• 1 week ago

Eczema and Atopic Dermatitis in Children

What Is Eczema (Atopic Dermatitis)?

Atopic dermatitis, commonly known as eczema, is a chronic, recurring skin condition that causes dryness, redness, intense itching, and sometimes skin thickening or infection. It typically appears in infancy or early childhood, often within the first six months of life, and may persist for years with flare-ups and remissions.

Eczema occurs due to a combination of genetic predisposition, immune system overreaction, and a compromised skin barrier. Children with eczema often have a family history of asthma, allergies, or hay fever, and their skin tends to be more sensitive to irritants and allergens.

The condition is not contagious and does not spread from person to person. While there is no permanent cure, eczema can be effectively controlled with skincare, trigger avoidance, and medications when needed.

Common Symptoms of Eczema in Children

  • Severe itching, often worse at night
  • Dry, flaky, or rough patches of skin
  • Redness and inflammation
  • Thickened or darkened areas from chronic scratching
  • Tiny fluid-filled bumps that may ooze and crust over
  • Sleep disturbances due to nighttime itching

  • Affected areas:

    • Babies: cheeks, forehead, scalp, torso
       
    • Older children: elbow creases, behind knees, neck, wrists, ankles

Causes and Common Triggers

The exact cause of eczema isn’t fully known, but it’s linked to a combination of genetic, immune, and environmental factors. Children with eczema have skin that loses moisture more easily, making it vulnerable to irritants and allergens.

Common triggers include:

  • Dry air, cold weather
  • Soaps, shampoos, and detergents
  • Wool and synthetic fabrics
  • Sweating, overheating, rapid temperature changes
  • Stress, lack of sleep
  • Certain foods (milk, eggs, peanuts—especially in younger children)
  • Environmental allergens (dust mites, pollen, pet dander, mold)

Identifying and avoiding individual triggers is key to preventing flare-ups.

Diagnosis

Eczema is usually diagnosed based on clinical history and skin examination. There are no specific tests to confirm eczema, but tests may help identify allergic contributors.

  • Allergy tests (skin prick or blood IgE testing) if food or environmental allergy is suspected
  • Skin swab or culture if secondary infection is suspected
  • Rule out conditions like seborrheic dermatitis, psoriasis, or fungal infections

Treatment Strategies

The goal is to reduce inflammation, relieve itching, and restore the skin barrier.

1. Moisturizers (Emollients)

  • Used at least twice daily, especially after bathing
  • Creams or ointments (not lotions) are preferred
  • Core of eczema management—even without active flare-ups

2. Topical Steroids

  • Used during flare-ups to reduce inflammation
  • Strength and duration determined by your pediatrician
  • Must be applied correctly to avoid side effects

3. Calcineurin Inhibitors

 (e.g., tacrolimus, pimecrolimus)

  • Non-steroidal anti-inflammatory creams
  • Useful for sensitive areas like the face
  • Suitable for long-term maintenance in older children

4. Oral Antihistamines

  • May be prescribed to reduce itching and support sleep

5. Antibiotics

  • Only if the skin becomes infected from scratching

Proper skincare is the foundation of treatment, even when the skin looks healthy.

At-Home Care and Lifestyle Adjustments

  • Use short, lukewarm baths daily or every other day
  • Avoid soaps—use mild, fragrance-free cleansers
  • Apply moisturizer within 3 minutes after bathing
  • Dress your child in cotton or breathable fabrics
  • Keep nails trimmed and consider mittens for babies
  • Use hypoallergenic laundry detergent
  • Maintain consistent indoor humidity (especially in winter)

Eczema Management with Dr. Ekin Pasinlioğlu

  • Individualized treatment plans and skincare routines
  • Education on trigger identification and avoidance
  • Prescription and monitoring of topical therapies
  • Evaluation of possible allergies with testing as needed
  • Guidance for daycare/school accommodations
  • Referral to dermatology or allergy specialists when appropriate