The do’s and don’ts of treating children’s eczema at home

With a variety of over the counter products available to treat eczema, it can be tricky to know how best to treat children’s eczema at home. In this expert guide for parents, leading consultant paediatric allergist Dr Helen Brough details the do’s and don’ts of treating children’s eczema at home, including advice on choosing and applying products and bath time routines as well as when to see a specialist.

What are the signs of eczema?

The signs of eczema can be varied but often include:

• dryness
• inflammation
• redness
• itching

The classical parts of the body that are affected in eczema in infants are the face, the creases of the knee and the elbow. It may also be noted in infants around the neck when they start teething because a wet, dribble rash can exacerbate the eczema. Often children that have eczema also have cradle cap so it is important to address that.

Children of darker skin tones can sometimes have a different distribution of eczema, often affecting the skin around the extensor surface of the arms and legs. Typically, the nappy area is spared from eczema as it is quite humid and thus the skin is protected and is unlikely to dry out. As the child gets older, the facial eczema lessens and the distribution of the itching and the redness becomes more typical. However, I do often see children with severe eczema that affects the whole body.

When should I take my child to see a doctor about eczema?

There are a lot of useful resources on the National Eczema Society website, which is a charity that supports people with eczema. Accessing this information to read about all the different things that can help improve your child's eczema is a good place to start.

If your child has eczema that causes them to itch and you are not seeing good results from standard eczema moisturising creams, it's important to get advice from a medical professional, especially if you feel it is affecting their daily life. If your child develops infected eczema they should see a doctor urgently.

What are the do’s and don’ts of treating children’s eczema at home?

Treating children's eczema at home is really important. There are lots of simple things that, if done correctly, can massively improve the child's skin condition. Whenever I see a child in clinic, I always form a written eczema treatment plan and go through each stage with the parents.

The first thing is to ensure that children with eczema have a daily bath. This should be in tepid water because very hot water can irritate the skin and can cause the child to start scratching. The bath should not be longer than ten to fifteen minutes because being in water longer can irritate the skin and make it more vulnerable.

Giving your child with eczema a daily bath is very important because they are unable to clear their skin of bacteria, viruses and fungi as their skin lacks certain proteins. It also is helpful to have a daily bath to remove residues of irritant factors on the skin and foods that can potentially sensitise the child through the skin.

During these daily baths, it is very important not to use bubble baths, standard soaps or detergents to wash the child. Children with eczema should have a non-soap substitute for washing, which is usually a cream. This is normally applied to the child's skin and then rinsed off with water. Once the child has come out of the bath, ideally into a temperate room (not too cold and not too hot), the skin should be patted down gently with a towel.

After bathing, the second thing to consider is using the right type of moisturising creams in the correct way. I only recommend using clinically proven eczema products and there are a variety of lotions, creams and ointments that are available which different children may find suitable.

The best product to use can also vary according to the weather. If it is very cold, ointments can sometimes be more suitable because they are thicker and so they trap more moisture in as lots of children find that their eczema is worse during the winter time. In the summer time, it may be better to use creams as they are lighter and more easily absorbed.

Lotions and creams can sometimes be more irritating to the skin than ointments. It's really important to not use a fragranced cream and to select one that contains simple and few products in it. I always tell parents in my clinic that before putting the cream all over the child’s body, they should test it in a little patch on one area of the child's skin to check that it doesn’t irritate them.

For young children, around two hundred and fifty grams of cream should be used per week whereas in older children approximately five hundred grams is needed. The cream should be applied in a thick layer all over the child, including the face and the scalp if these areas are dry. It's very important to ensure that the skin is moisturised using a smooth, downward stroke as opposed to rubbing because that can irritate the hair follicles of the skin. Therefore, using smooth, downward strokes in the direction of the hair to apply the cream and then allowing the moisture to be absorbed into the skin is best.

Another very important thing to remember is that parents should wash their hands before applying the cream onto their child's skin. Also, I often see that parents put their hand inside a pot of an ointment in order to retrieve some of the product before applying it. However, this means that the pot becomes contaminated with bacteria. As the pot then remains at room temperature, this allows lots of bacteria to grow. When this is later applied to the child’s skin, it can cause irritation. This is very commonly done but can be easily avoided. It is wonderful to see how simple strategies can make a massive difference to a child's skin condition as well as their individual quality of life and that of their family.

If you are seeking an expert opinion on how best to treat your child’s eczema and wish to book a consultation with Dr Brough, you can do so by visiting her Top Doctors profile.