Childhood rashes - Eczema
Eczema is a common chronic skin condition in children. Typically, eczema is characterised by an itchy rash that comes and goes. Eczema is not contagious but does tend to run in families and commonly first appears in early childhood.
Treatment involves keeping the skin hydrated and healthy between flare-ups, reducing environmental triggers where possible and treating the inflammation during the flare-ups with creams prescribed by your child's doctor.
There are other treatments available for severe eczema. Your doctor will work with you to devise an ongoing management plan to keep your child's eczema under control.
Does my child have eczema?
Eczema can look different at different ages:
- Babies usually have a rash on their face and neck which may weep and crust.
- Children often have a dry rash, characteristically in the creases of knees and elbows, around the mouth, neck, wrists and ankles.
- From age 12, the it may be more widespread and severe.
When the skin is red, dry and itchy, it is known as a 'flare-up'. It is common for the severity of eczema to change, sometimes it is very mild and other times it gets worse. Between flare-ups, people with eczema tend to have dry sensitive skin.
See your doctor to diagnose your child's rash, as other skin conditions can look similar to eczema. Your doctor will examine the rash, ask you about how and when it began, and ask whether other family members have noticed a similar rash. This is because while not contagious, eczema may have a genetic basis and does tend to run in families. A child with eczema often has one or more relative with eczema or a related condition, such as asthma, hay fever or allergic conjunctivitis.
What triggers eczema?
Each child with eczema has their own set of individual triggers, although sometimes the condition can flare and subside for no apparent reason.
Examples of common exacerbating factors and triggers in children include:
- Heat — avoid overheating with blankets and long hot showers
- Irritants — soaps, shampoos, chlorine, chemicals, fragrances, make-up, scratchy clothes and materials
- Allergens — dust mite, moulds, grasses, plant pollens, pets, soaps and shampoos, foods
What are the complications of eczema?
Affected skin can be very itchy. The itchiness can cause sleep difficulties for your child or infant and scratching can also lead to breaking of the skin.
Broken skin may become infected with bacteria that commonly live on children’s hands. Bacterial infections may cause inflamed blisters which can weep and form crusts.
Warts and herpes (cold sores) can also infect eczema rash. Infection with herpes can cause serious problems and is an emergency which needs to be treated urgently. If someone has a cold sore, make sure to keep a distance from a child with eczema.
How do I prevent my child with eczema having flare-ups?
The goal of treating eczema is to prevent and minimise flare-ups, as well as maintain skin health between flare-ups.
Moisturisers should be used between flare-ups to keep the skin in good condition, reduce the itch associated with dry skin and reduce the chance of infections. It is important to moisturise after showering or bathing once the skin is dry.
People with eczema have sensitive skin so irritants should be avoided. This includes many soaps and moisturisers. Your pharmacist can help you choose products suitable for eczema.
Trying to avoid triggers is worthwhile. Food allergies are not common eczema triggers. It is important not to put your child on a diet without medical advice, as nutrition for children shouldn't be compromised unnecessarily.
What do I do when my child has a flare-up?
Your child’s eczema will improve more quickly if it is treated soon after you first notice the rash. Prompt treatment will also reduce the likelihood of complications, so it’s best to see your doctor or pharmacist at the first sign of a flare-up.
Keep your child’s fingernails short to avoid them scratching as much as possible.
Eczema is often treated using a steroid cream or ointment. You should get advice from your doctor or pharmacist about the best one to use for your specific case as different creams are used depending on the part of the body, the severity and the age of the child.
If your child’s eczema does not improve after two days of regular treatment or if there are signs of infection, weepy, crusted or broken areas, it is important to see a doctor.
There are many treatments that can be used to treat eczema. For many children, eczema is a condition that comes and goes, and changes in intensity over time, so you may need to see your doctor a few times for the same condition.
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Last reviewed: August 2020