Overview
Eczema (also called atopic dermatitis) is a common skin condition in children that causes dry, itchy, red patches and can affect your child's sleep, comfort, and daily activities.
Why this matters for your child
Daily comfort & activities
Flare-ups may limit participation in activities like sports or swimming, and scratching can lead to skin infections.
Sleep & focus
Itching can disrupt sleep and make it hard for your child to concentrate during the day.
Self-esteem
Visible skin changes can affect self-esteem and mood.
Common symptoms
Parents typically notice the symptoms below. In babies, eczema often shows up on the cheeks, scalp, arms, and legs. In older children, it usually appears in the creases of elbows and knees, on the neck, wrists, and ankles.
- Dry, rough, or scaly patches of skin
- Red or pink patches (may look purple or darker on brown or black skin)
- Intense itching, especially at night
- Scratching that leads to raw or bleeding areas
- Thickened skin from repeated scratching
- Crusty or oozing patches during flare-ups
When to see a doctor
Consider evaluation if your child:
- Has persistent itchy, dry skin that doesn't improve with regular moisturizer
- Develops signs of skin infection (increased redness, warmth, pus, or honey-colored crusting)
- Has eczema that interferes with sleep or daily activities
- Shows widespread rash or severe flare-ups
- Develops painful blisters or sores (could indicate a serious viral infection)
How we evaluate this condition
Medical history
We'll ask about your child's symptoms, family history of allergies, asthma, or eczema, and what makes the rash better or worse.
Physical examination
Diagnosis is based on the appearance and location of the rash, along with your child's history.
Additional testing
Lab tests or skin biopsies are rarely needed. We may consider allergy testing only if we suspect specific triggers.
Treatment & management options
The best way to treat eczema is to prevent it. The skin care basics below are the foundation of all eczema care, with prescription medications added during flares.
Skin care basics (the foundation)
- Moisturize liberally at least once daily, especially right after bathing — pat skin dry and apply moisturizer to damp skin to lock in moisture (Eucerin Original Healing Lotion is a great option to prevent flares)
- Bathe daily or every other day with lukewarm water and gentle, fragrance-free cleansers (Dove Sensitive Skin Bar Soap is a good choice)
- Avoid potential triggers — products with fragrances, dyes, or essential oils
During a flare-up
- Apply prescription anti-inflammatory medication (topical corticosteroids and non-steroid ointments) to affected areas as directed
- Aggressively moisturize — apply Aquaphor or Vaseline to flares as often as possible throughout the day
- Identify and remove triggers — think about what might have caused the flare (new soap, new fabrics, seasonal allergens, stress, illness)
- Keep your child's fingernails short, and consider soft cotton gloves at night to prevent scratching damage
- Continue the skin care basics above to prevent more flares
When to intensify treatment
If a flare-up doesn't improve within a few days with the above interventions, contact us. We may recommend wet wrap therapy, stronger medications, or evaluation for infection.
Topical medications
- Topical corticosteroid creams or ointments for active eczema patches on the body — usually applied twice per day, for up to 2 weeks (hydrocortisone and triamcinolone are the most commonly used)
- Non-steroid anti-inflammatory creams (like tacrolimus or pimecrolimus) for flares in sensitive areas like the face, groin, and armpits
- Newer prescription creams (crisaborole, ruxolitinib, roflumilast, tapinarof) for certain cases
Advanced treatments (for severe cases)
Injectable medications such as dupilumab are available for children. These are typically prescribed by a specialized doctor, such as a dermatologist.
What causes eczema in children?
Eczema develops from a combination of genetic and environmental factors working together. It can come and go throughout a person's life.
Genetic factors
- Family history is the strongest predictor — if one or both parents have eczema, asthma, or allergies, your child's risk increases
- Some children inherit genes that affect the skin's ability to hold moisture and form a protective barrier
- These genetic changes make the skin more vulnerable to dryness, irritants, and allergens
How the skin barrier breaks down
- In children with eczema, the skin doesn't hold moisture well, leading to dryness and cracks
- The damaged barrier allows irritants, allergens, and bacteria to penetrate more easily
- The immune system overreacts to these triggers, causing inflammation and itching
- Scratching damages the skin further, creating a cycle of itching and inflammation
Environmental triggers
- Irritants — harsh soaps, detergents, fragrances, wool clothing, extreme temperatures
- Allergens — pollen, dust mites, pet dander, certain foods (in some children)
- Climate — low humidity, hard water, air pollution
- Infections — bacteria (especially Staphylococcus aureus) and viruses
- Stress and sweating can also trigger flare-ups
Important to know
Eczema is not caused by poor hygiene, and it's not contagious. Your child cannot catch it from or spread it to others.
This guide is for general education only. When in doubt, call us — we'd rather hear from you.