Most children get itchy rashes at one time or another. But eczema can be a nuisance that may prompt scratching that can only make the problem worse.

The term eczema refers to a number of different skin conditions in which the skin is red and irritated and occasionally results in small, fluid-filled bumps that become moist and ooze. The most common cause of eczema is atopic dermatitis, sometimes called infantile eczema although it occurs in infants and older children.

The word "atopic" describes conditions that occur when someone is overly sensitive to allergens in their environment such as pollens, molds, dust, animal fur, and certain foods. "Dermatitis" means that the skin is inflamed, or red and sore.

Children who get eczema often have family members with hay fever, asthma or other allergies. Some experts think these children may be genetically predisposed to get eczema, which means characteristics have been passed on from parents.
Eczema is not contagious, so there's no need to keep a baby or child who has it away from siblings, other kids, or anyone else.

About half of the kids who get eczema will also someday develop allergic rhinitis (hay fever) or asthma themselves. Eczema is not an allergy itself, but allergies can trigger eczema. Some environmental factors such as excessive heat or emotional stress can also trigger the condition.

Signs and Symptoms
Children with eczema usually develop dry slightly raised, itchy skin with small bumps on different parts of the body including their cheeks, forehead, or scalp. The rash may spread to the extremities (the arms and legs) and the trunk. They may also experience scaly rashes in the bends of the elbows, behind the knees, or on the backs of the wrists and ankles.
Children often try to relieve the itching by scratching the affected. But scratching can make the rash worse and can eventually lead to thickened areas on the skin.

How Long Does It Last?
In many cases, eczema goes into remission and symptoms may disappear altogether for months or even years.
For many children, it begins to improve by the age of 5 or 6; others may experience flare-ups throughout adolescence and early adulthood.

Prevention
Scientists believe that eczema is inherited, so there's no way to prevent it. However, because specific triggers can make it worse, flare-ups can be prevented or improved by avoiding possible triggers such as:
Pollen, mold, dust, animal fur, allowing the skin to become too dry, certain harsh soaps and detergents (often the medicated ones), certain fabrics (such as wool or coarsely woven materials), certain skin care products, perfumes, and colognes (particularly those that contain alcohol), tobacco smoke, some foods (which depends on the person, but dairy products and acidic foods like tomatoes seem to be common culprits), emotional stress, excessive heat and sweating

Also, curbing the tendency to scratch the rash can prevent the condition from worsening and progressing to cause more severe skin damage or secondary infection.

Diagnosis
Diagnosing eczema can be challenging because there's no test available to diagnose it definitively. Therefore the diagnosis is largely based on the history and physical examination. It is also important to identify the environmental factors that trigger flare-ups

Treatment
Topical corticosteroids, also called cortisone or steroid creams or ointments, are commonly used to treat eczema and are not the same as the steroids used by some athletes. These medicines are usually applied directly to the affected areas twice a day.
These creams and ointments vary in strength, and using the wrong strength in sensitive areas can damage the skin, especially in infants, therefore it is important to stick to the formulations and instructions given by your doctor.
Other prescription treatments your doctor may recommend include:antihistamines (to help to control itching), oral or topical antibiotics (to prevent or treat secondary infections, which are common in children with eczema)

Helping Your Child
You can help prevent or treat eczema by keeping your child's skin from becoming dry or itchy and avoiding known triggers that cause flare-ups. Try to follow these suggestions: Avoid giving your child frequent hot baths, which tend to dry the skin. Use warm water with mild soaps or non-soap cleansers when bathing your child. Avoid using scented soaps. Avoid excessive scrubbing and toweling after bathing your child. Instead, gently pat your child's skin dry. Avoid dressing your child in irritating clothing, such as wool or coarsely woven materials. Dress your child in soft clothes that "breathe," such as those made from 100% cotton.

Apply moisturizing ointments (such as aqueous cream), lotions, or creams to your child's skin regularly and always within a few minutes of bathing, after a very light towel dry. Even if your child is using a corticosteroid cream prescribed by the doctor, apply moisturizers or lotions frequently (ideally, two to three times a day). But avoid alcohol-containing lotions and moisturizers, which can make skin drier. Some baby products can also contribute to dry skin. Keep your child's fingernails short to minimize any skin damage caused by scratching. Try having your child wear comfortable, light gloves to bed if scratching at night is a problem. Help your child avoid becoming overheated, which can lead to flare-ups. Eliminate any known allergens such as certain foods, dust, or pet fur from your household. (This has been shown to help some.) Have your child drink plenty of water, which adds moisture to the skin.

When to see the Doctor
Fevers, pus-filled bumps on or around affected areas and the presence of blisters
Also, visit your doctor if you notice a sudden change or worsening of the eczema or if it isn't responding to the doctor's recommendations.

Reviewed by: Andrew Sekitoleko MBChB
Date reviewed: October 2011