*STATEWIDE REFERRAL CRITERIA have been published for this condition. For more information, please see the Department of Health website www.health.vic.gov.au/statewide-refrral-criteria*

Introduction

This guideline relates to eczema in paediatric patients. For more information on assessment and management of eczema, please refer to the Clinical Practice Guidelines : Eczema

When to refer

Dermatology Department:

• Moderate to severe eczema that has not responded to 6 weeks of compliant first-line management (refer to Eczema CPG)
  • Patients must have failed treatment while using a minimum of methylprednisolone aceponate 0.1% for the body
• Consideration of systemic therapies
• Referrals for allergy assessment and testing are not accepted by Dermatology

Allergy & Immunology Department:

• Eczema and concerns with recurrent infections or poor growth
• Eczema and concerns with immediate food allergic reactions
• Severe/ uncontrolled eczema, especially babies under 12 months, who have not responded to first-line management (refer to Eczema CPG)

Services available closer to home

Adequate paediatric specialists to assist with eczema management may be general paediatricians, dermatologists and/ or allergists.

Referral criteria/required information

Assessment of dermatitis (eczema) management in children | health.vic.gov.au

How to refer

RCH Specialist Clinics Referral.pdf

Please complete the above and submit via:

• Fax (03) 9345 5034 or
• Email screferrals@rch.org.au
• Urgent referral or clinical query call ED admitting officer or Registrar on-call (03) 9345 5522

Information for families

• Eczema is a chronic inflammatory skin disease, and although there is no cure it can be well controlled
• Eczema is not directly caused by foods and allergy testing is usually not required. Restrictive diets are also not helpful
• Topical steroids are safe and effective when used correctly, and are essential for the treatment of eczema flares
• Minimize common eczema triggers including overheating, dry skin, irritants and infection
• • Kids Health Info : Eczema (atopic dermatitis)
  • Kids Health Info : Skin infections – bleach baths
  • RCH Knowing your child’s eczema https://www.rch.org.au/uploadedFiles/Main/Content/derm/knowing-your-childs-eczema-booklet(1).pdf
  • RCH Eczema triggers identification questionnaire https://blogs.rch.org.au/derm/

Resources and links

• Clinical Practice Guidelines : Eczema
• ACD topical steroid consensus statement https://www.dermcoll.edu.au/wp-content/uploads/2022/09/ACD-Consensus-Statement-Topical-Corticosteroids-September-2022-.pdf

Acknowledgements

The development of this guideline was coordinated by the Department of Dermatology (Dr Ryan Toholka and Liz Leins) and the Department of Allergy and Immunology (Dr Jo Smart and Dr Paulina Alhucema). Guideline reviewed in January 2025.