Eczema and skin conditions (Atopic eczema and common skin conditions in children)
How common childhood skin conditions, especially atopic eczema, are managed — using moisturisers (emollients) every day, treating flares with topical steroids, and avoiding triggers.
✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review
In short
- Emollients (leave-on moisturisers) are the daily foundation — use them generously and often, even when the skin looks clear, and instead of soaps.
- Treat flares promptly with a topical steroid of the right strength for a short course; used correctly the benefits outweigh the risks, and under-treating often makes things worse.
- Find and reduce triggers and control the itch; scratching damages skin and feeds the itch-scratch cycle.
- Know the signs of infected eczema (weeping, crusting, rapidly worsening, fever) — and seek urgent help for any widespread painful blistering rash or a child who is unwell.
A plain-English summary. The detail — including risks and recovery — is below.
At a glance
A general guide. Your specialist will give you advice for your situation.
Calmer, more comfortable skin with less itching and better sleep
Avoiding topical steroids entirely is not a safe approach for a child with flaring eczema — under-treatment usually causes more harm than correctly used...
Starting a topical steroid usually begins to calm redness and itch within a few days, alongside generous daily emollients.
A clear, written eczema plan showing daily care and how to treat flares.
Starting a topical steroid usually begins to calm redness and itch within a few days, alongside generous daily...
A flare often settles with a short steroid course; the steroid is then stepped down while emollients continue...
Daily emollients keep the skin in better condition between flares. Triggers are managed and the plan is adjusted...
Eczema tends to come and go, and many children improve as they get older. The plan is reviewed and updated over...
What is eczema and how are childhood skin conditions managed?
Atopic eczema (atopic dermatitis) is a very common childhood skin condition where the skin becomes dry, itchy, red and sometimes cracked or weepy. It tends to come and go, with calmer periods and flares, and often runs in families alongside asthma and hay fever. Other common childhood skin conditions include nappy rash, cradle cap, impetigo, viral rashes and warts, but eczema is the one most often managed long-term.
The foundation of eczema care is simple but must be done consistently: using leave-on moisturisers (emollients) generously and often, every day, even when the skin looks clear. Emollients are used instead of soaps and bubble baths, which can dry and irritate the skin. When the skin flares, a topical steroid (steroid cream or ointment) is used for a short course to calm the inflammation.
A common worry is that steroid creams are harmful. Used correctly — the right strength, in the right place, for short courses — their benefits outweigh the risks, and under-treating a flare often causes more problems than the treatment. Mild steroids are used on the face and gentle areas; stronger ones are used briefly and not on young children's faces without specialist advice.
Management also means finding and reducing triggers (such as soaps, heat, certain fabrics or, in some children, specific foods), controlling the itch, and knowing when skin is infected and needs extra treatment. Eczema cannot usually be cured, but most children's eczema can be well controlled and many improve as they grow.
Types, options & approaches
There may be different ways to do this. The right approach depends on the clinical question and your circumstances.
Emollients vs topical steroids
| Feature | Emollients | Topical steroids |
|---|---|---|
| When used | Every day, even when clear | Short courses for flares |
| Main job | Repair and protect the skin barrier | Calm inflammation and redness |
| How much | Generously and often | Thin layer to affected areas |
| Strength matters? | Choose what suits the skin | Match strength to site and age |
| Stopping | Keep using long-term | Step down as the flare settles |
The two work together: daily emollients reduce flares, and steroids treat flares when they happen. Apply emollient and steroid a little apart so each can work.
Preparing for your treatment
- Keep a note of where the eczema is, how often it flares, what seems to trigger it, and how it affects sleep and mood.
- Bring all current creams and any previous treatments so the clinician can see what has been tried.
- Ask to be shown how much emollient and steroid to use, and how to apply them.
- Ask which steroid strength is right for which part of the body and for how long.
- Note any signs of infection (weeping, crusting, sudden worsening) and any fevers.
- Mention family history of eczema, asthma or hay fever, and any suspected food triggers.
- Ask for a written plan so you know exactly what to do day-to-day and during a flare.
What happens
The clinician looks at your child's skin and asks about the pattern of flares, triggers, itch, sleep and what treatments have been used. Eczema is usually diagnosed from how the skin looks and behaves rather than by a test.
They will set out a stepped plan: daily emollients as the foundation, a topical steroid of the right strength for flares, and advice on triggers and itch. They should show you how much to apply (emollients are used in large amounts; steroids as a thin layer) and explain how to step treatment up and down.
If the skin looks infected, treatment for infection is added. For severe or stubborn eczema, referral to a dermatology team may be arranged for additional options.
You should leave with a clear, ideally written, plan, an understanding of how to use each treatment safely, and advice on when and how to seek help if the eczema worsens or becomes infected.
Is this treatment right for me?
A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.
May not be suitable if…
- Avoiding topical steroids entirely is not a safe approach for a child with flaring eczema — under-treatment usually causes more harm than correctly used steroids.
