Symptoms: Eczema usually causes an itchy, red, bumpy rash. Children with eczema usually have dry skin. Patches of eczema can be small or large, and are sometimes round or oval shaped. In babies, the rash is usually on cheeks, arms, legs and neck. It is usually not in the diaper area. In older children and adults, it is usually on the insides of elbows, backs of knees, wrists and ankles. Some people get it on their eyelids. In more severe cases, it can be widespread over their whole body. After eczema fades it sometimes leave pale spots (hypopigmentation) that are more noticeable in the summer time when the rest of the skin gets more tan.
Causes: For most children, there is no one cause of eczema. A small percentage of children with eczema have food allergies. When that food is removed from the diet, the eczema may improve (though doesn't usually go away completely). Many parents find that there are triggers that worsen their child's eczema. These may include very cold or very hot weather, viral illnesses, and detergents, lotions or soaps that are scented. Minimizing these triggers can lessen the eczema, but it is important to know that even if all of these triggers are avoided, eczema can still flare up.
Treatment: The most important element of treatment for eczema is moisturizing. Frequent moisturizing, particularly after baths, will help keep skin moist and prevent eczema from worsening. Most children with eczema do better with less frequent baths, maybe every 2 to 3 days. Some children need moisturizers applied several times a day, every day, and others only need it occasionally when the eczema is flaring up. If, despite good moisturizing, itchy patches of eczema remain, a topical steroid cream will help treat the eczema. Despite the worries of some parents, topical steroid creams are safe when used as directed. For mild eczema, over the counter 1% Hydrocortisone twice a day will help. If it is not helping after 1 week, call your doctor. For more severe eczema, a prescription strength topical steroid will be prescribed by your doctor. The goal is to use the lowest strength steroid for the shortest time needed to settle down the eczema flare.
Eczema is very itchy, and controlling scratching can also help the rash. In babies, keeping nails cut short and covering hands with socks at bed time can help. In older children a dose of an anti-histamine can decrease itching and keep the child from scratching.