Skin care for children with eczema

Skin care for children with eczema emollients

  • Emollients are designed to soothe and hydrate the skin
  • Ointments are better for dry skin as they form a layer on the skin
  • They are safe to use and the effects are short lived therefore they must be applied often but you do not need to apply thickly
  • If emollient is in a tub, a spoon should be used to decant some onto a saucer as this will prevent contamination of the creams
  • Emollients should be applied quickly and gently onto skin in a downward movement in order to minimise plugging of the hair follicles, which can lead to infection
  • Encourage your child to apply emollients each time you see them scratching
  • Regular and frequent use of the emollients can go some way to reducing a flare-up of eczema.

Bath emollients

  • To minimise stinging, apply a soap substitute before entering the bath
  • They are designed to disperse in water and coat the body on entering and leaving the bath
  • Water should be tepid, as hot water will cause irritation to the skin
  • Pat dry as rubbing will cause irritation.

Topical steroids

  • These are needed to control the eczema as they reduce inflammation
  • Only use what your doctor prescribes and never be tempted to use other people’s prescriptions
  • You should decant some onto a saucer and apply enough to show a fine visible film to all areas of eczema
  • It should be applied twice daily unless your doctor informs you otherwise
  • When you see an improvement, try reducing application to once daily
  • If control of the condition is maintained, you can try applying the topical steroid on alternate days and so on until eczema is controlled
  • If your child has a flare-up of eczema you should go back to twice-daily application of topical steroid, or contact your GP
  • Leave approximately 30 minutes between steroid and emollient application to avoid dilution of the topical steroid
  • Skin care should become part of your everyday routine—please do not be tempted to miss any treatments.

Hair and scalp care

  • Hair should be washed and rinsed separately from your bath as the shampoo may irritate the skin
  • If a medicated shampoo is used, massage it onto the scalp and leave for five minutes before rinsing
  • If eczema is on the scalp avoid use of hair dryer as the heat will cause irritation.

Infection

Staphylococcus aureus is an organism that is found on the skin of most children with eczema and can be there without causing any problems. However, sometimes when the skin is damaged through persistent scratching it may lead to infection.

Symptoms that suggest your child may have developed an infection include:

  • sudden deterioration in your child’s eczema
  • your child is unwell
  • eczema is wet and weeping.

Your doctor may take a skin swab to check that the correct antibiotic is prescribed.

When the skin is infected you should not use ointments but change to a cream as the ointment acts as a protective cover and will prevent oozing, which could make the eczema worse.

Streptococcus infection is another organism which can cause skin infection. Your child’s skin may be very red and they may be unwell.

It is often possible to treat these infections at home with antibiotics but remember it may be necessary to admit your child to hospital for a few days.

Herpes simplex virus (cold sores)

Children with eczema should be kept away from those with cold sores and if you have one, please avoid kissing your child.

Children with eczema have an abnormal response to this virus and it will quickly spread.

You can recognise it as clusters of little blisters grouped together or eroded lesions.

If you suspect your child has contracted cold sores, please see your GP immediately as you will need to get an antiviral medicine.

If it is widespread your child will be admitted to hospital for intravenous antiviral drugs.

Treatment notes

  • Avoid extremes of temperature
  • Use non-biological washing powder and no fabric softeners
  • Avoid scented products
  • Avoid wool garments
  • Damp dust and vacuum the sleeping environment daily—try to do this when your child is not around
  • Bedroom should be cool and well ventilated
  • Avoid contact with animal hair/fur

Please note: If using Pimecrolimus or Tacrolimus cream please see product box for further information.

Contributors
Liz Alden George Vasilopoulos