This factsheet provides information about eczema, a chronic skin condition that causes dry, itchy skin and is not contagious. It explains that scratching the inflamed skin can cause it to spread. While there is no cure, treatment focuses on moisturizing to replace lost moisture and using emollients and steroids as needed to reduce inflammation and irritation. Following treatment guidelines can help control eczema symptoms.

1. Child health information factsheet
Eczema
Eczema is a chronic (long lasting) skin condition that is not contagious (does not spread to others).
Although there is no cure, there are many ways to help settle the symptoms and keep eczema
under control.
Skin affected by eczema has difficulty holding in moisture causing it to be very dry and itchy. It can result
in constant scratching which is difficult to manage and upsetting for your child. It may disturb their sleep
and make them feel miserable.
Scratching the skin makes it flake and break down. This increases the inflammation and irritation and
the skin becomes drier and itchier. The inflamed skin sends out messages to other skin cells, and the
eczema spreads.
The good news is that, although they still may have dry skin, most children will be free of eczema by
their mid-teens, sometimes sooner.
Treatment for eczema
One of the most important ways of controlling eczema is to slow down and replace the moisture loss.
Emollients are special moisturisers for eczema skin. They help protect the skin and provide an oily surface
film that slows down water loss.
To be effective it is important to apply a large amount of emollient and use it several times a day. There
are several different emollients available so it may take a while to find the best one for your child.
How to apply emollients
The way these emollients are applied to the skin is also very important. Rubbing in causes friction,
warmth and irritation all of which are things we are trying to avoid.
Emollients should be gently stroked into the skin in the direction of hair growth which will allow
maximum cooling effect and minimum irritation. Applying the emollients in this way will achieve the
most effective, soothing, moisturising benefit of the emollient.
Keeping the skin clean is very important in helping to reduce infections. Bath additives and shower gels
with emollients gently clean without drying. They help to prepare the skin for other treatments by gently
cleansing the skin and sealing in moisture from the water.
Some bath emollients also have built-in anti-bacterial and anti-itch agents. Ordinary soaps should not be
used as they can dry and irritate eczema skin. A special detergent free soap substitute gently stroked into
the skin and then rinsed off will give the best results. All these products are now available in packaging
which makes them easy to use at school or for sports.
www.uhs.nhs.uk

2. Child health information factsheet
Bathing also helps the skin to absorb the emollients when they are put on immediately after the skin has
been towel dabbed dry.
Steroids
When the skin is red and inflamed it needs medication. Topical steroids are used and they play an important
part in the treatment of eczema but it is important to understand how and when to use them.
They come in different strengths. 1% hydrocortisone is mild, of low risk and can be used all over the
body, including the face. Stronger steroids should not be used on the face except under close medical
supervision.
The strength and type of the steroid prescribed will depend on how old your child is, how severe and
where the eczema is. Ointments are often preferred as they tend to be more effective than creams on
the dry skin.
It is important that enough steroid is used to have an effect. Usually it is put on before the emollient,
only to the affected areas, once or twice a day for a limited period. They should be put on the same way
as emollients, gently stroked onto the skin in a downward motion.
The skin normally acts as one of the first lines of defence against infections. When this barrier is broken
germs have easy access and this also causes irritation, inflammation and itching. If you see any yellow
crusting or seeping, it is likely that the eczema is infected
A visit to your GP is advisable as antibiotic medicines and topical steroids combined with the emollient
you are already using may be needed.
If you have any questions or concerns please contact
Sister Di Keeton paediatric dermatology nurse
John Atwell day ward: 023 8079 4366
V3 Revised Sept 2011 Review date Sept 2014 CHO.049.03
www.uhs.nhs.uk
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