The do’s and don’ts of treating children’s eczema at home

Written by: Professor Helen Brough
Published:
Edited by: Sophie Kennedy

With a variety of over the counter products available to treat eczema, it can be tricky to know how best to treat children’s eczema at home. In this expert guide for parents, leading consultant paediatric allergist Dr Helen Brough details the do’s and don’ts of treating children’s eczema at home, including advice on choosing and applying products and bath time routines as well as when to see a specialist.

 

 

What are the signs of eczema?

 

The signs of eczema can be varied but often include:

  • dryness
  • inflammation
  • redness
  • itching

 

The classical parts of the body that are affected in eczema in infants are the face, the creases of the knee and the elbow. It may also be noted in infants around the neck when they start teething because a wet, dribble rash can exacerbate the eczema. Often children that have eczema also have cradle cap so it is important to address that.

 

Children of darker skin tones can sometimes have a different distribution of eczema, often affecting the skin around the extensor surface of the arms and legs. Typically, the nappy area is spared from eczema as it is quite humid and thus the skin is protected and is unlikely to dry out. As the child gets older, the facial eczema lessens and the distribution of the itching and the redness becomes more typical. However, I do often see children with severe eczema that affects the whole body.

 

 

When should I take my child to see a doctor about eczema?

 

There are a lot of useful resources on the National Eczema Society website, which is a charity that supports people with eczema. Accessing this information to read about all the different things that can help improve your child's eczema is a good place to start.

 

If your child has eczema that causes them to itch and you are not seeing good results from standard eczema moisturising creams, it's important to get advice from a medical professional, especially if you feel it is affecting their daily life. If your child develops infected eczema they should see a doctor urgently.

 

 

What are the do’s and don’ts of treating children’s eczema at home?

 

Treating children's eczema at home is really important. There are lots of simple things that, if done correctly, can massively improve the child's skin condition. Whenever I see a child in clinic, I always form a written eczema treatment plan and go through each stage with the parents.

 

The first thing is to ensure that children with eczema have a daily bath. This should be in tepid water because very hot water can irritate the skin and can cause the child to start scratching. The bath should not be longer than ten to fifteen minutes because being in water longer can irritate the skin and make it more vulnerable.

 

Giving your child with eczema a daily bath is very important because they are unable to clear their skin of bacteria, viruses and fungi as their skin lacks certain proteins. It also is helpful to have a daily bath to remove residues of irritant factors on the skin and foods that can potentially sensitise the child through the skin.

 

During these daily baths, it is very important not to use bubble baths, standard soaps or detergents to wash the child. Children with eczema should have a non-soap substitute for washing, which is usually a cream. This is normally applied to the child's skin and then rinsed off with water. Once the child has come out of the bath, ideally into a temperate room (not too cold and not too hot), the skin should be patted down gently with a towel.

 

After bathing, the second thing to consider is using the right type of moisturising creams in the correct way. I only recommend using clinically proven eczema products and there are a variety of lotions, creams and ointments that are available which different children may find suitable.

 

The best product to use can also vary according to the weather. If it is very cold, ointments can sometimes be more suitable because they are thicker and so they trap more moisture in as lots of children find that their eczema is worse during the winter time. In the summer time, it may be better to use creams as they are lighter and more easily absorbed.

 

Lotions and creams can sometimes be more irritating to the skin than ointments. It's really important to not use a fragranced cream and to select one that contains simple and few products in it. I always tell parents in my clinic that before putting the cream all over the child’s body, they should test it in a little patch on one area of the child's skin to check that it doesn’t irritate them.

 

For young children, around two hundred and fifty grams of cream should be used per week whereas in older children approximately five hundred grams is needed. The cream should be applied in a thick layer all over the child, including the face and the scalp if these areas are dry. It's very important to ensure that the skin is moisturised using a smooth, downward stroke as opposed to rubbing because that can irritate the hair follicles of the skin. Therefore, using smooth, downward strokes in the direction of the hair to apply the cream and then allowing the moisture to be absorbed into the skin is best.

