Eczema in babies & children
Eczema is a condition which makes skin red, dry and itchy. Read on to find out more about this common condition.
What is eczema?
The most common type of eczema is called atopic eczema. ‘Atopic’ simply means sensitivity to allergens. The condition can affect people of any age, but it tends to be more common in children. Atopic conditions include eczema, hay fever, food allergies and asthma, and often run in families. If you have any of these conditions, your child is more likely to have eczema, but 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. It can affect any part of the body, but 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 sore, more red, 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 are worse 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 hay fever, or a brother, sister or parent with eczema, asthma or hay fever
Treatment of 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 find out exactly which things are making the condition worse. Your GP may be able to advise a strategy to help find out what triggers your child has.
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 help them avoid scratching.
Moisturising with emollients regularly
Keeping the skin well moisturised helps keep eczema under control. Even when children are going through periods where there 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.
For flare-ups and particularly sore areas, your GP may prescribe topical steroids, which can be applied to the skin. These can help reduce the inflammation within a few days. 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:
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.
Most viruses do not affect eczema but the virus that causes cold sores (Herpes simplex) can cause a complication of eczema. This is 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 in the day, call 111 or take your child to your local A&E, as this is a potentially dangerous infection which needs prompt treatment.
Eczema can be a difficult condition to manage and treat, and it causes stress for some children for a number of reasons. It can disrupt sleep due to itching or discomfort whilst having a flare-up. Unfortunately, eczema affects the self-confidence of some children. 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.
• 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 to 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 had a bacterial infection, or eczema herpeticum