The skin condition eczema is pretty common in little ones, which is why we’ve compiled a parents’ guide to help you find the best treatment for your child’s symptoms
What is eczema?
Eczema is a condition which makes skin red, dry and itchy. The most common form of eczema is atopic eczema (‘atopic’ simply means sensitivity to allergens). This type of eczema can affect people of any age, but it tends to be more common in children. Atopic conditions often run in families and can also include hayfever, food allergies and asthma. Your child is more likely to have eczema if you have any of these conditions, however not all children whose parents have atopic conditions have eczema.
Likewise, many children who have eczema do not have parents with atopic conditions. Sixty percent of children with atopic eczema have completely grown out of it by their teens.
Symptoms of eczema
Eczema can make the skin dry, cracked, sore, red and itchy. While it can affect any part of the body, in babies and children it's usually found on the hands, the inside of joints that bend (inside of elbows and back of knees), and the face and scalp.
Scratching affected areas often makes them inflamed, and they can occasionally bleed. If eczema is well controlled, children can have periods where the condition is barely noticeable. Flare-ups of eczema are periods where certain areas of affected skin worsen, and symptoms are more noticeable and bothersome.
Eczema can be diagnosed by your GP. Possible signs include:
• Visibly irritated, dry, itchy, red skin in the areas described above, or a history of irritation in these areas
• Generally dry skin over the last 12 months
• A history of asthma or hayfever, or a sibling or parent with eczema, asthma or hayfever
Treating eczema
Eczema treatment relies upon the following principles:
Avoiding environmental irritation
This means avoiding triggers which may make eczema worse, such as certain detergents, some fabrics or dietary triggers. Each person with eczema has different triggers, so it can be tricky to know what to stay away from. Your GP may be able to advise a strategy to help find out what triggers your child has.
Avoiding scratching
For young children who scratch, particularly in their sleep, you can get mittens to cover their hands overnight. Keeping your child's nails short can also prevent them from scratching.
Moisturising with emollients regularly
Keeping the skin well moisturised helps keep eczema under control. Even when children are going through periods where their eczema is hardly noticeable, evidence shows that continuing to use emollients daily helps to prevent flare-ups. There are many different emollients available, and they can be used all over the body. Ask your pharmacist which emollient is most suitable for your child.
Topical steroids
For flare-ups and particularly sore areas, your GP may prescribe topical steroids which can help reduce the inflammation within a few days of being applied to the skin. Make sure you follow your doctor’s instructions and read the patient information leaflet which comes with the medicine.
When using topical steroids, you should continue using your child's regular emollient. You can apply the emollient first and wait around 30 minutes before applying the steroid or apply the steroid at a different time of the day. Be sure to carry on using the topical steroid for 48 hours after the flare-up has cleared.
See your GP if you find that you’re having to use the topical steroid frequently on your child so they can review the treatment and check it’s working.
Complications of eczema
Eczema can leave the skin vulnerable to infection with bacteria or viruses, which means it requires slightly different treatment. Here's what to look out for:
Bacterial infection
If your child's eczema becomes oozy, develops a yellow crust or there are yellow or white spots in the affected areas, this can be a sign of bacterial infection. Other signs of bacterial infection include rapidly worsening eczema symptoms or a high temperature. If you think your child had a bacterial infection on top of their eczema, take them to see the GP.
Eczema herpeticum
Most viruses do not affect eczema, but the virus that causes cold sores (Herpes simplex) can lead to a complication of eczema called eczema herpeticum. If your child has blisters or sores in their eczema-prone areas, they have painful areas which are getting worse rapidly and they have a fever or feel unwell, contact your GP immediately. If you can't contact your GP, call 111 or take your child to your local A&E, as this is a potentially dangerous infection which needs to be treated promptly.
Psychological factors
Eczema can be a difficult condition to manage and treat, and it can cause stress for a number of reasons. It may disrupt sleep due to itching or discomfort whilst having a flare-up. For some children, eczema also affects their self-confidence. If you're concerned about the psychological impact of eczema on your child, there are various support resources available from the National Eczema Society. You could also see your GP to discuss whether your child would benefit from some psychological support.
Next steps
• See your GP if you suspect your child may have eczema
• If your child is diagnosed with eczema, you should use emollients at least twice a day to help maintain good control
• Topical steroids can help in the management of flare-ups. Never use steroids prescribed for you on your children
• Seek medical advice urgently if you suspect your child has a bacterial infection or eczema herpeticum
