Eczema in babies and children

Eczema (Opens in new tab) (also called atopic dermatitis) is a common and chronic (Opens in new tab) (long-term) skin condition in babies and children.

Eczema usually begins before 1 year of age. Eczema causes dry, red, itchy skin. An eczema flare is when eczema gets worse. Usually, there is no single cause for an eczema flare.

Some children grow out of eczema, but others will have it for life. 

Eczema is not contagious.

The most common symptom of eczema is dry, red, itchy skin.

Where and how eczema appears on your child’s body can depend on their age. For example:

• Babies younger than 18 months of age usually have a rash on their face and sometimes also on their scalp, body, arms or legs.
• Older children often have the rash in the creases (folds) of their knees, ankles, elbows or wrists.

Your child's eczema can be caused by a combination of genes and triggers in their environment. 

There are many known triggers for eczema. Every child with eczema will have their own triggers. Sometimes, the condition can flare for no clear reason.

Examples of common triggers in babies and children are:

• heat (Opens in new tab) — for example, overheating with clothing and blankets
• irritants — such as soaps, shampoos, fragrances and scratchy clothes
• environmental allergens — such as dust mites (Opens in new tab), grasses (Opens in new tab), plant pollen (Opens in new tab) and animal fur (Opens in new tab)
• food allergies (Opens in new tab)

Other triggers for babies and children include irritants such as playing in sandpits and
sitting on carpets or grass.

You should not put your child on a special diet without advice from your doctor or a dietitian (Opens in new tab).

It is important to see your doctor if you are concerned about your child’s health or their skin.

See your doctor if your child’s eczema is:

• not improving with usual treatment
• getting worse
• affecting their sleep, feeding or daily activities

It is also important to get medical advice if you are unsure if the rash is eczema, as other skin conditions can look similar.

Seek medical care urgently if there are signs of infection, such as yellow crusting, weeping (oozing), increased redness, swelling or pain. You should also see your doctor straight away if your child develops a rapidly worsening rash with blisters, fever or appears unwell, as they may have a more serious infection.

If you need to see your doctor but cannot wait for an appointment, you may be able to get treatment at a Medicare Urgent Care Clinic (Opens in new tab). Use the Service Finder (Opens in new tab) to find your nearest one.

Your child’s doctor can diagnose eczema by:

• asking about your child’s symptoms and what triggers them 
• asking about your child’s health and your family’s medical history (Opens in new tab) 
• examining (Opens in new tab) your child’s skin

Usually, they won’t need a referral for tests. 

If needed, your doctor may refer (Opens in new tab) your child to a dermatologist (Opens in new tab) (skin specialist).

Your child’s eczema can be treated with a combination of self-care and creams or ointments. 

There is no cure for eczema, but treatment can improve your child’s symptoms.

Treatment involves:

• protecting your child’s skin every day 
• making sure they reduce their contact with irritants or triggers
• treating eczema flares 
• controlling itch 
• preventing and treating infections

The goal of your child’s treatment is to reduce flares by keeping their skin healthy. 

Everyday care for your child’s skin

Tips for daily care of your child’s skin:  

• Moisturise your child’s skin twice daily, including after bathing. Continue to moisturise even when their skin is healthy. Use plain and thick moisturisers. Avoid moisturisers with fragrances or alcohol. 
• Bathe your child every day in lukewarm water and avoid long baths. 
• Use non-perfumed laundry (clothes) detergent. 
• Bathe or shower your child soon after they swim in a chlorinated pool. 

You should try to avoid:

• soaps or shampoos — use soap-free cleansers that won’t irritate your child’s skin
• products that contain chemicals called methylisothiazolinone (MI) or methylchloroisothiazolinone (MCI)
• known irritants and triggers, if possible 
• nappy wipes — use a cloth with water and bath oil instead

Controlling itch

These tips may reduce itch:

• Apply a cool, soft, wet cloth to the area for immediate relief. Leave for around 5 to 10 minutes, then apply a layer of moisturiser.
• Mineral salt sprays can also help with immediate relief.
• Wearing a wet singlet or t-shirt under a thin layer of clothing can help relieve itchiness. You might need to do this several times throughout the day.
• At bedtime, apply a wet dressing until the eczema clears.
• Manage anxiety and behaviours that make your child scratch. 
• Keep your child’s nails short and use mittens with infants. 

Learn more about wet dressings (Opens in new tab) from the Royal Children’s Hospital.

Treating your child’s skin during a flare

Your child’s doctor may give you steroid or non-steroid creams or ointments to use where the skin is affected during a flare. This treats inflammation (redness and itching).

Different creams are used depending on:

• the part of your child’s body affected
• how bad the eczema is
• your child’s age

You should apply moisturiser after using the corticosteroid cream.

You may be given milder creams to use in sensitive areas like the face and nappy area.

Ask your doctor or pharmacist if you have any questions about using corticosteroid cream.

For many children, eczema is a condition that comes and goes. It can change over time, so you may need to see your doctor many times.

Your child’s eczema is more likely to improve quickly if you treat it soon after you first notice the rash. Following your doctor’s instructions will also lessen the chance of complications.

Treating severe eczema

If your child has severe eczema that is hard to treat, their doctor may prepare an eczema treatment plan.

Your child might need to go to hospital for treatment with wet dressings. Wet dressings help to restore moisture to the skin, prevent infection and treat your child’s damaged skin. 

Sometimes, when your child has a flare, their skin can become infected. They may develop bacterial (Opens in new tab) or viral infections (Opens in new tab). Herpes simplex virus is a common virus that can cause severe infections in children with eczema. 

If your doctor thinks your child’s skin may be infected, they may take a swab and send it to a laboratory to check the cause. Depending on the cause, the doctor may prescribe an antibiotic (Opens in new tab) or antiviral medicine for your child. 

Itchy skin can cause other complications, including:

• sleeping problems 
• poor feeding
• slow weight gain (also known as failure to thrive)

Children who have eczema are more likely to have:

• allergic rhinitis or hay fever (Opens in new tab)
• asthma
• food allergies

Eczema can’t be prevented, but you can reduce flare-ups by keeping your child’s skin well moisturised and avoiding triggers.

If you know what triggers your child’s eczema, you and your doctor can make a plan to manage it and keep their skin healthy.

The Eczema Association of Australasia (Opens in new tab) is a national non-profit charity that can provide information and support. Call 1300 300 182.

Eczema Support Australia (Opens in new tab) provides advice and support on managing eczema. You can call them on 1300 329 362.

The Royal Children’s Hospital has an eczema triggers questionnaire (Opens in new tab) to help you identify the potential triggers for your child’s eczema. 

Languages other than English

The Royal Children’s Hospital has translated their fact sheet about eczema (Opens in new tab) into many community languages. 

Information for Aboriginal and/or Torres Strait Islander peoples

Eczema Support Australia has a collection of resources about eczema (Opens in new tab) for Aboriginal and/or Torres Strait Islander peoples.