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 and 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 is no cure for eczema - just good management.

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 more detailed information below about bathing, moisturising and steroid use.

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.

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 500g tub every 2 to 3 weeks.
• If your child still has red, itchy, active eczema please see your healthcare provider.

VIDEO: How using moisturiser helps children with eczema

Bathing can be really helpful for tamariki 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

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 health professional if skin is irritated by the bath, or if infection occurs. Wash the whole body and face.

Choosing a bleach to use

Bleach is sold as household cleaner. Choose one that is 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.

How to use bleach baths

Fill your bath or tub with warm water.

• A full-sized bath filled 10cm 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 mls 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 – do not share towels.
• Apply steroid and moisturiser creams as in your eczema plan.

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

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

• Steroid creams are safe and essential for eczema care.
• Use 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.
• Stop steroid creams when eczema has gone and start if eczema returns, but keep using moisturiser every day.
• If your child still has red, itchy, active eczema please see your healthcare provider.

The amount of steroid cream you should use is measured in fingertip units or FTU. This page has information and images(external link) of how much steroid you should apply. Be sure to read the information about fingertip units and children.

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.