Paediatric Pearls from Gold Coast Health.
Atopic eczema is common in early childhood and can affect up to a third of children. It can significantly impact on a family’s quality of life and is both physically and emotionally distressing for parent and child. The key to management is good adherence to a sensible maintenance regime and timely treatment of flares.
A daily maintenance regime should be followed even if the eczema is well controlled. This includes the avoidance of triggers, if known, and regular moisturising. Daily cool soap free baths and Vitamin D supplementation is helpful for children with moderate to severe eczema. Bleach baths can also be considered
Tips on applying moisturisers:
- Some children need more: Apply liberally at least twice a day at minimum.
- Moisturisers should be applied over topical steroids if used.
- Do not double dip: Remove moisturiser from tub onto clean paper and apply to skin from paper to avoid bacterial contamination of the tub.
Eczema flares should be treated as soon as there is a deterioration noted. Topical steroids and anti-inflammatory creams are the mainstay of treatment. We generally use a 1% Hydrocortisone preparation for the face and a stronger steroid such as Advantan (Methyprednisolone), Diprasone (Betamethasone) or Aristocort (Triamcinolone) for the body. Wet wraps are essential in the management of moderate and severe eczema flares and are very helpful in promoting comfort and sleep.
Poorly controlled eczema leaves the skin open and prone to secondary infections. Antibiotics and antivirals, after the relevant swabs have been taken, may be required if secondary infected eczema is suspected.
Comprehensive resources for families and medical professionals are available at the Royal Children’s Hospital website
and Perth Children’s Hospital website