- Using only occasional moisturiser is not enough; emollients need to be used generously and daily.
- Cutting out foods to 'treat' eczema is rarely helpful and can harm nutrition; it is the wrong approach for most childhood eczema.
- Self-treating a widespread painful blistering rash at home is not safe — this needs urgent medical care.
Delay or rearrange if…
- The skin looks infected (weeping, crusting, rapidly worsening) — this may need treating before or alongside other changes.
- Your child is unwell with a fever and worsening skin — seek assessment first.
- A reaction to a new product has just occurred — stop it and review before continuing.
- Major dietary changes are being considered without clinical advice — discuss first.
Alternatives to discuss
- Optimising emollients and trigger avoidance before adding stronger treatments
- Non-steroid anti-inflammatory creams (calcineurin inhibitors) for sensitive areas, usually on specialist advice
- Wet wrap treatment for difficult flares under guidance
- Dermatology referral and specialist treatments (phototherapy, systemic medicines) for severe eczema
- Allergy assessment only where a trigger is genuinely suspected
Before you decide
Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.
What matters most to me?
Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.
What are all my options?
Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.
What would make me pause?
Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.
What happens if I do nothing today?
For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.
Benefits
- Calmer, more comfortable skin with less itching and better sleep
- Fewer and less severe flares when emollients are used consistently
- A clear plan so you can treat flares early and confidently
- Reduced risk of skin infection when eczema is well controlled
- Better mood, concentration and quality of life for the whole family
- Safe, effective use of steroids by matching strength to site and using short courses
Risks & complications
- Stinging or irritation from some emollients or creams (a different product often suits better)
- Eczema returning if emollients are stopped or used too sparingly
- Skin infection during flares (weeping, crusting, rapid worsening)
- The time and effort of daily skin care, which families can find demanding
- Skin thinning from overusing strong steroids in the wrong place or for too long
- A flare not settling, needing a review or a change of treatment
- Reaction to a specific product ingredient
- A widespread, painful blistering infection (such as eczema herpeticum) that needs urgent treatment
- Severe eczema needing specialist systemic treatment under close supervision
Two opposite mistakes are common: using too little emollient, and avoiding steroids out of fear so flares are under-treated. Used correctly, steroids are safe and effective; the main harm comes from using strong steroids in the wrong place or stopping treatment too soon. Ask exactly which product to use where, how much, and for how long. Seek urgent help for a widespread painful blistering rash, rapidly worsening or infected eczema, or a child who is unwell with a fever.
Published figures to discuss
Eczema outcomes depend largely on consistent emollient use, treating flares promptly and managing triggers, rather than on fixed rates. Side effects of correctly used topical steroids are uncommon, and complications such as skin infection vary with severity and care. These figures vary widely between children, so single percentages would be misleading and are not quoted here. The key point is that good daily care reduces flares and infection.
| Figure | Reported range | How to interpret it | Source / confidence |
|---|---|---|---|
| Flares and relapse | Common | Eczema is usually managed as a relapsing condition with daily emollient care and flare plans, not a one-off cure. | Guide sourcesClinical context |
| Topical steroid skin thinning | Uncommon when used correctly | Risk rises with high potency, delicate sites and prolonged unsupervised use; undertreating inflammation can also harm the child. | NHS — Atopic eczemanhs.ukSource-linked context |
| Eczema herpeticum or infection | Uncommon but urgent | Painful rapidly worsening eczema, blisters, fever or a child who seems very unwell needs urgent review. | NHS — Atopic eczemanhs.ukSource-linked context |
| Rash red flags | Clinically important | Non-blanching rash, mucosal involvement, swelling, breathing difficulty or a very unwell child should not be treated as simple eczema. | Guide sourcesClinical context |
These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.
What happens afterwards
Eczema is managed long-term rather than cured. 'Afterwards' means how the skin responds to consistent care, with flares treated as they come. Many children's eczema improves as they grow.
- Skin that improves within days of starting treatment for a flare
- Needing to keep using emollients even when the skin looks clear
- Occasional flares that the plan helps you treat early
- Mild, brief stinging from some products that settles or prompts a switch
Aftercare
- Apply emollients generously and often, every day, even when the skin is clear.
- Use emollient washes instead of soap and bubble bath, and avoid shampoo on the body in babies.
- Treat flares promptly with the right strength of topical steroid for the advised length of time.
- Apply emollient and steroid a little apart so each can work, and use steroids as a thin layer to affected skin only.
- Keep nails short and help reduce scratching; cool, loose cotton clothing can help.
- Watch for signs of infection (weeping, crusting, rapid worsening, fever) and act on them.
- Avoid known triggers where possible, and keep to the plan during good spells too.
- Attend reviews and ask about a written plan if you do not have one.
