What is eczema?

Skin with active eczema becomes dry, red, itchy and inflamed. It can easily get infected. Eczema can affect any part of the body and can change a lot from day to day.

Eczema can usually be controlled by good skin care and avoiding triggers. The treatment your child needs will change with time. A few children still have bad eczema despite good care and need specialist review.

Triggers

Skin with eczema is more likely to be irritated by things in the environment. These triggers may include:

• soap and detergent
• infections
• dust, house dust mites, pet fur
• overheating

Food allergy can occur in children with eczema, but removing foods does not usually improve eczema. This can be dangerous and lead to food allergy developing. See your doctor for assessment if you are concerned.

Infection

Infection is the most common cause of flares of eczema. Infected eczema may be bright red, weeping and crusted. See your doctor for antibiotic treatment.

The cold sore virus can cause severe painful infection – avoid contact with cold sores. See your doctor if infection occurs.

Skin care

Good skin care with appropriate creams and ointments is very important.

Baths

Bath every day in warm (not hot) water for up to 10 minutes. Twice a day during flares.

DO NOT USE SOAP. Use a soap substitute, moisturiser or soap-free wash and rinse well. 

Shampoo should be rinsed off over a basin or at the end of the bath.

After the bath pat the skin dry, do not rub. Do not share towels. Now apply creams.

Antiseptic baths twice a week can help prevent infection and improve eczema. See When and how to use bleach baths for your child with eczema [1].

You can use antiseptic bath oils (QV Flare up) instead but these are not funded.  Follow the instructions.

Moisturisers (emollients)

Apply moisturisers many times a day – the more often the better. Apply generously all over and smooth in the direction of hair growth until it has soaked in. 

Regular use of moisturisers reduces the need for steroid creams. Aim to use a 500g tub or more every 2-4 weeks, and a lot more during flares.

Do not put your hands into tubs of cream as this can introduce infection. Instead, spoon out the amount you need onto a clean dish or tissue.

Steroid creams

Apply steroid creams once a day to all areas with active eczema - inflamed, red and itchy skin. Don't wait for eczema to get really bad before you use steroids. Eczema needs steroid creams to improve – these are very safe and effective when used correctly.

Apply steroid creams immediately after the bath, before or after moisturising. Apply a thin layer to make the skin shine.

When eczema is not active (not red and itchy) stop using the steroid cream and continue to moisturise. Restart steroids whenever eczema comes back.

See your doctor/nurse

• if eczema is infected - weeping, yellow crusts, painful
• if the eczema doesn't go away with using steroids everyday for 2 weeks
• if your child needs steroids creams most days of most weeks
• if your child is not sleeping or missing school because of eczema

Handy hints

• wash your hands before and after applying creams
• let your child help to apply their own creams
• choose products without added fragrance and perfume
• keep your child's fingernails and toenails clean, filed and short
• don’t dress your child too warmly and keep the bedroom cool
• avoid putting scratchy fabrics next to their skin
• damp dust and vacuum the house regularly
• chlorinated swimming pools may worsen some children's eczema - apply moisturiser before swimming, shower afterwards and apply moisturiser again - some children prefer saltwater pools or the sea
• the best sun protection is shade and clothing - sun creams can be used on areas without eczema - choose one for sensitive skins with an SPF 30 or more
• see the videos demonstrating eczema care [2]

Skin care plan

Moisturise, moisturise, moisturise 

• apply lots of moisturiser to the whole body many times during the day - use even when there is no eczema
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Steroids

• apply steroid cream once a day to areas of itchy red active eczema
• face and neck:  _________________________________________
• body:  _________________________________________
• stop steroids when redness and itch has gone - start if eczema returns and see your doctor or nurse if steroids are not working

Bath

• do not use soap - use a soap-free wash
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• antiseptic baths twice a week if infection is a problem

Other

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Doctor/nurse contact number:

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