Eczema in Children: A Practical Guide for Parents

Eczema, also called atopic dermatitis, is a very common skin condition in children. It causes the skin to become dry, itchy, inflamed and sometimes cracked or weepy.

Eczema often starts during infancy and can come and go over time. Although there is currently no cure, most children can achieve very good control of their eczema with a consistent skin-care routine and appropriate treatment during flare-ups.

At my practice, I often see children whose eczema is affecting their sleep, comfort, school or family life. The good news is that eczema can usually be managed effectively once you understand how to care for the skin and recognise a flare early.

What does eczema look like?

Eczema can vary considerably between children and can range from mild dryness to widespread, inflamed and cracked skin.

Common symptoms include:

• Dry or rough skin
• Red or inflamed patches
• Intense itching
• Scratching and scratch marks
• Thickened skin from repeated scratching
• Cracked skin
• Oozing or crusting when eczema becomes infected

In babies, eczema commonly affects the cheeks, scalp and the outside surfaces of the arms and legs. In older children, it more commonly affects the skin folds, such as behind the knees and inside the elbows. The neck, ankles and around the eyes can also be affected.

Why does eczema happen?

There isn't one single cause of eczema.

Children with eczema have a skin barrier that does not work as effectively as normal. This allows the skin to lose moisture more easily and makes it more vulnerable to irritation and inflammation.

There is also a strong genetic component. Children are more likely to develop eczema if there is a family history of eczema, asthma or hay fever.

Eczema can also be affected by environmental factors.

Three particularly important triggers are: heat, dryness, and irritation.

Keeping the skin moisturised and avoiding overheating and irritating fabrics can therefore make a significant difference.

Everyday eczema care

The most important part of managing eczema is looking after the skin every day, even when the eczema looks clear.

1. Moisturise regularly

Moisturiser is one of the most important treatments for eczema.

A thick, plain moisturising cream or ointment should generally be applied generously over the whole body at least twice a day, including when the skin appears clear - eg brands like QV, CeraVe, Cetaphil

You may need to apply moisturiser more frequently if your child's skin becomes dry.

A good time to moisturise is immediately after a bath or shower, while the skin is still slightly damp.

If a particular moisturiser stings or irritates your child's skin, stop using it and try a bland alternative.

2.  Keep your child cool

Heat is a commonest trigger for eczema and itching.

Try to:

• Keep bedrooms and living areas comfortably cool 
• setting your house temperature under 20°C during the day and their room at or below 15°C overnight
• Avoid excessive layers of clothing
• Use lightweight cotton clothing
• Avoid overheating during exercise
• Use light bedding
• Avoid placing your child next to heaters
• Children with eczema may become particularly itchy at night when they become hot underneath blankets
• Keep baths and showers cool
• Hot water can make eczema worse by increasing skin dryness and triggering itching
• If you can, try bathing your child at least once a day in a cool bath - no hotter than 30°C

3. Choose comfortable clothing

Some fabrics and clothing features can irritate eczema.

Cotton and other soft fabrics are generally well tolerated. Wool, rough fabrics, seams, tags and scratchy materials can make itching worse.

If an item of clothing feels rough or prickly against your own skin, it may irritate your child's eczema too.

4. Avoid unnecessary irritants

Common irritants include:

• Soaps and fragranced products
• Perfumed laundry products
• Some baby wipes
• Rough fabrics
• Excessive heat
• Dry air
• Chlorinated swimming pools
• If your child swims, rinse off chlorine or salt water afterwards and moisturise the skin.

What should I do when eczema flares?

An eczema flare is when the skin becomes more inflamed, itchy or widespread than usual.

Typical signs include increasing redness, dryness, itching, scratching and sometimes cracking or oozing.

The key is to treat the flare early rather than waiting for it to become severe.

Topical corticosteroids

Topical corticosteroids, sometimes called steroid or cortisone creams, are an important treatment for eczema flares.

When used correctly  topical corticosteroids are safe and effective for children.

They work by reducing the inflammation responsible for redness and itching.

Moisturiser and steroid creams

During a flare, moisturiser should generally be continued alongside the prescribed anti-inflammatory treatment.

Can food allergies cause eczema?

This is a very common concern among parents.

Food allergies and eczema can occur together, particularly in young children, but food is not the cause of eczema in most children.

The RCH advises that allergy testing is not routinely required for every child with eczema, and restrictive diets are generally not helpful unless there is a clear reason to suspect a food allergy.

Some children with food allergies may develop symptoms such as hives, swelling, vomiting or worsening eczema after eating a particular food.

If you suspect that a particular food is causing a reaction, discuss this with your doctor rather than removing foods from your child's diet without medical advice.

Unnecessary dietary restriction can lead to nutritional problems and can make feeding more difficult.

Can eczema become infected?

Yes.

Children with eczema are more prone to bacterial and viral skin infections because scratching can damage the skin barrier.

Signs that eczema may have become infected include:

• Sudden worsening of the eczema
• Increasing pain or tenderness
• Yellow crusting
• Weeping or oozing
• Pus or pustules
• Increasing redness
• A significant increase in itching
• Fever or your child appearing unwell

When should I see a doctor?

You should arrange a medical review if:

• Your child's eczema is not improving despite regular treatment.
• It is interfering with sleep or daily activities.
• Your child is scratching until they bleed.
• You are unsure how to use their prescribed creams.
• You think the eczema may be infected.
• Your child has recurrent skin infections.
• You suspect a food allergy.
• The eczema is significantly affecting your child's quality of life.

When to seek medical advice

This article is intended as general information and does not replace an assessment by your GP or other healthcare professional. Every child's eczema is different, and treatment should be tailored to their age, severity of eczema and the areas of skin affected.

If you are concerned about your child's eczema, particularly if it is affecting their sleep, causing significant discomfort or appears infected, arrange an appointment with your GP.

Written by Dr Max Lippiatt

Specialist General Practitioner

Last reviewed September 2026

If you are concerned about your child's eczema is infected, you can arrange an appointment with Dr Max Lippiatt, a General Practitioner in Abbotsford.