Eczema is an inflammation of the outer layers of the skin. This inflammation leads to a red, itchy, and scaly rash. The eczema rash may be present for a long period of time or it may come and go. It is common in children.
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Eczema rash is caused by inflammation that causes skin irritation and damage. This inflammation is caused by an overreaction of the immune system. It is not known exactly why the immune system has this reaction, but is thought to be a combination of genetic and environmental factors.
Eczema is more common in children who are of African or Asian descent.
Other factors that may increase your child's chances of eczema:
- A personal history of asthma or allergies
- Urban areas or places with low humidity
- A family history of eczema or allergic disorders
- Stress, especially if it leads to scratching
- Medications that suppress the immune system
- Excess weight or obesity
Irritants that can initiate flare-ups include:
- Very hot and very cold climates
- Exposure to allergens such as certain fabrics, perfumes in soaps, dust mites (common), foods, or nickel in jewelry
- Frequent washing of affected areas
- Scratching or rubbing of skin—eczema is known as the itch that rashes
- Use of rubber gloves in persons sensitive to latex
- Exposure to urushiol—oil from plants that causes contact dermatitis
Eczema usually begins at 3-6 months of age. It may improve over time, usually by ages 5-7 years. For some children, the condition may continue into adolescence and early adulthood.
The eczema rash may be present for a long period of time or it may come and go. It can appear anywhere on the body or in just a few areas that may vary by age. Symptoms may include:
- Dry, itchy skin
- Cracks behind the ears or in other skin creases
- Red rashes on the cheeks, arms, and legs
- Red, scaly rash
- Thick, leathery skin
- Crusting, oozing, or cracking of the skin
You will be asked about your child’s symptoms and medical history. A physical exam will be done. The diagnosis is made by the appearance and location of the rash. Your child may be referred to a specialist.
There is no cure for eczema. Treatment is focused on managing symptoms.
Talk with your doctor about the best treatment plan for your child. The main goals of treatment are to:
- Heal the skin and keep it healthy
- Avoid skin infections in damaged skin
- Identify and avoid triggers to prevent flare-ups
Treatment options may vary. Your child’s doctor may recommend more than one depending on your child’s condition.
Irritation of the skin can start or worsen flare-ups. Dry skin is one of the most common culprits. Steps to help decrease dry skin and flare-ups include:
- Limiting bath time to 1-3 times a week for a maximum of 10 minutes.
- Avoid using water that is too hot or cold during baths or showers.
- Using mild, unscented bar soap, or non-soap cleanser.
- Use moisturizer daily, or more often as needed. These may be lotions, creams, or ointments, depending on the severity and location of the rash.
- Avoid irritants that trigger your eczema.
Skin infections and irritations need to be treated right away. The longer the inflammation remains, the more damage is done.
In some cases, medication may also be needed to manage flare-ups or symptoms:
- Prescription creams and ointments containing cortisone or other ingredients to reduce inflammation
- Prescription or over the counter antihistamines to help prevent itching
- Oral medications
Infections may also need to be treated with oral or topical antibiotics.
If skin care and medications are not effective, light therapy may be used. This therapy exposes the affected skin to specialized light. Treatment options may include:
- Treatment with ultraviolet A light and 5-methoxypsoralen (PUVA)
- Photopheresis for severe cases
Eczema is difficult to prevent, especially if there is a family history. To help reduce your child's chances of eczema:
- Breastfeed your baby.
- Use formula that contains hydrolyzed casein or 100% whey protein for bottle-feeding if your baby is at high risk.
- Avoid perfumed products.
- Apply a daily moisturizer if your baby is at high risk.
- Expose your child to pets at an early age.
- Take probiotics during pregnancy and after giving birth if you are breastfeeding.
Healthy Children—American Academy of Pediatrics https://www.healthychildren.org
National Eczema Association https://nationaleczema.org
Canadian Dermatology Association https://www.dermatology.ca
Caring For Kids—Canadian Paediatric Society https://www.caringforkids.cps.ca
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1/28/2015 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T115212/Atopic-dermatitis : Horimukai K, Morita K, Narita M, et al. Application of moisturizer to neonates prevents development of atopic dermatitis. J Allergy Clin Immunol. 2014;134(4):824-830.
1/4/2016 DynaMed's Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T115212/Atopic-dermatitis : Zhang A, Silverberg JI. Association of atopic dermatitis with being overweight and obese: a systematic review and metaanalysis. J Am Acad Dermatol. 2015;72(4):606-618.
- Reviewer: EBSCO Medical Review Board Michael Woods, MD, FAAP
- Review Date: 11/2018
- Update Date: 12/20/2017