Eczema typically presents as itchy skin that may be dry, red or both, often persisting for months or longer. Commonly affected areas include the front of the elbows, back of the knees, neck, and face.
A child with eczema should seek medical attention if:
While there is no cure for eczema, it can improve over time with certain measures. Controlling the itch is important for the child's quality of life and sleep, as well as for preventing complications such as frequent skin infections and lichenification (skin thickening resembling tree bark, which is challenging to reverse).
The main areas of therapy include:
Preventing dry skin is the cornerstone of eczema management. Dry skin is prone to itching and cracking, facilitating irritant penetration and exacerbating eczema. Moisturisers, either prescribed by a doctor or any suitable over-the-counter brands that are alcohol- and scent-free, should be applied to all affected areas, including the face, regularly.
Opt for cotton clothing over woollen or synthetic fabrics to avoid skin irritation. Avoid detergents and harsh soaps. If house dust mites are a concern, consult your doctor for methods to reduce them. In cases where eczema begins early, before 1 year of life, a food allergy may be involved. Please consult a doctor for a thorough evaluation.
Steroid creams, prescribed by a doctor, can effectively reduce skin inflammation when a flare occurs. They must be used strictly as directed. Alternative non-steroidal creams are also available and can help with controlling the itch and inflammation.
To alleviate itching and promote better sleep, doctors may prescribe topical or systemic anti-itch medications. These are complementary to moisturisers and topical steroids.
In cases where bacteria worsen eczema, antiseptic washes may be helpful. For acute skin infections, topical or oral antibiotics may be prescribed by the doctor.
In patients with moderate to severe eczema, despite conventional skin care strategies, immunomodulators such as biologics (e.g. Dupilumab) and synthetic small molecules (e.g. Janus Kinase inhibitors) are approved treatments for patients with eczema. These drugs target specific parts of the immune system to help control the inflammation and itch. Please feel free to discuss these options with your doctor to find out more.
