Is it eczema?
Must be itchy
Provide eczema information leaflet
Check quality of life “how many times does your child wake you up each night”?
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