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Pediatric Dermatology

Atopic Dermatitis (Eczema)

Atopic dermatitis, or eczema, is a chronic skin condition that causes dry, itchy skin that can appear red, thickened or scaly. Affecting about 15 percent to 20 percent of children, the condition typically first appears between the ages of three months and six months. Atopic dermatitis usually improves as the child grows older and may resolve by school age or puberty. However, in some cases it may persist. Although there is no cure for atopic dermatitis, symptoms can be managed effectively with proper care.


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What Causes Atopic Dermatitis in Babies and Children?

The exact cause of atopic dermatitis in not known. However, the condition can be passed genetically from parents to a child. In addition, underdeveloped immune systems and external factors such winter weather have been linked to atopic dermatitis. Furthermore, children who have other family members with atopic dermatitis or allergies are at a higher risk to develop the condition.

What Are the Symptoms of Atopic Dermatitis in Babies and Children?

Atopic dermatitis symptoms are not exactly the same for every affected child. Symptoms may include:

  • Dry, scaly skin
  • Severe itching
  • Redness and swelling
  • Thickened skin
  • Light patches of skin on the face
  • Small, raised bumps that may become crusty and leak fluid if scratched
  • Darkened skin of eyelids or around the eyes

Symptoms may come and go, or be present most or all of the time. In babies, symptoms usually affect the face, neck, scalp, elbows and knees. In children, symptoms often occur inside the elbows, on the back of the knees, the sides of the neck, around the mouth, and on the wrists, ankles and hands.

How is Atopic Dermatitis Diagnosed in Children?

A pediatric dermatologist at UH Rainbow Babies & Children's Hospital will ask you about your child's symptoms and health history and if you have a family history of atopic dermatitis, asthma or nasal allergies. The provider will examine your child, looking for signs of atopic dermatitis. Other testing is usually not needed.

Treating Atopic Dermatitis in Children

The pediatric dermatologist will determine an individualized treatment plan for your child based on your child's symptoms, age, general health and the severity of the condition. Goals of eczema treatment are to ease itching and inflammation, repair the skin barrier, improve skin hydration, and prevent infection.

Treatment of atopic dermatitis can include avoidance of identified irritants, bathing with gentle soaps, keeping your child's fingernails short to prevent scratching, and the use of moisturizing ointments. Your child's dermatologist may also prescribe medicines, including steroidal ointments, antibiotics, antihistamines, calcineurin inhibitor cream/ointment, crisaborole cream, immunomodulatory medicines and, in extreme cases, injectable biologic medicines. In addition, light therapy may be recommended for some cases.

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