In this section
Cellulitis & other bacterial skin infections
Neonatal & infant skin care
Children with eczema have itchy skin plus 3 or more of the following:
Eczema bacterial infection
The type and frequency of eczema treatments changes depending on eczema severity and the presence/absence of infection
There is no cure for eczema, but it can be well controlled with optimal everyday management and correct treatment of eczema flares.
Common reasons for eczema treatments not being effective include:
All children with eczema should be provided with a home
eczema management plan and a demonstration of how to correctly apply topical treatments.
Optimal everyday management (clear skin - mild eczema flare, no infection)
In the management of eczema discuss the following with the caregiver.
Children with eczema must bathe daily and have moisturisers applied at least twice per day top-to-toe. This should continue even when the skin is clear.
Minimising common eczema flare triggers
Keep baths (<31oC), the home and car cool (<18oC)
Avoid air blowing heaters & low humidity environments
Use light bed coverings & pyjamas (eg cotton pyjamas, avoid woollen underlays, plastic mattress protectors, sleeping bags, hot water bottles)
Avoid thick and multiple layers of clothing
Avoid (alcohol) nappy wipes. Use cloth with water & bath oil.
Bathe or shower with bath oil immediately after swimming in a pool
Avoid dummies – drooling can cause irritation
Apply barrier cream to the perioral area when the infant is dribbling
Use a non-perfumed clothes detergent
Avoid chemicals such as soaps & talcum powders
Remove clothing tags
Avoid rough & prickly fabrics
Manage anxiety or behaviours that promote scratching
Keep nail shorts.
Daily bathing using appropriate cleansers and/or bath oils.
Wash hands before applying eczema treatments
Seek medical review early if concerns of infection not responding to prescribed treatment
Eczematous skin infections
Broken eczematous skin has a high-risk of bacterial and/or viral skin infections.
Encourage families to correctly use liberal amounts of topical skin treatments. Provide children with prescriptions for multiple quantities and repeats (authority) of each medication, to ensure they are always generously applied.
Bathing oils & wash
QV® bath oil & wash
Hamilton’s® bath oil & wash
Kenkay® bath oil & wash
Cetaphil® Gentle Skin Cleanser
Mustela®, AveneÒ, Bioderma®, La Roche Posay® bath oils and washes
White King® Bleach (4%)
Salt (table or pool)
Use once to twice daily
Note do NOT use any bath oils with benzalkonium chloride
Moisturisers & Emollients
Avene® Xera Calm Cream
10% Sorbolene®, 10% liquid paraffin, 10% soft white paraffin
Atoderm (Bioderma®) Cream
Mustela Stelatopia® creme
Dermeze® cream, Dermeze® ointment (for facial barrier when dribbling)
Cicalfate®, Cicplast® or zinc and castor oil creams for barrier creams
Apply once or twice daily top-to-toe
If eczema flares, apply at least four times per day
Barrier creams can be used often when the child is dribbling and applied prior to feeding
For sensitive areas (eg face, nappy)
Apply once to twice daily to affected areas
Ointment are preferred to creams for their emollient effects
Lotions are best used for the scalp
Cellulitis and other bacterial skin infections
HSV (Eczema herpeticum)Aciclovir 10 mg/kg (max 400 mg) oral five times per day for 7 days OR
If >2 yo: Valaciclovir 20 mg/kg (max 500 mg) oral bd for 7 days
Unwell or severe infection
Only start antiviral infections within 72 hours of onset of infection
Last updated April 2020