Introduction
Eczema is a skin condition that causes itchy and inflamed patches on the skin. It is also called atopic dermatitis.
Eczema can be common in babies and children. It can cause discomfort and can lead to skin infections.
Some children grow out of eczema, but others will have it for life.
Signs and symptoms
Signs and symptoms of eczema will appear on the skin.
They can include:
- general dryness and cracks
- itchiness
- redness
- irritation on the face - common in babies
- irritation on the fronts of knees and ankles and the inside of wrists - common in toddlers
- irritation in the folds of elbows and knees - common in older children
- a rash that spreads over the entire body.
Severe cases of eczema can cause cracks in the skin that weep fluid. This can lead to infection.
Children who have eczema are also more likely to have:
- food allergies
- asthma
- allergic rhinitis or hay fever
- family members who also have these conditions.
Diagnosis
Your child’s doctor will take a medical history and examine their skin during an eczema flare-up to diagnose the condition.
They may refer your child to a skin specialist called a dermatologist to do a skin biopsy. A skin biopsy is a test where a small sample of skin with eczema is removed and tested.
Treatment
Eczema is a life-long condition and cannot be cured.
Treatment involves:
- finding out what can trigger a flare-up
- managing the skin during a flare-up
- taking steps to avoid infection.
During an eczema flare-up, you may need to:
- moisturise your child’s skin more
- dress your child in smooth, cotton clothing to prevent irritation and sweating
- avoid using products that dry out the skin or make the eczema worse.
Your child’s doctor can prescribe a cortisone cream or ointment for an eczema flare-up. Cortisone creams and ointments are safe and should be applied only on areas of the skin affected by eczema. Your doctor will give instructions on using cortisone creams or ointments on your child.
Cortisone treatments are not to be used on the face or the nappy area. Read all labels carefully and ask your doctor or pharmacist if you have any questions.
If the eczema is severe and does not respond to treatment, your child may need to be treated in the hospital or at home with wet dressings.
Management
Preventing dry skin
Moisturisers can be used to prevent dry skin. Sorbolene cream or emulsifying ointments are available from chemists or supermarkets. They are cheap and do not need a prescription. Moisturisers should be applied all over the skin at least once a day.
Avoid creams that contain urea. Urea is a chemical that can sting if applied to broken or irritated skin.
Bath oils for eczema can be used in your child’s bath to prevent their skin from drying out.
Eczema and food allergies
Children who have eczema may also have allergies to certain foods.
Allergies do not cause eczema in children who do not already have the condition.
Allergic reactions can:
- cause symptoms that can be confused with eczema
- trigger an eczema flare-up
- make eczema symptoms worse.
Common allergy foods that can trigger an eczema flare-up in children include:
Your child's doctor may recommend avoiding or removing foods from their diet that trigger a severe eczema flare-up.
Removing trigger foods can improve eczema symptoms but will not cure the condition.
Speak to your local doctor if any foods trigger a reaction in your child that looks like eczema or makes an eczema flare-up worse.
Avoiding skin irritation
Some everyday things can irritate the skin and make eczema worse, including:
- wool and rough fabrics like carpets, seams, and lace on clothes
- dust mites in the home
- sand
- perfumed and 'medicated' products other than those prescribed by the doctor
- bubble baths
- hot baths
- soap
- chlorine in pools
- rapid changes in temperature, like hot car seats
- dry airflow, for example, heated rooms in winter and air conditioning in summer.
Keep a list of things irritating your child’s skin to help them avoid worsening eczema flare-ups.
Risk of infection
Children with eczema may develop severe infections from the herpes simplex virus (HSV). HSV is the same virus that causes cold sores. Family and friends should not kiss your child if they have cold sores. This will help avoid the spread of HSV.
Generally, there are no interactions between viruses, vaccinations and eczema.
Eczema can easily become infected when your child scratches their irritated skin.
Impetigo, also known as school sores, is a bacterial infection that can happen on top of an eczema flare-up.
Signs of infection can include:
- more redness than usual
- more itchiness than usual
- a hot feeling in the skin
- fluid oozing from the skin
- yellow crusting.
If you think your child’s eczema is infected, take them to your local doctor as soon as possible.
Resources and more information
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Eczema Association Australasia
