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Eczema is a common skin condition that usually begins before your child is one year old. The affected skin is dry, red and itchy. Sometimes these areas of skin can become cracked, weepy and then scab over.
Unfortunately there is no cure for eczema. However, there are many ways to keep eczema under control and help your child feel more comfortable. Eczema is not contagious.
It is common for the severity of the eczema to change, and you will notice that sometimes your child's eczema is mild, while at other times it gets worse. It is important to effectively manage the eczema and control it as soon as it flares up.
Secondary bacterial or viral skin infections are also common in children with eczema, especially when the eczema is not well controlled. Do not allow anyone with a cold sore to kiss your child, as the eczema may become infected with the cold sore virus. The signs of a secondary infection are weepy, crusted and broken areas of eczema.
The cause of eczema is not known. If a member of your family has eczema, asthma or hay fever, then it is more likely that your child will have eczema. Some children with eczema may also develop asthma or hay fever.
Eczema can be triggered by a number of things, such as:
Eczema can be well controlled at home in most children by identifying and avoiding triggers. Using the following strategies will help control the eczema and make your child more comfortable.
Each child may react to different things, and it may take a while to work out what is irritating your child's skin. Some common things that can irritate the skin include:
A thick, plain moisturiser with no fragrance should be used as often as necessary on your child, even when the skin is clear of eczema. Some children will require moisturiser application once or twice a day, while others will need it more often. Thicker creams are more effective than lotions.
Fragrance-free moisturisers, bath oils or soap-free body wash (not plant-based) should be used in the bath and shower.
Heat is the most common trigger for eczema. You can keep your child cool by:
It is a good idea to bathe your child at least once a day in a cool bath. The bath should be no hotter than 30°C, and have one to two capfuls of plain, non-perfumed bath oil added.
Scratching makes the eczema worse and can cause infection. Try these ideas to help them stop scratching:
Most children with eczema do not have any reactions to food. However, in some children, food allergy may be a trigger.
Take your child to the GP if:
If your child's eczema has developed a bacterial infection, they may need antibiotics. Very occasionally, if your child has a severely infected rash, they may need to be treated in hospital.
Bleach baths may be recommended if your child's eczema is infected and difficult to control. See
Formula for an eczema bath.
If your child’s eczema is complicated or difficult to treat, a doctor or dermatology nurse practitioner will prepare an eczema treatment plan for your child.
Your doctor may prescribe a cortisone-based cream or ointment. Cortisone is a natural hormone that is produced by the body. Cortisones are very effective in controlling eczema, and are safe if used as directed.
Weaker cortisones are used on your child’s face, and stronger cortisones are used on their body. It is important to apply the correct cortisone to all areas of eczema, even if the skin is open. Any medicines, creams and ointments should be used as prescribed by the doctor.
Even though weak cortisone creams are available over the counter from the pharmacy, it is important to get a cream or lotion that is suitable for your child, and that you know how to apply it properly. Seek medical advice before using over-the-counter cortisone treatments on your child.
If the eczema becomes crusted or scabs over, it is important to remove the scabs. The eczema treatment won’t reach the skin if scabs are in the way. To remove scabs, give your child a cool bath for 30 minutes to soften the scabs. Then before getting them out of the bath, wipe the crusts off with a soft, wet towel. Once the scabs are removed, your child’s eczema treatment plan should be followed again, with creams applied on the open skin.
Will the treatments cure eczema?
No. Eczema can be well controlled in most children by looking after the skin as suggested. This does not mean the eczema is cured. For many children, adequate skin care including cortisone treatment will need to be continued for many years. Your child may grow out of their eczema, especially with a good treatment plan. However, they will always have sensitive and dry skin.
Can my child have all the usual vaccinations?
Nearly all children with eczema can have all their vaccinations (including measles) in the normal way. This includes children who have egg allergy. Occasionally, the eczema may flare up after immunisations.
Can my child go swimming?
Yes, if the eczema is not flaring up. Before swimming, apply a layer of moisturiser from top-to-toe. Soon after swimming, wash the skin thoroughly in a cool shower or bathe your child with some bath oil, then reapply the moisturiser. If the eczema flares that night, apply a wet dressing just before your child goes to bed.
I’ve heard that cortisone is dangerous to use on children because it is a steroid, and steroids can have bad side effects. Is this right?
Cortisone treatments are very effective in controlling eczema, and as long as they are used as directed they are safe for children to use. Weak cortisone treatments won’t have any negative effects on a child's growth and development.
Developed by The Royal Children's Hospital General Medicine and Dermatology departments, and Centre for Community Child Health. We acknowledge the input of RCH consumers and carers.
Reviewed March 2018.
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