Red, itchy skin due to eczema can be distressing for both a child and the parent. No parent want their children to be in such discomfort. While eczema may feel out of your control, there are actions you can take to manage and minimise its effects. 

We asked expert pediatrician Dr Nelu Simonsz in an interview to share a list of management strategies for eczema in children.

What causes eczema in children?

Medical practitioners are yet to pinpoint the exact cause of eczema. They have, however, found out that this skin condition is often hereditary— many children with eczema have family members who have it. In addition, medical experts have identified a number of factors that can trigger or make it worsen the condition in children. Here are four of those factors;

  1. Food triggers

Food allergies and sensitivities can lead to an eczema flare up in children. Nelu says ” a food allergy itself does not cause eczema, but it can worsen eczema. So a child who has eczema can be triggered by the food they ate…but the food in itself is not going to cause a child to have eczema if they weren’t going to get it anyway” 

That said, unless a child becomes affected in other ways, or an allergy test has been performed it is not advisable to cease specific foods altogether. 

  1. Clothing triggers

Wearing layers and layers of clothes may trigger eczema too. Excessive heat and the harshness of wool and polyester clothing can irritate the skin. It is common for parents to overdress their children to avoid them becoming cold, however monitor this closely. Clothing made from cotton and bamboo – ‘breathable’ fabrics are recommended.

  1. Washing detergent

Some detergents and fabric softeners also tend to increase eczema. Pay attention to where and when an eczema flare up occurs, eliminate these detergents once you’ve discovered them.

  1. Fragrance lotions and creams

Using soaps, creams and lotions  with fragrance can worsen the eczema. Dr Nelu recommends that you avoid fragrances wherever possible. Instead, go for simple, benign moisturising lotions and body products.

Managing eczema in children

  1. Moisturising

When it comes to preventing or managing eczema, Dr Nelu believes that “the absolute key is moisturising”. Eczema worsens when the skin is dry as it impairs the barrier function. Dr Nelu suggests moisturising at least twice a day, preferably immediately after a bath—while the body is still wet. Use creams over lotions because creams are thicker and as such, provide a thicker layer of moisture.

  1. Avoid triggers

Triggers while sometimes difficult to avoid worsen eczema. Avoid trigger foods, wear light clothing, and keep away from fragrance lotions, if you’re unsure of the trigger it may help to keep a skin journal until patterns emerge.

  1. Keep nails short

Children are often tempted to scratch as eczema is known to become very itchy. Scratching can break the skin barrier which leads to an increased risk of infection. Trimming nails regularly and even using mittens in very young children will prevent breakages to the skin due to scratching.

  1. Get your child involved 

While getting your child to cooperate with you to manage eczema can be challenging. Kids generally try to avoid things that’ll inconvenience them, are not fun or uncomfortable to them.

To overcome this hurdle, Dr Nelu suggests incorporating measures to actively engage a child in their regime. One way to do this is to create a reward system, or encouraging ownership and a sense of responsibility. Setting a regular routine around other frequent tasks also help a child to become used to it.

  1. Wet wrap therapy

If you’re dealing with an intense eczema case, consider wet wrap therapy. This therapy is very rehydrating and it simply involves wrapping the trouble area with a water-soaked fabric to cool and calm the skin.

  1. Bleach Bath

According to Nelu, a bleach bath “helps to eradicate some of that bacteria overgrowth on the skin. And that’s for kids who get the really consistently infected eczemas”. This method should only be performed under the recommendations of the child’s health care practitioner, however has been shown to be an effective and simple treatment. Pour ¼ – ½ cup of household bleach into a bathtub full of water, and your bleach bath is ready. 

  1. Steroid Creams

Steroid creams can help as well. They should, however, be used with care. Many parents will cease use of steroid creams as the skin becomes fragile, this typically indicates overuse. Using correctly and as recommended is a viable option for the management of acute eczema outbreaks.

  1. Manage emotions too

Children that have eczema, especially if in visible areas may experience bullying and teasing from their peers. It is needless to say that this can affect their self-esteem negatively. Dr Nelu tells us that in such a situation as this “asking them directly how things are going at school and advocating for them through school” can help tremendously. It is also advised to discuss concerns with the teacher of your child.

While we’ve included standard treatments that can help to manage atopic eczema they may not work for all cases. We advise that you seek professional advice to determine an effective treatment plan for your child. If you wish to learn more about management strategies for eczema sign up to the eczema and psoriasis skin summit where you can watch presentations by industry leaders and hear stories of those with lived experience.