By Dr Yati
Eczema is a chronic inflammatory skin condition that affects 30% of children and it often develops before their first birthday. The earlier the eczema is managed, the earlier the child may grow out of their eczema. Typically, parents will bring the child to the clinic with symptoms of itchy, dry and red skin, typical rash distribution involving skin creases, typical age of onset and known atopic history (either personal history or family history).
Apart from the above symptoms, they may present with disturbed sleep, irritability, poor feeding, failure to thrive and developmental delay. During clinical assessment, the most important parts not to be missed are previous eczema treatments and previous skin infections.
Eczema can be well controlled with optimal everyday management and correct treatment during eczema flare. The parent should be provided with an eczema management plan and demonstration on how to apply topical treatments.
- Must bath daily (water be kept luke-warm and limited to 5 minutes) and have moisturiser applied at least twice per day
- Use soap free skin cleanser that will not irritate the skin. Avoid soap or shampoo
- Avoid moisturiser containing fragrance, plant or food products
- Minimise common eczema flare triggers
- Oral antihistamine can be taken for infant > 6 months of age to help in managing the itch
- During eczema flares, do not hesitate to apply topical steroids and increase the frequency of moisturiser to at least 4 times per day
- Wet dressings able to assist to keep the skin moist, protect from infection and further trauma
- Bleach baths may be recommended if there is sign of infected eczema or difficulty in controlling eczema
Royal Children Hospital Eczema Guideline
Dermnet NZ Eczema