Medically reviewed by The Dermatologists and written by Dr. Alexander Börve
Atopic eczema can be caused by sensitivity to certain foods, such as dairy, eggs, or fish. Infants with food allergies often have hives in addition to eczema. Children may experience other atopic symptoms including asthma and abdominal discomfort.
Very Common
More than 3 million US cases per year
- Requires medical diagnosis
- Symptoms: Dry and itchy skin, rashes
- Color: Typically brown
- Location: On the face, inside the elbows, behind the knees, on the hands and feet
- Treatment: Apply unscented moisturizer, avoid soap and other irritants
ICD-10: L20.9
ICD-9: 691.8
While an allergy or hypersensitivity reaction can cause atopic eczema, the origin of the eczema is usually unclear. The initial skin irritation can also be triggered by chemical substances or physiological challenges to the skin, such as contact with hot tub water or rough surfaces. Hereditary factors and certain climates can also cause eczema.
Atopic eczema is sometimes called infantile eczema in children. Many children outgrow these symptoms between the ages of one and two, but then develop an itchy eczema instead in some regions, such as the arms and knees.
Similar skin problems: Contact dermatitis, Irritative eczema
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Symptoms
Atopic eczema classically appears as red, thickened, itchy patches on the skin. It usually appears when the child is around one year old. The rash usually starts on the cheeks, and then spreads to the neck, chest, stomach or diaper area. Although young children may not be able to scratch the affected areas, the itching can cause difficulty sleeping or frustration.
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What can I do?
It takes time to treat eczema. If your child is showing a tendency to develop eczema, dry the skin after bathing with gentle pats rather than rubbing. Moisturizing is very important because the affected skin lacks certain fats resulting in an impaired skin barrier. Eczema is usually not improved by any particular diet, except in small children who sometimes have a food allergy that aggravates eczema.
Moisturize eczema several times a day
Apply an unscented moisturizer and cortisone cream to the affected areas. Moisturizers contain emollients, which are ingredients that soften the skin, and come in the form of ointments, creams and lotions. Cortisone is an anti-inflammatory steroid drug that also reduces the itching of eczema. Low-strength hydrocortisone creams can be bought without a prescription at the pharmacy. Cortisone cream should only be applied at the sites of eczema, while moisturizers can be used all over the skin.
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Avoid stress on the skin
- Avoid excessive washing with water and soap.
- Protect the sensitive skin from excessive heat or cold.
- Use mild soap and unscented products designed specifically for dry and sensitive skin.
- Do not use excessive detergent to wash the clothes and sunbathe in moderation.
- Avoid wool clothing, which can cause irritation and itching, and synthetic clothing, which can prevent the skin from breathing.
Get more information
As a parent of a child with eczema, you should get helpful information. This means, among other things, knowing when to use stronger cortisone cream, how to deal with escalation to milder cream, and how to use moisturizing cream. You can talk with a doctor or a dermatologist for more information.
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Should I seek medical care?
It is not always sufficient to treat the eczema your child solely with moisturizing creams and/or non-prescription cortisone creams. If the symptoms continue, professional attention may be needed.
Seek referral to a dermatologist if your child has one or both of these symptoms:
- Severe itching that does not improve with cortisone cream
- Eczema looks different (e.g. exuding or developing small yellow blisters) or is rapidly worsening
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Treatment for Atopic Eczema
Infections with bacteria or viruses can make eczema worse. Bacterial infection (usually due to Staphylococcus) makes the affected skin yellow, crusty, and inflamed. In this case, you may need specialized treatment.
An infection with the cold sore virus (herpes simplex) can cause a sudden painful widespread (and occasionally dangerous) flare of eczema, with weeping small sores. In this case, you may need treatment with oral antiviral treatment. Topical steroids should not be used.
Sometimes a dermatologist will perform a patch test. This medical test is used to identify specific allergies. It involves placing tiny amounts of allergens (substances that cause allergies for some people) on the child’s skin. The dermatologist will check the skin for reactions. Checks are often done after a few hours, 24 hours and 72 hours. Studies suggest that some allergens can make the eczema worse. A treatment plan often includes medicine, proper skincare, and lifestyle changes.
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Source:
Atopic Dermatitis/Atopic Eczema. Daniel Wallach et al. Review. Chem Immunol Allergy. Epub 2014 May 22. 2014;100:81-96.
British Association of Dermatologist. Atopic Eczema. Available at: http://www.bad.org.uk/shared/get-file.ashx?id=69&itemtype=document
American Academy of Dermatology. Atopic dermatitis. Available at: https://www.aad.org/public/diseases/eczema/atopic-dermatitis
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The Specialist doctor from the University Hospital in Gothenburg, alumnus UC Berkeley. My doctoral dissertation is about Digital Health and I have published 5 scientific articles in teledermatology and artificial intelligence and others.