 

Another very important thing to remember is that parents should wash their hands before applying the cream onto their child's skin. Also, I often see that parents put their hand inside a pot of an ointment in order to retrieve some of the product before applying it. However, this means that the pot becomes contaminated with bacteria. As the pot then remains at room temperature, this allows lots of bacteria to grow. When this is later applied to the child’s skin, it can cause irritation. This is very commonly done but can be easily avoided. It is wonderful to see how simple strategies can make a massive difference to a child's skin condition as well as their individual quality of life and that of their family.

 

 

 

If you are seeking an expert opinion on how best to treat your child’s eczema and wish to book a consultation with Dr Brough, you can do so by visiting her Top Doctors profile.

By Professor Helen Brough
Paediatric allergy & immunology

Professor Helen Brough is a consultant in paediatric allergy and clinical immunology and was the head of service at the Evelina London Children’s Hospital, Guy’s and St. Thomas’ Hospital between 2015 and 2023 where she led the largest Children’s Allergy Service in the UK.

She has specific interests in food allergy prevention, diagnosis and treatment, immunotherapy, asthma, eosinophilic gastrointestinal disorders and eczema. She jointly runs the joint asthma and allergy service at the Evelina London.

She co-authored two landmark studies on the prevention of food allergy, is the lead investigator for the Pronuts study (assessing peanut, sesame and tree nut allergy) and is an investigator for the oral and patch peanut desensitisation trials at the Evelina London.

She is the President of the Royal Society of Medicine Allergy and Immunology and was the chair of the Paediatric Section for the European Academy of Allergy and Clinical Immunology (EAACI) between 2022 to 2024. She organised the Annual National Allergy Meeting for the British Society of Allergy and Clinical Immunology from 2013 to 2016 and the European Allergy (EAACI) Congress in 2020. She was awarded the 2020 Distinguished Clinician Award by the American Academy of Allergy, Asthma and Immunology, the Barry Kay award for excellence in Paediatric Allergy research from the British Society for Allergy and Clinical Immunology in 2013, and ‘Health Professional of the Year’ runner-up in 2010 by Coeliac UK.

As a parent herself, Professor Brough knows how distressing and concerned a parent can be when dealing with their child’s condition. All consultations are child-centred and we will always give you and your child enough time to fully discuss all concerns, guiding and supporting you both through treatment plans. We pride ourselves that a common thread across all our reviews is that we are thorough and take time to explain conditions and treatments with all our patients.

Sometimes, parents can find it hard to remember all the information that is discussed during their child’s consultation. So, we always follow up every appointment with a consultation letter, detailing everything that was discussed during your consultation. Our team At Children’s Allergy Doctors, we make it easy for you to select an appointment with us, and at a time that suits you. All appointments can be directly booked online, or by telephone.

We have an experienced practice manager and a medical secretary who manage the secretarial, billing and administration of my practice. From appointment booking, communicating with parents, assisting with queries, or taking payments, they are dedicated to providing an excellent, friendly service to every patient and will be able to answer any queries that you may have.

Professor Brough graduated from King’s College, Cambridge University, with double honours in medicine and Experimental Psychology, before completing her clinical training at the Royal Free and University College London Medical School. She trained in Paediatrics in South London Paediatric training rotation, and was then awarded one of the few recognised Higher Specialist Training posts in Paediatric Allergy and Immunology. Professor Brough trained in some of the UK’s leading teaching hospitals: Guy’s and St. Thomas’ Hospital, King’s College Hospital, and Great Ormond Street Hospital.

She is also certified by the European Academy of Allergology and Clinical Immunology (EAACI) as a European Paediatric Allergist. She has also completed an MSc in Allergy, gaining a distinction at the University of Southampton and was subsequently awarded a PhD in determining routes of developing peanut allergy, at King’s College London University. Clinical studies and publications: Professor Brough co-authored two landmark studies on the prevention of food allergy, and is the lead investigator for the Pronuts study (assessing peanut, sesame and tree nut allergy), and an investigator for the oral and patch peanut desensitisation trials, which are currently running at the Evelina London.

She has published multiple original research articles as well as published a textbook, Rapid Paediatrics. Professor Brough regularly presents her research; both nationally and internationally and is an honorary senior lecturer at King’s College London. She has written reviews on the active management and prevention of food allergies, dietary management of peanut allergy and risks of exposure to food in the environment in allergic patients, and is also at the forefront of research on desensitisation to nuts.

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