Dr Phil Kieran: Will my child grow out of his eczema?

Some 85% of children will outgrow their eczema but it can take until puberty

Eczema affects 30% of children in Ireland. 

Dr. Phil Kieran

GENERAL PRACTITIONER

My six-year-old daughter still gets outbreaks of eczema, particularly behind his knees. I usually treat it with an over-the-counter cream. Will she eventually grow out of it?

Eczema affects 30% of children in Ireland.  

The inflammatory skin condition occurs when an irritant or allergen creates an autoimmune response causing the skin to lose moisture and become red, scaly and itchy. Like with your child, it most frequently affects places where the skin bends back on itself (flexures), like behind the knees and in the front of the elbows, but for those under two, it can be on the opposite side of the joints.

Eczema can most often be managed with over-the-counter treatments and doesn’t always require medical intervention. 

Most children (85%) will outgrow their eczema but it can take until puberty so, unfortunately, there is a while to go yet.

The mainstay of eczema treatment is moisturiser. When the skin cracks, it dries out, and when it dries, it becomes itchy and when we scratch it, it cracks, leading to an ongoing cycle. 

For mild eczema moisturising alone can revert the skin to its normal state but you may need to apply your chosen ointment four to five times per day. 

For infants, I usually recommend having a tub of moisturiser close to hand so you can easily reapply it during each nappy change. For older children, leave tubs of moisturiser around the house and any time you see them itch, teach them to rub it in instead of scratching. 

This habit will relieve the itch and repair the skin rather than damage it. If the irritation is severe, I would add in antihistamines to reduce scratching.

You may need to use steroid ointment as recommended by your GP. Please try to follow the advice on this accurately as the biggest cause of poor effect is undertreating or at the other end continuing to use the steroid cream for too long.

There are several things that can exacerbate eczema. Detergents remove oils from the skin, drying it out. One of the hidden culprits for this is fabric softener (it causes my eczema to flare up), so try stopping this and see if it helps. 

For the same reason, I often recommend using a soap substitute for children to wash their hands and for showers and baths. I recommend avoiding bubble baths as they tend to dry out the skin. You could use a bath additive to moisturise the skin and I recommend applying moisturiser after the bath too.

If the skin becomes very red, sore or starts weeping, there may be an infection and you should seek a medical review. But usually, eczema can be managed at home and in most cases, it will clear up - eventually. 

The Irish Skin Foundation has excellent online resources. See irishskin.ie/eczema.

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