Eczema in children Dr Trisha Macnair Eczema is common in childhood and can cause various degrees of discomfort.

In this article

What is it? What causes it? Who's affected?

What are the symptoms? How is it diagnosed?

What's the treatment? Advice and support

Eczema is a common type of itchy red rash sometimes called dermatitis.

Most children with eczema have atopic eczema, where there's a strong family history of atopic or allergic disorders, such as asthma, eczema, hay fever or food allergies, and no other obvious cause for the rash.

The underlying cause of atopic eczema isn't known

The underlying cause of atopic eczema isn't known, but there appears to be increased reactivity of the immune system and affected children often have other allergic conditions.

Triggers or precipitants, which make symptoms worse, include dietary factors (such as cow's milk), stress and contact with substances such as perfume, nickel, lanolin and detergents. Woollen clothing can also irritate ezcema.

Breastfeeding may help to prevent atopic eczema developing.

Other types of asthma include exogenous, caused by direct contact with irritant chemicals, and seborrhoeic (which includes cradle cap), caused by increased activity of the sebaceous glands in the skin.

As many as one in five children develops atopic eczema. It usually begins in the first year of life, but rarely before two months.

Children from families with atopic illnesses are at greater risk - as many as 50 per cent of children with atopic eczema also have asthma or hay fever.

Most children grow out of eczema by their teenage years.

The rash of eczema is dry, red and itchy. It may become dry, scaly and cracked, oozing yellowish fluid and forming crusts, especially if the child has been scratching.

The rash may develop anywhere on the body, but in younger children the face, cheeks, scalp, forearms and front of legs are most commonly affected.

In older children, the rash is usually more localised to flexures (the inside surfaces where joints bend the skin), especially at the wrists, elbows, knees and ankles.

Atopic eczema can be diagnosed by an experienced doctor, who may also be able to help pinpoint triggers.

The main aim of treatment is to keep the skin moist and supple, and to avoid cracks and fissures that can lead to complications such as infection.

Steroid creams may be used to calm inflammation

Emollients are oily treatments in creams or added to bath water, which help to keep the skin soft. Steroid creams may be used to calm inflammation and reduce itchiness, although care must be taken with long-term use.

Other medications, such as antihistamines, are sometimes used. Measures to reduce irritation, such as cool baths, cotton clothing and mittens to cut down scratching, can reduce the risk of secondary bacterial infections.

Eczematous skin is particularly vulnerable to bacterial infection, which can aggravate the eczema or cause serious illness. It needs swift treatment with antibiotics, so see your doctor if eczema gets worse. Infection with herpes simplex virus is even more dangerous and needs urgent treatment in hospital.

National Eczema Society

Helpline: 0870 241 3604
Website: www.eczema.org

This article was last medically reviewed by Dr Rob Hicks in February 2008