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Treating eczema in children

It is likely your child will eventually grow out of their eczema.

However, while they are affected the key to controlling it is to keep their skin well moisturised, to bathe regularly, and to use topical (rub-on) steroids when they need them. Antihistamines can sometimes help, and it is also important to manage any infections.

Moisturisers

Moisturisers (often called emollients) help to put moisture back into your child's skin.

Normal moisturising lotions aren't enough, but there are many different moisturisers specifically for eczema, available as creams and ointments.

Ointments moisturise better than creams, but tend to be thicker and more oily. Because of this, some people like to use a cream during the day and an ointment at night.

To prevent infection, keep your fingers and hands out of the moisturiser tub. Remove a dollop with a spoon and apply a thick layer, moving in the direction your child's hair grows. Don't rub it in – their skin will absorb it in about 10 minutes.

Your child cannot overdose on moisturiser. Apply the moisturiser as often as you need to keep their skin moist – if that means every hour, then do it every hour! You should be using about 500 g of moisturiser on their skin every one to two weeks.

If applying moisturiser stings your child, it is most likely because their skin is still too dry and they need more moisturiser.

You can buy moisturisers at the pharmacy, but it is usually cheaper to get them on prescription from your GP.

Don't use aqueous cream as a moisturiser. It is intended to be used instead of soap, so keep it for this purpose.

Bathing

Having a bath or shower every day will help to rehydrate your child's skin. The following guidelines will help to make sure they get the most benefit out of their daily bath or shower.

Topical steroids

FTU-squareYour doctor may prescribe a steroid cream for your child and give you specific instructions on how to use it.

There are different types and strengths of steroids. Use the strength necessary to get relief – usually no more than 1% hydrocortisone on your child's face. Your doctor will let you know what strength is best for your child.

Unlike moisturiser, which you should apply liberally, steroid creams need to be applied thinly. A useful measurement is called the finger-tip unit. One finger-tip unit (FTU) is a thin line of cream from the last joint of an adult's index finger to the tip of their finger.

This table shows how much steroid cream to use for different age groups. The links below are to age-specific leaflets, which also show this using diagrams. Apply your child's moisturiser first, wait 10 minutes, and then apply the steroid cream.

Age

Face & neck

1 arm & 1 hand

1 leg & 1 foot

Trunk (front)

Trunk (back)
including buttocks

3 to 6 months

1

1

1 ½

1

1 ½

1 to 2 years

1 ½

1 ½

2

2

3

3 to 5 years

1 ½

2

3

3

3 ½

6 to 10 years

2

2 ½

4 ½

3 ½

5

One FTU is enough for the face and neck, or the hands and feet, or one arm in a 3- to 6-month-old.

Guides for specific age groups:

You can also read more information on Patient about using topical steroids, including how to apply them, side effects, and common mistakes when using them.

Other eczema treatments

Other treatments for eczema in children include:

What if my child's eczema is not getting better?

If your child's eczema is not getting better, despite treatment, or is getting worse, you should go to see your general practice team. Your doctor or nurse may suggest stronger topical steroid creams to get the eczema under control. They may also check to see if any other condition, such as a skin infection, may be contributing to your child's skin problem.

On the next page: Infected eczema

Written by HealthInfo clinical advisers. Updated March 2017.

Sources

Page reference: 47145

Review key: HIEXC-14148