The principles of eczema skin, which has dry and cracked skin due to the change in the skin barrier. Everyday care for children with eczema is regular and frequent moisturising, which will protect and repair the skin, and this should happen even when the skin is clear.
Avoiding irritants is important, those such as soaps, fragranced products, detergents, excessive heat, synthetic and woollen fabrics. If there should be some eczema flaring, this should be calmed with the use of a topical steroid. E.g. 1% hydrocortisone lotion.
The principles of using topical steroids is using them at the first sign of some inflammation or flaring, and continuing until that flaring has gone, plus one more day, and then stopping its use. It would be preferable to calm the flaring earlier rather than letting it get out of control and then taking more topical steroid to reduce the inflammation.
It is also reasonable to have a weekly Janola bath, which may help reduce some of the bacteria that can be present on eczema skin.
General Information on Eczema control
- Once per day, soak in lukewarm water for 10-15 minutes, pat off excess water with clean towel and immediately apply emollient cream
- Use soap substitute - Cetomacrogol or emulsifying ointment
- Antiseptic baths – to reduce impact from bacterial growth. Use 1-2 times per week in a diluted bleach bath (use 4-6% household bleach) 1/3 cup in a bath.
- Apply at least four times per day: Cetomacrogol cream OR emulsifying ointment
- Wash hands before applying
- Use a scoop to remove emollient, to reduce bacterial colonisation of the cream
- Apply in direction of hair growth
- Apply frequently during the day to keep skin ‘shiny’ and reduce bacteria sticking to skin
- Do not use Aqueous cream – can be irritating to skin
- Use ‘finger-tip units’ as per Action Plan, at first sign of red inflammation/flare or itch. Stop 1-2 days after skin cleared
- 1% Hydrocortisone for face flares
- Advantan for body flares. Use 1-2 times daily up to one week at a time
- Watch for signs of infection – pustules, weeping, crusting, eczema not responding, or fever or malaise
- Avoid contacts with cold sores