Is it eczema?

Must be itchy

Educate

Provide eczema information leaflet

Check quality of life “how many times does your child wake you up each night”?

Regular moisturiser

1% hydrocortisone ointment twice a day prn – can be used on the face and torso for a number of months without the risk of significant skin thinning

If oozing, crusting, painful, clothes sticking to the skin

Secondary bacterial information with Staphylococcus aureus – treat with two weeks of flucloxacillin or another anti-staphylococcal antibiotic (not amoxicillin or co-amoxyclav

If infant who reacts to cow’s milk formula

4 week trial of extensively hydrolysed formula, then confirm allergy by reintroducing milk

do not do allergy tests – high risk of false positive reactions

Refer to specialist if

Eczema not responsive to treatment detailed above

Complex allergies to foods

troublesome asthma or hay fever

failure to thrive

other atypical features