Atopic Dermatitis and Eczema (Child)

Atopic dermatitis is a dry, itchy red rash. It’s also known as eczema. The rash is ongoing (chronic). It can come and go over time. It's not contagious. It makes the skin more sensitive to the environment and other things. The increased skin sensitivity causes an itch, which causes scratching. Scratching can make the itching worse or break the skin. This can put the skin at risk for infection.

Atopic dermatitis often starts in infancy. It's mostly a childhood condition. Some children outgrow it. But others may still have it as an adult. Atopic dermatitis can affect any part of the body. Symptoms can vary based on a child’s age.

Infants may have:

  • Patches of pimple-like bumps

  • Red, rough spots

  • Dry, scaly patches

  • Skin patches that are a darker color

Children ages 2 through puberty may have:

  • Red, swollen skin

  • Skin that’s dry, flaky, and itchy

Atopic dermatitis has many causes. It can be caused by food or medicines. Plants, animals, and chemicals can also cause skin irritation. The condition tends to occur in hot and dry climates. It often runs in families and may have a genetic link. Children with hay fever or asthma may have atopic dermatitis.

There is no cure for atopic dermatitis, but the symptoms can be managed. Careful bathing and use of moisturizers can help reduce symptoms. Antihistamines may help to relieve itching. Topical corticosteroids can help to reduce swelling. In severe cases, your child's healthcare provider may prescribe other treatments. One of these is light treatment (phototherapy). Another is oral medicine to suppress the immune system. More recently, advanced biologic medicines such as dupilumab have been introduced. The skin may clear when your child stops scratching or stays away from irritants. This is a chronic condition. So symptoms of atopic dermatitis may come and go at any time.

Home care

Your child’s healthcare provider may prescribe medicines to reduce swelling and itching. Follow all instructions for giving these to your child. Talk with your child’s provider before giving your child any over-the-counter medicines. The healthcare provider may advise you to bathe your child for short periods in warm water and use a moisturizer after bathing. Keep in mind that moisturizers work best when put on the skin 3 minutes or less after bathing.

General care

  • Talk with your child’s healthcare provider about possible causes. Don’t expose your child to things you know they are sensitive to.

  • For babies from birth to 11 months:  Bathe your child daily or every other day in slightly warm water for 20 minutes. Ask your child’s healthcare provider before using soap or adding anything to your newborn’s bath.

  • For children age 12 months and up: Bathe your child daily or every other day in slightly warm water for 20 minutes. If you use soap, choose a brand that is gentle and scent-free. Don’t give bubble baths. After drying the skin, apply a moisturizer that is approved by your healthcare provider. A bath before bedtime, especially a colloidal oatmeal bath, can help reduce itching overnight.

  • Dress your child in loose, soft cotton clothing. Cotton keeps the skin cool.

  • Wash all clothes in a mild liquid detergent that has no dye or perfume in it. Rinse clothes thoroughly in clear water. A second rinse cycle may be needed to reduce residual detergent. Stay away from using fabric softener.

  • Try to keep your child from scratching the irritation. Scratching will slow healing and possibly cause infection. Apply wet compresses to the area to reduce itching. Keep your child’s fingernails and toenails short.

  • Wash your hands with soap and clean running water before and after caring for your child.

  • Try to keep your child from getting overheated.

  • Try to keep your child from getting stressed.

  • Check your child’s skin every day for continued signs of irritation or infection (see below).

Follow-up care

Follow up with your child’s healthcare provider, or as advised.

When to get medical advice

Call your child's healthcare provider right away if any of these occur:

  • Fever of 100.4°F (38°C) or higher, or as directed by the provider

  • Symptoms that get worse

  • Signs of infection, such as increased redness or swelling, pain that gets worse, or foul-smelling drainage from the skin

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