Eczema is a common skin condition that causes irritated, inflamed and itchy skin. It is particularly prevalent in children, with around 10-30% of children developing the condition before the age of 5.

Eczema in children is characterised by dry, red and cracked skin that weeps and crusts over when scratched. Although the condition usually improves over time and often disappears completely by adulthood, it can be very distressing for children and parents during flare-ups.

This overview of eczema in children includes the symptoms, causes, diagnosis, and the treatments and lifestyle changes that I may prescribe to help manage the condition.

If your child has eczema, you can book an appointment to see me in clinic.

Overview of eczema in children

Eczema, also known as atopic dermatitis, is an inflammatory skin condition typified by intense itching, dryness and recurring rashes on the body. It often first appears in early childhood with up to 90% of cases occurring before the age of 5.

Eczema can affect children of any ethnicity but is more common in those with a family history of eczema, asthma or hayfever.

The condition causes the skin barrier to weaken allowing moisture to escape and irritants to penetrate. This triggers inflammation and itching. Scratching then further damages the skin leading to a ‘vicious itch-scratch’ cycle. Eczema flare-ups can hugely impact quality of life and sleep. However, most children grow out of eczema by their teenage years.

Testimonials

Patient’s parent for child with eczema, via iWantGreatCare.org

“Our 4 year old has had eczema from about 6 months, and despite trying all available medical advice from GPs and other places, we were unable to find a solution. Based on Dr Ramnik’s investigations and tests to identify possible causes, and his understanding of what had not previously worked well, his approach has worked well for our boy and we have seen the results within one week.”

Symptoms

The main symptoms of eczema in children are:

  • Dry, cracked, scaly, inflamed skin
  • Intense itching, especially at night
  • Red rashes on cheeks, scalp, arms, legs etc.
  • Weeping, crusting and flaking of affected areas
  • Thickened, cracked skin patches
  • Papules (small, raised bumps)
  • Skin discolouration from scratching
  • Broken skin from constant scratching
  • Sleep disturbance from itching

Causes

The exact cause of eczema is unknown but various factors can trigger flare-ups including:

  • Genetics – family history increases risk
  • Overactive immune system and inflammation
  • Environmental irritants e.g. soaps, detergents
  • Allergies e.g. food, pollen, dust mites
  • Dry skin and reduced skin barrier function
  • Stress, hormones, infections
  • Harsh weather e.g. cold, dry air

Diagnosing eczema in children

There is no specific test for eczema. I typically diagnose it by examining the skin and identifying the characteristic symptoms and rashes. I will also review the child’s medical history and ask about symptoms.

Keeping a diary of flare-ups and possible triggers can help with diagnosis.

Treatment

Although not curable, various treatments can help control and manage eczema in children including:

  • Emollients – applying moisturising creams frequently to hydrate skin
  • Steroid creams – to reduce inflammation and itching
  • Antihistamines – control itching and allergies
  • Antibiotics – treat secondary infections
  • Oral medications (immunosuppressants) for severe cases

Identifying and avoiding triggers is also important. It’s also vital to keep skin hydrated and resist scratching.

Lifestyle Changes and Coping Strategies

Simple lifestyle changes can minimise flare-ups of eczema in children:

  • Moisturise skin frequently, especially after bathing
  • Use gentle, fragrance-free skincare and laundry products
  • Have lukewarm baths and avoid harsh soaps
  • Wear soft, breathable fabrics like cotton
  • Use mild laundry detergents and avoid fabric softeners
  • Minimise exposure to irritants and allergens
  • Keep nails short to prevent skin damage from scratching
  • Apply cold compresses to itchy areas
  • Distract with activities when itchy
  • Teach children not to scratch

Support Resources

Living with eczema can be challenging for children. Support resources include:

  • Speaking to your doctor for advice
  • Finding an eczema support group to share experiences
  • Seeing a counsellor to help cope with stress/anxiety
  • Getting advice/support from patient organisations like the National Eczema Society
  • Joining online communities to connect with other families
  • Seeing a specialist like a paediatric dermatologist

Frequently Asked Questions

Will my child grow out of eczema?

Most children find their eczema improves significantly or even disappears completely by adulthood, so there is a good chance they will grow out of it. However, some people continue to experience symptoms into adulthood.

How can I tell if my child has eczema or just dry skin?

Eczema causes much more than just dry skin. There will also be inflamed, weeping and cracked skin along with intense itching and scratching. The condition also fluctuates with flare-ups. Simple dry skin is easily managed with regular moisturising.

What foods should children with eczema avoid?

Identifying and avoiding any food allergies is recommended via an elimination diet supervised by a doctor or dermatologist. Common triggers include eggs, milk, nuts, wheat, soy. Everyone is different though – some children have no food triggers.

How can I help my child sleep better?

Itching often worsens at night, disrupting sleep. Try lukewarm baths, cotton pyjamas, antihistamines, and moisturisers before bedtime. Mitts may help stop scratching. Maintain a cool, comfortable bedroom temperature.

Will eczema leave scars on my child's skin?

Constant scratching can cause skin damage that leads to scarring for some children with severe eczema. Try to minimise scratching to reduce this risk. Any scarring should fade over time.

Summary

Eczema is a common childhood condition characterised by dry, irritated skin and intense itching. While the exact cause is unknown, various triggers like allergies and weather can lead to flare-ups.

Although incurable, I can help you manage symptoms with emollients, medications and lifestyle changes.