Helping kids love the skin they’re in

What is eczema?

Eczema (also known as atopic eczema or atopic dermatitis) is a long-term condition that affects the skin’s ability to act as a protective barrier. In children with eczema, the skin loses moisture more easily and becomes sensitive to everyday triggers.

This can lead to dry, itchy, inflamed skin and repeated flare-ups. Although eczema often improves with age, early and effective management can make a big difference to comfort, sleep, and quality of life.

In the UK, eczema affects up to 1 in 5 children. There are several types of eczema, and it can look quite different from one child to another. For some children, it causes mild itching and irritation. For others, the skin can become very sore, cracked, and sometimes even bleed.

The National Eczema Society lists several types of eczema, including: Asteatotic eczema, Atopic eczema, contact eczema (dermatitis), Discoid eczema, Ear eczema, Eczema around the eyes, Eczema in later life, Facial eczema, Hand eczema, Pompholyx (dyshidrotic) eczema, Scalp eczema, Seborrhoeic dermatitis & cradle cap in infants, and Varicose eczema. While eczema is usually a long-term condition, it can be managed with the right care and treatment.

Why does my child have eczema?

Eczema usually develops because of a combination of genetics (if it runs in the family) and everyday environmental factors.

Genetics play an important role, and it is common for eczema, asthma, hay fever, and food allergies to appear together in the same child or family. However, there is not one single gene responsible for all these conditions. Changes in the FLG gene are known to reduce filaggrin, which damages the skin barrier and makes it vulnerable to water loss and allergens. However, many affected children do not have this gene change.

Many children with eczema have sensitive skin that dries out easily and reacts to soaps, allergens, or temperature changes.

What does eczema look like?

In babies, eczema often appears as red, itchy patches on the cheeks and scalp. In older children, it can appear on any area of the body, but often appears in creases such as the elbows and knees. Skin can appear very dry, red and blotchy. Scratching can cause bleeding and infection, leading to weeping skin.

What eczema triggers should I watch out for?

Triggers will be different for each person, depending on the type of eczema they have and how bad it is. Because the skin of people with eczema is dry and easily damaged, it is more likely to become red and inflamed when exposed to substances that irritate or cause allergic reactions. Generally, triggers are accepted to be:

• Allergens such as pollen, pets, and dust mites
• Household irritants, including fragrances and soaps or fragranced skin care products
• Clothing made from wool or rough fibres

Cold weather, sweating and heat can irritate the skin and bring on symptoms

Can allergies make eczema worse?

Yes. Allergies to pets, pollen, dust mites, or foods can make eczema worse. Non-IgE–mediated food allergies can trigger eczema flares, particularly in younger children. IgE-mediated food allergies can also be present in children with eczema, and having eczema is a risk factor for developing IgE-mediated food allergies, especially if the eczema is not well-controlled early in life. This is why early and effective eczema management is essential to help reduce this risk.

Managing allergies is an essential part of eczema care. Allergy skin testing can help identify specific allergens that may be making your child’s eczema worse.

How is eczema treated in children?

Once eczema has been confirmed, doctors will usually prescribe emollients, a medical-grade moisturiser. They work by adding a layer of oils that increase the skin’s water content and create a barrier. In addition to softening the skin and keeping it hydrated, the barrier prevents allergens from reaching sensitive skin.

You might need to try several products until you find the right one. Emollients should be used instead of soaps, which often dry the skin and cause irritation. To be effective, emollients must be used at least four times every day.

For some people, using the right emollient and avoiding known allergens can be enough to keep eczema under control. However, many people will also need to use topical steroids, which means a steroid applied directly to the skin. The strength of the steroid depends on the age of the child, the severity of the eczema and where it appears on the body. While some steroid creams and ointments are available over the counter, selecting the appropriate strength is important, so it is always best to consult a doctor.

Treatments for more severe eczema can include oral steroids, phototherapy, immunosuppressant drugs and inhibitors.

Quick tips for managing eczema:

• Identify and avoid triggers, where possible
• Discourage scratching (easier said than done!)
• Keep children’s nails short
• Don’t use harsh or perfumed soaps
• Use emollients at least four times daily
• Teach your child how to apply it themselves
• Talk to them about their eczema

How can I manage my child’s eczema day-to-day?

To reduce the impact of eczema on your child, it is important to manage it properly. Your doctor or dermatologist will be able to give guidance, but general advice includes:

• Regular emollients (moisturisers) at least 4 times daily to keep skin well hydrated.
• Bathing care: avoid very hot water and dry skin.
• Avoiding known triggers: rough fabrics, harsh soaps, temperature extremes and allergens.

Can eczema affect my child at school?

Unfortunately, eczema can affect children of all ages at school. The National Eczema Society offers valuable guidance on managing eczema in school and communicating with teachers about care plans (e.g., applying creams during the day).

How does eczema impact quality of life?

Eczema can be itchy and uncomfortable, disrupting sleep and concentration. Because it is visible and causes a lot of scratching, it can also impact your child’s self-esteem.

How can I manage my child’s eczema day-to-day?

To reduce the impact of eczema on your child, it is important to manage it properly. Your doctor or dermatologist will be able to give guidance, but general advice includes:

• Regular emollients (moisturisers) at least 4 times daily to keep skin well hydrated.
• Bathing care: avoid very hot water and dry skin.
• Avoiding known triggers: rough fabrics, harsh soaps, temperature extremes and allergens.

When should I consult a doctor about my child’s eczema?

• Eczema isn’t improving with regular care
• Signs of infection (pus, warmth, worsening redness)
• Severe itching disturbs sleep or daily activities
• You’re unsure how to manage treatments
• It is impacting your child’s mental health

If symptoms do not improve with usual treatment, your child may require further evaluation by a specialist.

Do you have expertise in treating eczema in children?

As a children’s allergy specialist, I have spent more than 25 years helping families understand and manage allergic conditions such as eczema.

I trained in Birmingham, Liverpool and hospitals across the Midlands. As well as holding degrees in medicine, pharmacology, and child health, I am a certified European Paediatric Allergist. This means I have spent many years studying how children’s immune systems and airways work, and how to keep them healthy.

In my NHS role, I lead one of the busiest allergy services in the region, caring for around 3,000 children each year. Many of these children have eczema or allergy-related breathing symptoms. I have helped to shape national guidelines, improve allergy services across the UK, and support healthcare professionals who care for children with allergies. I’ve also recently been awarded the title of honorary professor for my teaching work at The University of Birmingham.

Every child deserves the chance to breathe well, play freely and feel safe. My role is to reassure and empower parents and give children with allergies the best possible start.