm, humid environment in the average bed is paradise for house dust mites. Here’s how to keep house dust mite activity in your child’s bed to a minimum:
- Air bedding daily – hanging duvets and sleeping bags over the side of the cot or across back of hard chair ensures that both the bedding and mattress dries out on a daily basis. This reduces the activity of house dust mites in both. Pillows can be aired by propping them up on an open backed chair.
- Use a 60°C hot wash for bedding as warm washing will remove house dust mite droppings but won’t kill the mites themselves. Alternatively, recent research has shown that house dust mites can be killed by soaking bedding for 30 minute a solution of water and eucalyptus oil (1 part oil to 120 parts water) for 30 minutes before using a regular 40°C wash cycle. The eucalyptus smell may linger for 2 to 3 days.
- Wash duvets and pillows regularly – While house dust mite proof duvet and pillow covers are available, they can be ‘hot’ making eczema children more itchy. Instead, as children’s bedding will fit in domestic washing machines, we find that it is more effective just to wash it regularly. As it can take more than 12 hours to get duvets washed and dried, we have an extra set to use while the first set is drying (also useful for night-time ‘accidents’!). Alternatively you could use high quality Egyptian cotton covers on duvets and pillows as the weave of this fabric can be so tight that adult mites have trouble passing through them. Although finding designs that appeal to children can be a bit challenging!
- Keep mattresses mite free – a lot of cot and some children’s mattresses have a waterproof (and dust mite proof) PVC covered side which can make keeping house dust mites out your child’s mattresses relatively easy. Alternatively, micro-porous mattress covers which keep dust house mites out of the mattress (or for old mattresses, out of the bedding) are available. However, both of these solutions can be ‘hot’ making some eczema children more itchy so we use a padded mattress protector (washed fortnightly) to improve air circulation and absorb moisture and Egyptian cotton sheets.
- Put kids to bed with dry hair – as wet hair will make their pillow damp and encourage house dust mites to move in and breed.
- Don’t wear PJs around the house – by keeping PJs for bedroom use only, the risk of transferring house dust mites into bedding from other parts of the house is greatly reduced.
- Keep your own bed mite free too. If your eczema child is likely to appear in your bed on a regular basis, you’ll need to use the same washing regime and mattress/duvet protection for your bed as you do for their own bed.
Three ways to get rid of house dust mites in cuddly toys
Soft toys can harbour a lot of house dust mites so most medical professional recommend not having them in the bed at all. But for eczema children who find it difficult to sleep, taking away their favourite toy can cause more problems than it solves.
Here are 3 ways to make cuddly toys house dust mite allergy friendly:
- Put the cuddly toys in a plastic bag and freeze (at -15°C) for at least 16 hours to kill the house dust mites. Then warm wash and dry thoroughly to get rid of the droppings.
- Tumble dry for one hour on the hot (extra dry) setting to kill the house dust mites then warm wash and dry thoroughly. Do check whether the toys in question can be tumble dried first!
- Soak the soft toy in a liquid detergent/eucalyptus oil
A few mites will survive all these methods so you will need to clean them every week. Of the three, the eucalyptus oil method is the most complicated but also the most effective. To make the solution add 4ml of essential eucalyptus oil and 1ml of clear non-biological washing detergent (we use Ecover Delicate) to 200ml of water, mix and stand for 10 minutes. The resulting liquid should be a stable milky, opaque solution that does not separate. If it does, you will have to try another clear liquid detergent. Add the solution to 5 litres of water and stir.
You’ll need to make sure that toys are thoroughly dry after washing as house dust mites thrive in damp, dark conditions and will take advantage of any remaining dampness. If really helps if you can persuade your child to love relatively small cuddly bed fellows as it makes the washing and drying process easier and quicker!
Controlling house dust mites around the house
House dust mites can be active wherever there is a food source, not just in bedding, so here are the practical ways we use to control house dust mites around our home:
- Keep indoor humidity low (between 30 and 50%) by opening windows (at least once a day), using trickle vents on double glazed windows, keeping bathroom doors shut, using extractor fans in both the bathroom and kitchen (especially as we cook using gas). Where possible we avoid drying washing in the house, if this is not realistic we keep it to one, well ventilated, room and close the door to keep the rest of the house dry – we use the bathroom as it is warm and has an extractor fan.
- Turn down the central heating to 19°C or lower and use thermostatic radiator values to keep bedrooms cooler again.
- Keep floors (and upholstery ) really clean – while hard floors can cleaned more easily than carpets, good HEPA filter vacuum cleaners can reduce house dust mite quantities significantly in carpet, upholstery and mattresses. As we have a family history of house dust mites we have replaced carpets with hard floors over the years, which has made a huge difference. We have also invested in leather sofas which has helped again. It took time to afford this but we found that investing in really good vacuum cleaner worked well while we saved up. Now we use a steam mop for floors to kill off any house dust mites. Top tip: If you do decide to go for hard floors, it’s a good idea to buy the slipper socks (with grippy soles) for the whole family while you get used to the lack of grip.
- Damp dust on a regular basis including mobiles, tops of curtains, the bottom rails of the cot and skirting boards. Baby wipes are great for this! It’s also worth washing curtains regularly as they can collect a remarkable amount of dust over time.
Managing a house dust mite allergy away from home
Controlling house dust mites in your own home is time-consuming enough but what if you are staying away from home with your allergic child? Here are our top tips:
- Take your own bedding, but plan on cleaning it as soon as you get back home to avoid contaminating your child’s own bed.
- If you can, have your eczema child sleep in a bed that isn’t used regularly – the lack of regular warmth and moisture will mean that house dust mite activity should be lower. If this isn’t possible, you can create a fairly effective temporary house dust mite barrier using disposable bed protectors (sold for potty training). These also have the advantage of having an absorbent top layer so aren’t as ‘hot’.
- Air the bedding daily, as you would at home. If you are staying in a hotel, it’s a good idea to ask the staff not to make up the beds.
- Try to stay somewhere with a hard floor – a number of boutique hotels and holiday cottages in the UK have hard floors and the self catering accommodation in Mediterranean countries usually has tiled floors through out.
- Expect your child’s eczema to flare-up while you are away and go prepared with your usual emollient creams and, if possible, some hydrocortisone from your doctor.
These methods work for our family’s house dust mite allergies. What works for your family?
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Read more article on avoiding baby eczema triggers in Daily Life:Living with Eczema
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