Childhood eczema

Overview

Childhood eczema (also called atopic dermatitis) is a common skin condition that makes the skin dry, red, itchy, and sometimes cracked or weepy. It happens when the skin’s natural barrier doesn’t work properly and the immune system overreacts to triggers.

Yes, childhood eczema is very common. About 1 in 5 children in the UK develops eczema, and it often starts before their first birthday.

Eczema most often affects infants and young children, but it can start at any age. It is more common in children with a family history of eczema, asthma, or hay fever.

Symptoms

Common symptoms

• Dry, sensitive skin that feels rough or scaly
• Intense itching, especially at night
• Red or brownish patches, often on the cheeks, elbows, knees, or wrists
• Small raised bumps that may leak fluid when scratched
• Thickened, leathery skin from long-term scratching

Symptoms in children

• Irritability or trouble sleeping because of itching
• Scratching that can break the skin and lead to infection
• Patches that appear on the face, scalp, or the creases of elbows and knees
• Weeping or crusting when the skin is infected

Causes

Main causes

• A problem with the skin’s barrier — it loses moisture more easily and lets irritants in
• An overactive immune system that reacts to harmless triggers (like dust, pollen, or certain foods)
• Genetics – eczema often runs in families

Risk factors

• Family history of eczema, asthma, or hay fever
• Personal history of allergies or asthma
• Living in cold or dry climates that dry out the skin
• Exposure to irritants like harsh soaps, wool, or perfumes

When to see a doctor

See a doctor urgently if:

• If your child has signs of infection — fever, spreading redness, pain, or yellow crusts
• If itching is so severe it prevents eating, drinking, or sleeping

Book a routine appointment if:

• If eczema is not getting better with gentle skin care and over-the-counter moisturisers
• If you are unsure about how to manage flare-ups
• To discuss a treatment plan that fits your child’s needs

Diagnosis

A doctor or nurse can usually diagnose eczema by looking at your child’s skin and asking about symptoms and family history. There is no single test — the diagnosis is based on the typical appearance and pattern of the rash.

Tests that may be done

• Sometimes patch testing is done if an allergic trigger is suspected
• A skin prick test or blood test may help identify allergies, but these are not routine

What to expect at your appointment

The doctor will ask when the rash started, where it appears, how itchy it is, and if family members have eczema or allergies. They will examine the skin and may suggest a skincare routine or refer you to a dermatologist if needed.

Treatment

Treatment aims to keep the skin hydrated, reduce itching and inflammation, and prevent infections. It usually involves a regular skincare routine and, if needed, medicines prescribed by a doctor.

Self-care at home

• Moisturise at least twice a day — use a thick, fragrance-free moisturiser (emollient) generously
• Use lukewarm (not hot) baths and add a bath oil if recommended
• Pat the skin dry gently and apply moisturiser within 3 minutes of bathing
• Avoid known triggers like wool, rough fabrics, perfumed products, and extreme temperatures
• Keep your child’s nails short and consider cotton mittens or gloves at night to reduce scratching

Medical treatments

When self-care isn’t enough, doctors may prescribe topical treatments such as corticosteroid creams or ointments to reduce inflammation. These are applied for short periods. Other options include topical calcineurin inhibitors (non-steroid creams) for sensitive areas, and in severe cases, light therapy or oral medicines that calm the immune system. Your doctor will explain the right choice for your child.

When is surgery considered?

Surgery is not used to treat childhood eczema. If a secondary infection becomes severe (for example, a pus-filled boil or abscess), a doctor might drain it, but this is rare.

Living with this condition

Caring for eczema becomes part of your daily routine. Set a regular time for bathing and moisturising — many families do it before bed. Keep moisturiser handy at home and at school or nursery. Teach your child to rub the cream in gently, not scratch. It may take a few weeks to see improvement, so be patient and consistent.

Lifestyle tips

• Dress your child in soft, breathable cotton clothes — avoid wool and synthetics next to the skin
• Keep the home cool and humidified, especially in winter
• Use fragrance-free laundry detergents and skip fabric softeners
• Try a ‘soak and seal’ bath: bathe, pat dry, and apply cream immediately while skin is still damp

Diet and exercise

Unless your doctor has confirmed a food allergy, there is no special diet for eczema. A balanced diet supports overall health. Exercise is fine — just rinse off sweat after and moisturise. If certain foods seem to trigger flare-ups, keep a diary and discuss with your doctor.

Mental health and emotional wellbeing

Eczema can be frustrating and stressful for both child and family. Itching may disturb sleep, and the appearance of the skin can cause embarrassment or teasing. It is important to talk about these feelings. Your healthcare team can help with strategies, and mental health support is available if needed.

Prevention

You cannot always prevent eczema, especially if it runs in the family. However, regular moisturising from birth can help protect the skin barrier. Avoiding known triggers and sticking to a good skincare routine can reduce the number and severity of flare-ups.

Vaccines

Children with eczema can receive routine vaccines as scheduled. In fact, immunisations are especially important because children with eczema are at higher risk of skin infections from some diseases like chickenpox. Always tell the vaccinator about your child’s eczema, but it is rarely a reason to delay vaccines.

Screening programmes

There is no routine screening test for eczema. If your child has signs of allergies (like hay fever or food reactions), your doctor may recommend allergy testing to help identify triggers that worsen eczema.

Complications

If left untreated

• Skin infections – bacteria or viruses can enter through broken skin and cause impetigo or eczema herpeticum
• Chronic sleep loss – itching at night can lead to tiredness, irritability, and difficulty concentrating
• Thickened, leathery skin (lichenification) from long-term scratching
• Impact on growth and development if severe eczema is not managed

Long-term outlook

The outlook for childhood eczema is very good. Most children grow out of it by their teenage years. Even if it persists, modern treatments and a consistent skincare routine can keep symptoms under control, allowing your child to live a full, active, and happy life.

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