Eczema in children

Eczema is a dry skin condition that causes the skin to become red (inflamed) and itchy. On darker skin, eczema may not look red – it may look darker or lighter, and feel rough. 

You can usually control your child's eczema by:

• avoiding triggers
• bathing once a day
• using lots of moisturiser
• using steroids on the skin (topical steroids) when your child's skin has active eczema.

You can easily manage most eczema at home but it needs care every day. There's no cure for eczema – just good management. Avoiding triggers, bathing, moisturising and steroid use are all part of the management of eczema in children.

Avoiding triggers

Stay cool
Getting too hot from clothing or heating can make eczema worse. 

Avoid soap and fragrances
Soap and fragrances are the most common triggers of eczema. Only use skin care products designed for eczema. Many are available on prescription from your doctor or nurse prescriber.

Read information about bathing, moisturising and steroid use in the sections below.

Video: How to care for eczema in 3 easy steps

Apps reviewed by Healthify

You may find it useful to look at some eczema apps.

Bathing can be really helpful for tamariki (children) with eczema. Bathing once a day helps to clean the skin and prepares the skin for creams after the bath.

When bathing:

• use a moisturising wash or soap substitute
• don't use soap or bubble bath
• pat the skin dry
• apply eczema creams immediately after the bath.

Video: How bathing once a day can help children with eczema

Antiseptic baths 2 times a week can help prevent infection and improve eczema.

Using bleach baths

Bleach – sodium hypochlorite baths decrease bacteria (bugs) on the skin. This can help improve active eczema and prevent skin infection.

Once diluted in bath water, it's similar to a swimming pool with chlorine. 

When to use bleach baths

When the skin is dry, red, and itchy or infected (active eczema). Some cracked eczema skin will sting when having a bath. Adding bleach won't make this worse. 

How often to use bleach baths

Twice a week. See a healthcare provider if their skin is irritated by the bath, or if infection occurs. Wash their whole body and face.

Choosing a bleach to use

Bleach is sold as household cleaner. Choose one that's plain and has no added fragrance or detergent. They come in different strengths. Bleach gets weaker over time so you may need to replace with a fresh bottle.

Make sure you store bleach where children cannot reach it.

How to use bleach baths

Fill your bath or tub with warm water.

• A full-sized bath filled 10 cm deep holds about 80 litres of water.
• A baby's bath holds around 15 litres of water.
• Work out how much water is in your bath by filling it to a mark using a bucket or large bottle.

Add bleach and mix well.

Work out the amount of bleach to add to the bath.

• For a 4.2% product, add 1 mL for every litre of water.
• For a 2.1% product, add 2 mL for every litre of water.

Soak in the bath for 10 to 15 minutes then wash with non-soap cream.

• You can choose to rinse off after or not.
• Pat skin dry with a towel – don't share towels.
• Apply steroid and moisturiser creams as in your eczema plan(external link).

You can print these instructions out(external link) and keep them handy.

Using lots of moisturiser many times a day is really important for tamariki with eczema. 

• Use it at least twice a day – more if possible.
• Use it all over the body, including the face.
• Put it on using a downward motion (in the same direction as the hairs grow).
• Use a spoon to scoop out creams that come in a tub, rather than your fingers.
• Aim to finish at least one 500 g tub every 2 to 3 weeks.

Video: How using moisturiser helps children with eczema

Topical steroids are steroids you put on the skin. They help to soothe inflamed (flared) eczema and allow the skin to heal and become comfortable.

Topical steroids are essential for eczema care and safe when used as directed. Use topical steroids on any skin with red, itchy, active eczema. On darker skin, eczema may not look red – it may look lighter or darker, and feel rough.

Put enough topical steroid on the skin for you to see a good shiny layer.

Stop topical steroids when eczema has gone and start if eczema returns, but keep using moisturiser every day.

'Tapering' – reducing steroids gradually

If your child has bad eczema flare-ups, it can be helpful to gradually reduce steroids rather than stopping them suddenly. This reducing is called ‘tapering’ and can help the skin recover more smoothly. Your health professional can give you a tapering plan to follow.

‘Maintenance’ or ‘weekend therapy’

If the same areas of skin keep flaring up, it can be helpful to use the steroid creams as ‘maintenance’ or ‘weekend therapy’. On 2 days of the week, use the steroid cream on the areas of the skin that keep flaring up. This can help to prevent flaring before it starts. Talk to your healthcare provider if you think these plans could help your child. 

Video: When and how to use steroid creams for children with eczema

See your healthcare provider if:

• your child's eczema is not showing signs of improvement after 5 days, or
• if your child has signs of a skin infection.

Signs of a skin infection include:

• crusting
• weeping
• pustules (yellow or white pimples)
• blisters
• fever
• pain.

You can print out an eczema action plan and take it with you when you see your child's health professional. Ask them to mark on the diagram where to put moisturiser and topical steroids on your child's skin. The action plan is available in English(external link) and Samoan(external link).