How to treat and control eczema in children

Does your child have dry, itchy skin patches? If so, they could have eczema (atopic dermatitis). Eczema in children can be itchy and painful. Scratching can also lead to infection of the rashes.

While there is no known cure for eczema, it can be managed so your child feels better. There are also things you can do to help your child avoid eczema flare-ups.

Repairing the skin barrier in cases of dryness

The skin barrier does not keep water out of children with eczema. As a result, the skin becomes dry and cracked, making it more susceptible to infection. Dry skin is also extremely itchy. Daily gentle skin care is essential for improving the skin barrier.

This includes:

Bathing (or showering) your child daily or every other day for five to 10 minutes in lukewarm water. There is no need for soap, but a gentle non-soap cleanser can be used on sweaty areas (armpits, neck, groin), as well as the hands and feet. Only use fragrance-free and hypoallergenic cleansers. Scrubbing your child’s skin with anything rough is not recommended. Avoid bubble bath washes as they often contain foaming ingredients, which can damage the skin’s top layer, leaving it open to irritation and dehydration.

After a bath or shower, pat your child’s skin dry. Apply any topical medications prescribed by your doctor to the rash areas before applying any moisturisers.

Apply a moisturiser to your child’s body immediately after bathing (while your child’s skin is still damp). This helps “lock in” the water’s moisture. The creamier the moisturiser, the more effective it will be. Petroleum jelly or fragrance-free moisturising creams are good options (lotions are thinner and less effective). Even after the rash has healed, moisturisers should be applied once or twice daily.

Dress your child in soft materials such as 100% cotton. Laundry detergents that are fragrance-free and mild should be used. In the dryer, do not use fabric softeners. Reduce your child’s exposure to things that are known to irritate their sensitive skin.

How to help reduce itching

Gentle skincare, as described above, is the first step toward less itchy skin. Other methods for relieving itching include:

• Antihistamine medications (always consult your doctor or pharmacist before administering medications to your child).
• Topical steroid medicines applied to the skin
• Non-steroid eczema medications (beneficial for mild eczema and sensitive skin areas such as armpits)
• Biologic therapies (medications that target the immune system component that is causing the irritated skin rash)

Skin infection management and prevention

Bacteria and viruses can aggravate eczema rashes, so keep an eye out for signs of infection.

Look for oozing, crusting, pus bumps, blisters, or a worsening rash that isn’t improving with standard treatments. If you suspect your child’s skin is infected, consult a doctor. Infections may necessitate the use of antibiotics or antiviral medications.

When can I discontinue my child’s eczema treatment?

When your child’s skin is no longer itchy, and the rash areas are smooth and soft, you can begin to use the medications less frequently. It is common for the skin to become discoloured after the rash flare heals, but the colour will gradually return to normal. However, because eczema is a chronic skin condition, it is critical to maintain your child’s daily routine of gentle skin care and moisturiser use to avoid future flares and infections.

How can I help my child avoid future eczema flare-ups?

One of the most important things you can do to prevent future eczema flares is to avoid triggers. Eczema triggers differ from child to child. Some parents and doctors may consider allergy testing to identify additional triggers that can be avoided. Some examples of triggers are:

• House dust mites
• Fragrances (including perfumes, colognes, air fresheners, candles, and incense)
• Sweat and heat
• Hormones
• Insect stings and bites
• Dander from pets
• Pollen
• Second-hand cigarette smoke
• Fabrics made of wool and synthetics
• Certain foods