Eczema (atopic dermatitis) is a chronic inflammatory skin disease that causes dry, itchy skin. It occurs in almost 20% of children and usually begins in the first few years of life.
In babies, eczema usually starts as a dry, itchy rash on the cheeks. Older children often get the rash in the folds of their knees or elbows, on the backs of hands, or on the scalp.
Eczema Program at Lurie Children's
Our experts provide thorough evaluation and comprehensive testing for eczema, including education on skin care and treatment options.
What Causes Eczema?
The exact cause of eczema is unknown. In many patients, there is a family history of allergies, such as hives, hay fever, asthma or atopic dermatitis. Many people with eczema may also have one of those other conditions. In most cases, no allergic factors can be found that trigger or cause eczema.
Does Eczema Worsen with Age?
Eczema usually begins in infancy between the ages of 2 to 6 months. The skin is dry and the rash is itchy. Infants may be restless, rubbing against their sheets or other objects. They will try to scratch if they are able. The rash may involve only the face, or it may cover a large part of the body.
As the child gets older, the rash may become more localized (more concentrated in one place). In early childhood, the rash is commonly found on the legs, feet, hands and arms. As a child becomes older, the rash may be limited to areas such as the bend of the elbows and knees, on the backs of the hands and feet, and on the neck and face. If the rash has been on the skin for a long time, the skin in that area may become thickened, leathery and sometimes darker in color. The more the child scratches, the worse the rash gets and the thicker the skin gets.
Will My Child Outgrow Eczema?
Most children with eczema (atopic dermatitis) outgrow the condition before school age; some continue to have problems as an adolescent or even as an adult.
What Can Make Eczema Worse?
Patients with eczema usually have sensitive and dry skin. Many patients find that during the winter months when the humidity is very low, the dryness and itchiness is worse.
Some patients are very easily irritated by sweat and may have more problems during the summer months.
Sudden changes in temperature are irritating to patients. Use of harsh soaps or detergents and exposure to wool may also cause itching and irritation.
What Are the Basics of Dry Skin Care?
- Baths should not exceed 5–10 minutes.
- Use lukewarm water. Avoid hot or cold water.
- Do not vigorously scrub skin with a washcloth, sponge or brush. Use your hands to clean your child.
- Use a mild soap (your doctor will have suggestions).
- To dry your child, pat them dry with a towel, then apply the recommended prescriptions. Then use a moisturizer.
- Do not use bubble bath or other fragranced soaps or washes.
Moisturizing the Skin
- Apply the moisturizer twice daily to the entire body. This should be done after prescription medications are applied.
- Creams and ointments come in jars and tubes. They contain more oil and are often preferred. Lotions most often come in pump dispensers. (Lotions are best in the hot summer; creams and ointments are better for very dry skin and winter use.)
Watch Dr. Anna Fishbein Teach about Dry Skin Care in Patients with Eczema:
Can Eczema Cause Other Problems?
Sometimes a “secondary infection” develops with eczema. Infections can be caused by bacteria, fungus or viruses. A bacterial infection is the most common, and most often occurs as the result of scratching. The rash gets very red with pus-pimples and scabs. If this occurs, your doctor will prescribe an antibiotic to control the infection.
How Is Eczema Treated?
There is no permanent cure for eczema. The main goal is to decrease the skin rash and relieve the itching. There are a number of different types of medicine that you can use for eczema.
Your doctor will order the medicines that they feel are best for your child. Most often your doctor will prescribe medicines that are applied to the skin.
Steroid ointments or creams are very important in decreasing the itching and inflammation. Your doctor will suggest a treatment that is most appropriate for the severity and location of your child's rash.
When the skin rash is clear, it is best to stop using the steroid ointment or cream. You should continue to use moisturizers to try to prevent new rashes from starting. Of course, if itching or rash comes back, your child may have to use the steroid ointment or cream again.
Antihistamines help control itching. Some of these medicines may also cause your child to be slightly tired but this may help your child sleep better at night. Antibiotics can be useful as well to control any infection.