Eczema is a common pediatric skin condition causing an itchy rash, which when severe can cause irritability, sleep problems and if it gets infected it can make your little one unwell.

The Who, What, Why, When of eczema

According to the American Academy of Pediatrics“eczema is a chronic skin problem that causes dry (or sometimes oozing), red, itchy skin. It is also called atopic dermatitis.” Approximately one in five children develop eczema: 65% develop symptoms before the age of 1 and 90% before the age of 5. Most babies will outgrown eczema before the age of 4 but some are life long sufferers. Symptoms and sites vary and may go through periods of remission and flare-ups. Babies tend to get eczema on their face and scalp, spreading to the elbows and knees as they get older. Teens and adults more commonly have eczema on their hands and feet. Eczema often runs in families with a history of allergic conditions including eczema, hayfever and asthma.

Treatment for mild eczema

• Daily moisturizing of entire face and body with fragrant-free cream or ointment. Apply multiple times if needed. Colloidal oatmeal has been found to be effective in management of mild eczema and dry skin. Try adding uncooked oatmeal to an old stocking and run the bath water through it, or use a dermatologist recommended oatmeal product.  

• Post-bath: gently pat dry and apply moisturiser.

• Avoid irritants such as coarse non-cotton fabrics, fabric softeners, hot baths and fragrances.

• Keep nails short and discourage scratching (increases irritation and infection risk)

• Look out for flare up triggers including: heat, stress, food, medication, pets and environmental factors. Consider allergy testing. Once identified avoid triggers as much as possible.  

• There is scanty evidence of the effectiveness of alternative therapies (hypnosis, acupuncture, herbal medicines, natural oils such as coconut, probiotics and vitamin) helping with eczema but more research needs to be done. Proceed with caution.

• Join a reputable eczema organization such as The National Eczema Society to get product recommendations and the latest advice on treatment. 

Treatment for moderate to severe eczema

If your child is young or develops additional symptoms - weeping skin, blisters, pus spots, raised temperature or becomes physically unwell - they should see a doctor, who may recommend:

• Prescription medication: Steroid based creams or ointments, antibiotics for infected skin and oral steroids may be needed in severe cases.

• Over the counter: Cream or ointment (topical steroids or topical immunomodulators) or oral antihistamines.

• Paste bandages, wet wraps and light therapy may be needed for severe cases (under medical supervision).

Eczema can be downright unpleasant for your child and for you, so don’t suffer in silence. If mild, try some of the simple solutions above. If it’s severe it’s essential to get medical advice. As with any treatment it’s important to monitor the individual’s response and modify treatment as needed.

Sources:
Dermatol Pract Concept. 2016 Jul 31;6(3):23-9. doi: 10.5826/dpc.0603a06. eCollection 2016. “Diet and eczema: a review of dietary supplements for the treatment of atopic dermatitis.” Schlichte MJ1, Vandersall A2, Katta R3.