Eczema is a common itchy skin disease, which particularly affects young infants and children. Treatment includes
- a moisturiser which act as a barrier and help to protect the skin from irritants and dirt
- an anti-inflammatory cream or ointment, usually steroid
- anti-histamines don’t reduce the itch of eczema and are of little use in this condition
Moisturisers:
Ointments stay on the surface of the skin. Creams seep into the skin and contain more chemicals that can irritate the skin.
For these reasons, ointments are preferred to creams.
Moisturisers to consider
Moisturisers to avoid
Anti-inflammatory creams and ointments
Steroid creams and ointments have been used for many years to treat children's eczema. They come in different strengths: mild, moderate, potent, very potent.
Very potent steroids (Dermovate) should never be used to treat children's eczema
Most children with mild eczema respond to a mild steroid (1% hydrocortisone ointment) used twice a day. 1% hydrocortisone can be used regularly for many months or even years without a significant risk of skin thinning. More potent steroids should only be used for shorter periods of 1 week, unless directed by your doctor.
Apply the anti-inflammatory cream or ointment FIRST, before applying the moisturiser.
Newer non-steroid anti-inflammatory creams and ointments are available. They are used in children who do not respond to 1% hydrocortisone ointment and have extensive eczema, particularly involving the face
If the anti-inflammatory creams and ointments don't work or stop working, the reason is not that the child has got used to the treatment. If the skin is crusty, oozing, painful and sticks to the clothes it is likely that it is infected. A course of antibiotics may be required to treat the infection. If the skin starts stinging and becoming more red when the creams are applied the child may have developed an allergy to them. Go and see your doctor. Fucidin based ointments should not be used for more than 1- 2 weeks, otherwise antibiotic resistance will develop.