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How to Manage Childhood Eczema

Doctor Q&A

MD, Pediatrician, Shawnee Mission Pediatrics

The most common analogy to use when describing something soft – really soft – is to call it “baby skin soft.” What could be softer – right?

Right, but not for kids who suffer from eczema, an inflammatory condition of the skin characterized by patches of red, rough, inflamed, and sometimes oozing skin.

Sadly, about one in every ten kids will develop eczema.

The itching and subsequent scratching, even to the point of bleeding, can be of great concern and frustration for parents.

But with some background information about this bothersome condition and some advice about treating it, you can keep your baby’s eczema from getting under your skin. 

What Causes Eczema?

Eczema is caused by a variety of different factors, primarily these:

  • The interplay of genetics

  • Skin barrier dysfunction

  • Immune dysregulation



Around 70 percent of affected children have a family history of the condition, and there are certain genetic mutations known to be associated.

In general, the skin allows for excessive moisture loss, and a defective immune response leads to abnormal inflammation of the skin.

What are the Symptoms of Eczema?

The vast number of cases present early in childhood, with up to 65 percent of cases presenting in the first year of life. Symptoms include:

  • Redness

  • Roughness

  • Itching

  • Dryness

  • Crusty, scaly patches

  • In some cases, oozing 



Your child may have all of these symptoms, or just a few.

How is Eczema Treated?

The management of eczema can be summed up in one word: MOISTURIZE!

A fragrance- and dye-free emollient or thick cream, like Aquaphor®, is best. Applying this to your child's skin two or more times daily is recommended.

For the majority of children with mild to moderate symptoms, this alone will be effective.

For children with difficult-to-treat eczema or acute flare-ups, treatment is more complicated, but does provide relief:

  • Topical steroids are the mainstay of therapy and are very effective, but should be used under a doctor's supervision to avoid unwanted side effects or mistreatment.

  • Calcineurin inhibitors are non-steroidal alternative ointments that lack many of the typical steroid side effects. Pediatricians commonly prescribe Eucrisa®, which works well, but is only appropriate for those older than 2 years.

  • Antihistamine medications (diphenhydramine) can be used to reduce itching.


Can Home Remedies Help?

Yes! Being hyper-vigilant about the application of a moisturizing emollient is the best thing you can do for your child.

But these tips have proven helpful, too: 

  • Keep your child’s baths and showers short.

  • Bathe your child in room temperature water.

  • Apply moisturizer to slightly damp skin immediately after a bath to help trap in the moisture.

  • Avoid scented skin products or detergents.

  • Dress your child in soft fabrics, such as cotton, to avoid excess irritation.


Can A Child Outgrow Eczema?

Thankfully, as childhood progresses, a good number of children will either outgrow their eczema or see a reduced severity of symptoms.

Many children will have resolution of their symptoms by age 4 to 5, but around half of affected children will have persistent issues throughout childhood.

Kids who do have continued issues with eczema face these difficult challenges: 

  • Day-to-day pain and irritation is the number one problem.

  • Long-term use of steroid treatment can cause loss of the skin's normal pigmentation and thickness.

  • Eczema in childhood can weaken the skin’s integrity, making it more prone to bacterial and viral infections.


Is Eczema Related to Other Conditions?

Eczema, also known as Atopic Dermatitis, is part of the Atopic Triad, which includes asthma and allergic rhinitis (hay fever).

A child will typically develop eczema first before progressing on to one or both of the other conditions, so careful follow-up by a pediatrician is needed to optimally manage any conditions that may develop. 

For more information on eczema and a host of other pediatric issues, visit healthychildren.org.

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