Atopic Dermatitis (Eczema)

Affecting about 15 to 20 percent of children, eczema typically first appears between the ages of 3 and 6 months. Atopic dermatitis can improve as the child grows older and may resolve by school age or puberty. However, in some cases it may persist.

Eczema Causes

While the exact cause of atopic dermatitis is not known, there are several factors that might influence it. These include genetics and external factors such as cold weather, the use of hot water when bathing, skin irritants such as fragranced products, and dry, hot temperatures.

There is a common misperception that eczema in infants is caused by food allergies. While children with eczema are at a higher risk for developing food allergies, eczema is not necessarily caused by the allergy itself. However, because there is an association between the two conditions, children with eczema can benefit from an evaluation with a pediatric allergist to determine if a food allergy is present.

Eczema Symptoms

In children, eczema typically affects the face, neck, scalp, inner elbows and behind the knees.

Signs and symptoms of eczema include:

• Dry skin
• Itching
• Darker or lighter patches of skin
• Redness of the skin
• Scaly patches
• Thickened skin

Scratching the eczema flareups can also lead to bacterial skin infections and other skin-related conditions. If left untreated, the chronic itching and irritation can also affect a child’s sleep and mental well-being.

Diagnosing Eczema in Children

The symptoms of eczema can be very similar to those of other skin conditions, so it’s important to receive a proper diagnosis from a children’s health expert. To diagnose atopic dermatitis, your child’s healthcare provider will perform a physical exam and ask questions about your child’s medical history, including history of allergies, as well as whether any family members have atopic dermatitis or conditions such as asthma or seasonal allergies. While testing is usually not needed to diagnose atopic dermatitis, your child’s provider may perform allergy testing if other associated allergic conditions are suspected.

Eczema Treatment in Children

There is no cure for eczema, but symptoms can be controlled in a variety of ways. Treatment will depend on your child’s specific symptoms and their severity, as well as factors such as their age and overall health.

Non-medication treatment options include:

• Avoiding eczema triggers and irritants as determined by your child’s provider
• Daily bathing using a gentle, non-irritating cleanser and lukewarm water instead of hot water when bathing
• Frequently moisturizing with a gentle cream or ointment, as advised by your child’s provider
• Keep your child’s fingernails short to prevent scratching
• Have your child wear soft clothing to avoid further irritating the skin
• Keep your child cool and comfortable, since being hot or sweaty can cause skin flare-ups

Your child may be prescribed medication can help with eczema symptoms. These may include:

• Antihistamines
• Corticosteroid cream or ointment
• Calcineurin inhibitor cream or ointment
• Phototherapy (light therapy)
• Immunomodulatory or biologic therapies to help regulate the immune system.

Though it can’t be cured, atopic dermatitis symptoms may start to lessen or even go away when your child gets older. If your child has eczema, preventive care is essential to avoid flare-ups and restore the proper skin barrier. You should also continue to follow your child’s doctor’s advice during eczema flare-ups to minimize symptoms and provide relief faster.