What is Childhood Eczema and How to Help Manage it?

The information included is for educational purposes only and is not intended as a substitute for medical advice. Eczema requires diagnosis by a medical practitioner. See your medical practitioner for further information. 

Eczema: the bane of many parent’s existence, especially in the first few years of a child’s life. Seeing the rash, or worse, the discomfort it brings to your child, can at times be very confronting, especially if you are unsure of what it is or how to manage it. But fear not, there are several easy to follow approaches that can help you manage your child’s eczema. 

What exactly is eczema and how can it affect my child?

First, some background. Eczema, also known as atopic eczema or atopic dermatitis, is a chronic skin condition that affects around 15-20% of children, and is most common between the ages of 2 and 4 years.  It often disappears with time, but for some people, it may persist into adulthood.

While the exact causes of eczema are unknown, there is a strong genetic factor, and eczema often occurs together with asthma and hay fever. This is called ‘atopic tendency’. While eczema can’t be cured, it can be effectively managed in most children.

Eczema commonly appears first on the face of younger children, but as children grow older, it’s the skin around the joints that can become the most problematic.

Redness, inflammation and intense itching are the main symptoms. In severe cases, the skin may begin crusting or weeping, which could be signs of a bacterial infection. Whether the symptoms are mild or severe, however, eczema needs to be diagnosed by a medical professional to ensure you’re getting the right treatment for your child. Discuss the problem first with your GP or paediatrician. If the condition doesn’t respond to the initial management strategy, they may refer you to a dermatologist.

Managing eczema

There are two key strategies that should form the basis of every eczema management routine:

1. Identifying & avoiding triggers
   
   Just as things like dust and pollen can aggravate hay fever, some irritants are known to trigger or even worsen eczema. These aren’t the same for everyone, but often include heat, animal dander, dust, sweat, fragrances, wool clothing & carpets, soap, stress, and food allergens like egg.
   
   It’s important to be aware of these triggers and watch for any others that might be affecting your child. One way to do this is to use a symptom diary, where you can record when and where symptoms occur. This can make it easier to spot patterns or triggers in your child’s diet or environment.
   
   
2. Regular use of moisturisers
   
   Even when the skin appears normal (not red or inflamed), people with eczema have a weakened skin barrier—the part of the skin responsible for keeping water in and irritants out. Just like a bucket with holes in the bottom, eczema-prone skin will lose water more quickly than normal skin and is often bordering dryness and irritation. Similarly, the incessant itch associated with eczema can be made worse by dry skin.
   
   To work effectively, the skin barrier needs to be hydrated all the time, so regular use of moisturisers should form the foundation of any eczema management strategy. This is why all expert guidelines for eczema management recommend regular, liberal use of moisturisers.

Coping as a parent

Eczema doesn’t just affect your child. One study showed that mothers of young children with eczema had significantly higher stress scores than those of children without eczema. Stress scores also tended to increase with increasing eczema severity and were on par with the stress experienced by parents of children with severe disabilities. Acknowledging to yourself that it’s a difficult and stressful condition is important, and where possible, talk about your struggles with your partner, family or friends. There may be a support group in your area or, if not, online forums are a place where you can find others who can relate to the challenges of raising a child with eczema.

Routine can be key to reducing stress. Make sure you apply moisturisers to your child’s skin regularly, or if they’re old enough to do it themselves, encourage them to take part and apply it to their own skin under your supervision. As a long-term condition, it’s important to educate them and get them involved. If they have to use other medications or techniques (e.g. wet-wrapping), make sure these are worked into the routine as well. A regular bedtime can also help improve your child’s sleep, and as a result, yours.

Top tips for home

1. Keep fingernails trimmed short – this helps reduce skin damage caused by scratching.
   
   
2. Develop an eczema management routine with the help of your doctor. Know how much and how often to use moisturisers and establish a soothing bedtime routine.
   
   
3. Look for moisturisers that are specifically designed for use with eczema. Look for these types of products in your local pharmacy.
   
   
4. Encourage kids to take an active role in managing their eczema – for younger children, use sticker charts or other forms of positive reinforcement; for older children, help them write down or draw the steps in their moisturising routine for them to follow.
   
   
5. Keep a symptom diary to look for new triggers and patterns. Dedicated apps are also available.
   
   
6. Make time for self-care. Schedule breaks for yourself where a trusted friend or family member can step in.

Top tips for school

1. Discuss your child’s eczema needs with their teacher.
   
   
2. Ensure your child has moisturisers in their school bag and the classroom if they need to apply them throughout the day. Always ask your child’s teacher to supervise and assist in applying. 
   
   
3. Be aware that some children with eczema may experience bullying or embarrassment because of their condition. Talk to their teacher about ways to help ensure your child is comfortable and supported at school.

By Ian Harrison BSc (Hons), PhD and Josh Townley, PhD .

Ian is Ego Pharmaceutical's Scientific Communications Manager. He is a medical scientist and communicator with a bachelor's degree and PhD in Pharmacology, and over a decade's worth of experience across research and industry.

Josh is a science writer with 10 years experience in the pharmaceutical and skincare world, first developing products in the R&D lab, then registering them in the regulatory department. He has a PhD in chemistry and a bachelor’s degree in forensic science.