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Five ways to help care for your child鈥檚 atopic eczema

Eczema is a common condition that has a big impact on the lives of children and their families. It can cause soreness, itching and disturbed sleep.听Keeping eczema under control takes听a lot of effort.

Some parents find it difficult to know how best to look after their child鈥檚 skin. They sometimes find seeing their GP听unhelpful.听Some听parents are overwhelmed by the amount of information available and that they don鈥檛 know who or what to trust.

In this study a group of听parents of children with eczema,听and health professionals 鈥� nurses, doctors and听 community pharmacists 鈥� have worked together to offer 5 key messages听to improve eczema care. Using this knowledge will help.听

1)听Eczema is more than just dry skin 听

Children with eczema will听 always have dry skin
Dry skin is usually caused by skin inflammation, which makes the skin feel itchy
Itchy skin leads to scratching, which causes skin damage and then more itching
Correct eczema treatment can help prevent itching and skin damage
Moisturisers (emollients) should be used every day, even when the skin is clear
There is no one cause of eczema (apart from a variety of genes), but lots of individual triggers (such as being tired, teething, cold weather)听working together

More helpful tips

People with eczema are at increased risk of asthma, hay fever and food allergy听
Soap, bubble bath detergent and being too hot will irritate the skin and flare every child鈥檚 eczema
Some children find their eczema is made worse by pollen, grass, pets and sometimes food, these are individual triggers, which are allergies
It is impossible to find just one factor that causes eczema, triggers are almost always multiple and sometimes difficult to avoid like house dust mites
Try to find out听 your child鈥檚 individual triggers and avoid these triggers
Some children may 鈥榞row out of鈥� eczema but eczema can also be a lifelong听 condition, there is no easy way of telling which child will have eczema for life听

2)听Eczema doesn鈥檛 just go away 听

Children with eczema will听 always have dry skin
Dry skin is usually caused by skin inflammation, which makes the skin feel itchy
Itchy skin leads to scratching, which causes skin damage and then more itching
Correct eczema treatment can help prevent itching and skin damage
Moisturisers (emollients) should be used every day, even when the skin is clear
There is no one cause of eczema (apart from a variety of genes), but lots of individual triggers (such as being tired, teething, cold weather)听 working together

More helpful tips

People with eczema are at increased risk of asthma, hay fever and food allergy听
Soap, bubble bath detergent and being too hot will irritate the skin and flare every child鈥檚 eczema
Some children find their eczema is made worse by pollen, grass, pets and sometimes food, these are individual triggers, which are allergies
It is impossible to find just one factor that causes eczema, triggers are almost always multiple and sometimes difficult to avoid like house dust mites
Try to find out听 your child鈥檚 individual triggers and avoid these triggers
Some children may 鈥榞row out of鈥� eczema but eczema can also be a lifelong听 condition, there is no easy way of telling which child will have eczema for life

3)听Moisturisers are for everyday 听

Moisturisers (emollients) are important for treating and protecting dry skin
Emollients should be used every day, even when skin is clear to prevent flares
The best emollient is the one that suits your child and works
You may need more than one emollient, depending on the dryness of your child's skin, the part of the body affected or time of the year
Medical moisturisers contain no perfume or detergent听

More helpful tips

顿辞苍鈥檛 use soap or bubble baths. Nearly all emollients can be used听 instead of soap by putting on before getting in the bath or shower, washing by rinsing off
Put on emollients after patting skin dry with a soft towel. Apply in smooth downwards strokes and do not rub in
Emollients come in different forms, lotions, creams, gels and ointments
Lotions are lighter but do not moisturise as well, creams are better for daytime use or for places like the face, ointments are very greasy so for very dry skin or night-time use
There should be a gap (around 20 minutes if possible) between applying emollient and other eczema treatment creams

4) Steroid creams are okay when you need them 听

Steroids creams and ointments (topical steroids) are advised by the NHS as first-line treatments for eczema flares. They are very safe when used as directed
When using steroid creams, it is important to get control of the eczema. First with a short treatment burst, usually up to two weeks, so that the eczema 鈥榰nder the skin鈥� is treated. Some people with frequent flares find that using topical steroids for two days every weekend on their eczema 鈥榟ot spots鈥� helps them to then keep control. Talk to your healthcare professional about this
Steroid creams should be used for short treatment bursts, usually up to two weeks, or as advised by your healthcare professional
To treat eczema flares effectively, it is common to be prescribed a stronger steroid for 5-7 days听 and then reduce the strength
It is important to use enough topical steroid. The finger-tip unit shows the correct amount needed, which is explained in the leaflet in the steroid pack

More helpful tips

You usually need to apply steroid cream only once a day听
Topical steroids 听come in four strengths , mild, moderate, potent and very potent
Different strengths of topical steroids will be prescribed for different areas of the body, mild for the face and moderate or potent for the body
Different strengths of topical steroid will be prescribed depending on the age of your child and on how bad their eczema is
Topical steroids only need to be applied once a day. Around 30 minutes before bedtime is a good time to allow the medicine to take effect.听听
Topical steroids can have side effects such as skin thinning and spots but only if used for too long (constantly for months) and in the wrong places like on the face. Undertreated eczema is much more likely to damage your child鈥檚 skin and lead to a miserable quality of life

5) You know your child鈥檚 eczema best 听

Your primary healthcare professional, a GP, nurse practitioner or practice nurse can help you to manage your child鈥檚 eczema
Book an appointment just to discuss your child鈥檚 eczema, don鈥檛 add it on to when you are seeing your health care professional for something else
Write down how you currently manage your child鈥檚 eczema on a daily basis, use this to discuss how treatment can be improved
Try to keep a diary how your child鈥檚 eczema is. Note if their skin is dry or rough skin, itchy, flaking, red, weeping or oozing, bleeding or disturbing their sleep. There is an app to help you do this, 听
You can also take pictures of when your child鈥檚 eczema is bad, to help your health care professional. It is frustrating when the eczema is better on an appointment day.
Tell your health care professional how eczema affects your child and your family. You could complete this questionnaire with your child to discuss at the听 appointment.

More helpful tips

If your child is prescribed topical steroid cream, ask how much, how often, how to apply and when to stop. Book a review appointment for 2 weeks
Does your child鈥檚 emollient suit them? Does it reduce dry skin? If not ask for another emollient to be prescribed
If your child is prescribed topical steroids, ask how much to use, how often, how to apply and when to stop. Book a review appointment for two weeks鈥� time.
Ask your healthcare professional if a referral to a dermatologist (consultant doctor who specialises in treating skin conditions) is required, particularly if topical treatment is not effective or you are not coping
You need to see a healthcare professional if:

Your child鈥檚 eczema becomes infected, look out for signs 听of redness and irritated skin which is weepy with yellow crusts or pus spots. If you spot these signs take your child to the health centre
Your child鈥檚 skin becomes sore with painful tiny blisters.听There is a rare, but serious infection called eczema herpeticum, this has the same virus as the cold sore and can cause an eczema flare .Eczema herpeticum is a medical emergency and your child will need urgent medical care in hospital听