Eczema in babies and children
10-minute read
Key facts
- Eczema is a common skin condition in babies and children.
- Typically, eczema causes dry, red, itchy skin that comes and goes.
- It can be triggered by many things, such as heat, irritants and allergens.
- Eczema treatment aims to reduce flare-ups and keep the skin healthy.
- Some children will grow out of eczema, but others will have it for life.
What is eczema?
Eczema, or atopic dermatitis, is a common skin condition in babies and children.
It usually begins before 1 year of age. Typically, eczema causes dry, red, itchy skin. When eczema gets worse it’s called an eczema flare. Usually there is no single cause for an eczema flare.
About 1 in 5 children under 2 years of age have eczema. Some children grow out of eczema, but others will have it for life. Eczema is not contagious.
What are the symptoms of eczema?
The symptoms of eczema are:
- red skin
- itchy skin
- dry and cracking skin
Eczema can look different at different ages.
- Babies usually have a rash on their face. It may also be on their scalp, body, arms and legs.
- Children often have the rash in the creases of their knees, ankles, elbows and wrists.
It’s common for the severity of eczema to change. Sometimes it’s very mild and other times it gets worse.
When the skin is red, dry and itchy, it’s known as a 'flare'. Between flares, people with eczema tend to have dry, sensitive skin.
What causes eczema?
The cause of eczema is not known. It’s likely that eczema may have a genetic basis, as it tends to run in families.
Eczema can be triggered by many things. Examples of common triggers in babies and children are:
- heat — avoid overheating with clothing and blankets
- irritants — soaps, shampoos, fragrances and scratchy clothes
- environmental allergens — dust mites, grasses, plant pollens and animal fur
- food allergies
- playing in sand pits
- sitting on carpets or grass
It’s important not to put your child on a special diet without advice from your doctor or a dietitian.
Every child with eczema will have their own set of triggers. But sometimes the condition can flare for no apparent reason.
When should I see my doctor?
It’s important to see your doctor if you are concerned about your child’s health or their skin.
Your doctor can diagnose your child's rash. It’s important to get a diagnosis as there are other skin conditions that look similar to eczema.
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How is eczema diagnosed?
Your doctor will examine the rash and ask you about when it began. They may also ask whether other family members have eczema or other allergies.
Your doctor may refer your child to a dermatologist (skin specialist) to do a skin biopsy. A skin biopsy is when the specialist takes a small sample of skin for testing.
How is eczema treated?
Unfortunately, there is no cure for eczema. But there are many treatments you can try.
Treatment involves:
- protecting the skin every day
- reducing irritants and triggers where possible
- treating eczema flares with creams prescribed by your child's doctor
- controlling itch
- preventing and treating infections
Your child’s eczema will improve more quickly if you treat it soon after you first notice the rash. Prompt treatment will also reduce the chance of complications.
Corticosteroid treatment
Your child’s doctor may prescribe a corticosteroid cream or ointment for an eczema flare. This should only be put on skin affected by eczema. This treats the inflammation (redness and itching).
Different creams are used depending on:
- the part of the body affected
- the severity of the eczema
- the age of your child
Apply moisturiser after using the corticosteroid cream.
You may be given milder creams to use in sensitive areas like the face and nappy area.
Ask your doctor or pharmacist if you have any questions about using corticosteroid cream.
For many children, eczema is a condition that comes and goes. It can change over time, so you may need to see your doctor many times.
How do I prevent my child with eczema having flares?
The goal of treating eczema is to minimise flares and keep the skin healthy between flares.
It’s important to moisturise after showering or bathing once the skin is dry. Use moisturisers to:
- keep the skin in good condition
- reduce the itch caused by dry skin
- reduce the chance of infections
Use a thick moisturiser with no fragrance on your child. Apply this as often as needed, even when their skin is clear of eczema.
You can use bath oils for eczema to prevent their skin from drying out.
People with eczema have sensitive skin, so try to avoid things that irritate the skin. This includes many soaps, moisturisers and toothpastes. Your pharmacist can help you choose products suitable for eczema.
Controlling itch
The following things may reduce itch:
- moisturising the skin every day
- using cold compresses and wet dressings as directed
- considering giving your child a non-sedating antihistamine, especially if there are hives
What do I do when my child has a flare-up?
You can prevent skin damage by applying creams prescribed by your doctor as soon as eczema appears.
During an eczema flare, you may need to:
- moisturise your child’s skin more
- dress your child in smooth, cotton clothing to stop irritation and sweating
See your doctor if:
- your child’s eczema does not improve after 2 days of normal treatment
- there are weepy, crusted or broken areas, or signs of infection
Your doctor can prescribe a cortisone cream or ointment for an eczema flare.
Keep your child’s fingernails short to avoid them scratching as much as possible.
What are the complications of eczema?
Children who have eczema are more likely to have:
- allergic rhinitis or hay fever
- asthma
- food allergies
Affected skin can be very itchy. The itchiness can cause sleep problems for your baby or child. Itching can also lead to scarring.
Infections
Children with poorly managed eczema are more likely to have skin infections. Bacterial infections may need to be treated with antibiotics.
Severe cases of eczema can cause cracks in the skin that weep fluid. This can also lead to infection.
Herpes simplex virus
The herpes simplex virus, which causes cold sores, can cause severe infections in children with eczema. Family and friends should not kiss your child when they have cold sores.
Difficult to treat eczema
If your child’s eczema is difficult to treat, your doctor will prepare an eczema treatment plan. The plan is a medical document, that is completed by your doctor or nurse practitioner.
Your child may need wet dressing treatment at home or in hospital.
Resources and support
The Eczema Association of Australasia is a national non-profit charity that can provide information and support. Call 1300 300 182.
Eczema Support Australia provides advice and support on managing eczema. You can call them on 1300 329 362.
Speak to a maternal child health nurse
Call Pregnancy, Birth and Baby to speak to a maternal child health nurse on 1800 882 436 or video call. Available 7am to midnight (AET), 7 days a week.
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Last reviewed: March 2024