Atopic dermatitis - children - homecare
Atopic dermatitis is a long-term (chronic) skin disorder that involves scaly and itchy rashes. It's also called eczema. The condition is due to a hypersensitive skin reaction that is similar to an allergy. It may also be caused by defects in certain proteins in the surface of the skin. This leads to ongoing inflammation of the skin.
Atopic dermatitis is most common in infants and children. It may start as early as age 2 to 6 months. Many children outgrow it by early adulthood.
This condition can be difficult to control in children, so it's important to work closely with your child's health care provider. Daily skin care is important to help prevent flare-ups and keep the skin from being inflamed.
Infantile eczema; Dermatitis - atopic children; Eczema - atopic - children
Help for Itching and Scratching
Severe itching is common. Itching may start even before the rash appears. Atopic dermatitis is often called the "itch that rashes" because the itching starts, and then the skin rash follows as a result of scratching.
To help your child avoid scratching:
Day-to-Day Skin Care
Daily skin care with allergen-free products may cut down on the need for medicines.
Use moisturizing ointments (such as petroleum jelly), creams, or lotions. Choose skin products that are made for people with eczema or sensitive skin. These products do not contain alcohol, scents, dyes, and other chemicals. Having a humidifier to keep air moist will also help.
Moisturizers and emollients work best when they are applied to skin that is wet or damp. After washing or bathing, pat the skin dry and then apply the moisturizer right away. Your provider may also recommend placing a dressing over these skin moisturizing ointments.
When washing or bathing your child:
Dress your child in soft, comfortable clothing, such as cotton clothes. Have your child drink plenty of water. This may help add moisture to the skin.
Teach older children these same tips for skin care.
The rash itself, as well as the scratching, often causes breaks in the skin and may lead to infection. Keep an eye out for redness, warmth, swelling, or other signs of infection. Call your child's provider at the first sign of infection.
The following triggers can make atopic dermatitis symptoms worse:
To prevent flare-ups, try to avoid:
Using moisturizers, creams, or ointments every day as directed may help prevent flares.
Medicines From the Doctor
Antihistamines taken by mouth may help if allergies cause your child's itchy skin. These medicines are often available over the counter and do not require a prescription. Ask your child's provider what kind is right for your child.
Atopic dermatitis is usually treated with medicines placed directly on the skin or scalp. These are called topical medicines:
Other treatments that may be used include:
Your child's provider will tell you how much of these medicines to use and how often. DO NOT use more medicine or use it more often than the provider says.
When to Call the Doctor
Call your child's provider if:
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Eichenfield LF, Tom WL, Chamlin SL, et al. Guidelines of care for the management of atopic dermatitis: section 1. Diagnosis and assessment of atopic dermatitis. J Am Acad Dermatol. 2014;70(2):338-351. PMID: 24290431 www.ncbi.nlm.nih.gov/pubmed/24290431.
McAleer MA, O'Regan GM, Irvine AD. Atopic dermatitis. In: Bolognia JL, Schaffer JV, Cerroni L, eds. Dermatology. 4th ed. Philadelphia, PA: Elsevier; 2018:chap 12.
Sidbury R, Davis DM, Cohen DE, et al. Guidelines of care for the management of atopic dermatitis: section 3. Management and treatment with phototherapy and systemic agents. J Am Acad Dermatol. 2014;71(2):327-349. PMID: 24813298 www.ncbi.nlm.nih.gov/pubmed/24813298.
Sidbury R, Tom WL, Bergman JN, et al. Guidelines of care for the management of atopic dermatitis: section 4. Prevention of disease flares and use of adjunctive therapies and approaches. J Am Acad Dermatol. 2014;71(6):1218-1233. PMID: 25264237 www.ncbi.nlm.nih.gov/pubmed/25264237.
Tom WL, Eichenfield LF. Eczematous disorders. In: Eichenfield LF, Frieden IJ, Mathes EF, Zaenglein AL, eds. Neonatal and Infant Dermatology. 3rd ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 15.
Review Date: 7/13/2018
Reviewed By: Kevin Berman, MD, PhD, Atlanta Center for Dermatologic Disease, Atlanta, GA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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