- Plenty of leave-on emollient and an emollient wash
- The right strength of topical steroid for each body area
- A written eczema plan (when and how to step up and down)
- A note of triggers and what helps
- Short nails and cool, loose cotton clothing
- Knowledge of infection signs and when to seek help
- Your clinic's number, or NHS 111 (in England, Scotland or Wales) for worsening or infected skin — in Northern Ireland, use GP out-of-hours or your HSC Trust's Phone First service instead
Scars and how they heal
Eczema itself does not usually scar, but persistent scratching and infection can leave temporary marks, and skin may look lighter or darker for a time after a flare, especially on brown and black skin. These changes usually fade over weeks to months. Good control and reducing scratching help. Seek advice if skin breaks down, weeps or shows signs of infection.
⚠ Get urgent help if…
- A widespread, painful, rapidly spreading blistering rash, or clusters of small blisters (possible eczema herpeticum) — seek urgent medical help
- Eczema that is weeping, crusting yellow, hot or rapidly worsening (signs of infection) — seek medical advice promptly
- A child who is unwell with a fever alongside worsening skin — seek urgent advice
- A non-blanching rash that does not fade under a glass, difficulty breathing, or a child who is very drowsy, floppy, will not wake or has a seizure — call 999
- Eczema that is severe, not improving with treatment, or badly affecting sleep and daily life — arrange a review
- Any new severe allergic-type reaction (swelling, breathing difficulty) after a food or product — treat as anaphylaxis and call 999
Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.
General guidance — it doesn't replace the specific advice your specialist gives you.
Results & realistic expectations
Well-managed eczema means comfortable, less itchy skin, better sleep, fewer flares and a confident plan for treating them. Most children's eczema can be brought under good control, and many improve as they grow older.
Treatment controls eczema rather than curing it, so flares can still happen, especially if emollients are stopped or triggers change. A clear spell does not mean the eczema has gone — keeping up daily skin care is what maintains it. Be cautious of products or diets that promise to cure eczema, and of advice to stop steroids altogether, which can leave flares untreated.
Eczema is a long-term condition that tends to come and go. Many children's eczema improves significantly or settles as they get older, though some continue to have it into adulthood and the skin may always be on the drier, more sensitive side. Because the pattern changes, the treatment plan should be reviewed and adjusted over time.
Related tests, treatments or support
Eczema often occurs alongside asthma and hay fever (the 'atopic' conditions), and managing these together helps overall. Where food allergy is suspected as a trigger in a child with eczema, allergy assessment may be combined with skin care, though most childhood eczema is not driven by food.
Follow-up & long-term care
Follow-up depends on severity. Mild eczema may just need occasional review, while moderate or severe eczema benefits from regular review of the plan, treatment use and any specialist input. You should know who to contact if the eczema flares badly or looks infected, and how to get repeat emollients and creams in good time.
- Use emollients every day, long-term, even when the skin is clear
- Keep enough emollient and the right steroids in stock and reorder in time
- Review the written plan and treatment use at appointments
- Reassess triggers as your child grows and seasons change
- Seek review if control slips or flares become more frequent
Repeat, follow-on and what comes next
- Treatment is stepped up and down as eczema flares and settles; changing the plan is normal.
- If a flare does not respond, the strength of treatment or the diagnosis may need reviewing.
- The plan is revisited as a child grows and their eczema pattern changes.
Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.
What good aftercare looks like
- A clear, written eczema plan showing daily care and how to treat flares.
- Practical demonstration of how much emollient and steroid to use and where.
- Easy access to repeat emollients and creams so there is never a gap.
- A named contact and advice on recognising infection and when to seek urgent help.
- Review of control over time, with referral for severe or stubborn eczema.
What affects the cost
Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:
- Whether care is with a GP or a private dermatologist
- Number and length of appointments and reviews
- Emollients, topical steroids and any non-steroid creams
- Treatment of any skin infections
- Allergy testing if a trigger is being investigated
- Specialist treatments for severe eczema, such as phototherapy or systemic medicines
- Follow-up reviews and updates to the treatment plan
- Who provides care and their dermatology experience
- What each appointment includes and whether a written plan is provided
- Cost of any prescribed creams and how repeats are handled
- Cost of allergy testing if recommended, and whether it is needed
- Cost of any specialist treatments for severe eczema
- What happens if the eczema does not improve or becomes infected
- Cancellation policy and how care links with your NHS GP
On the NHS? Eczema diagnosis and treatment are provided on the NHS, including by GPs and dermatology services; some families use private care for a faster dermatology opinion, but ongoing skin care is usually managed at home and with the GP.
You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.
Consent traps and marketing red flags
These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.
Consent traps
- Not being shown how much emollient and steroid to use, or which strength goes where.
- Fear of steroids being reinforced so flares are left under-treated.
- No written plan for stepping treatment up and down.
- Advice to cut out foods based on unproven tests.
- No clear guidance on recognising infection and when to seek urgent help.
Marketing red flags
- Creams, supplements or diets that promise to 'cure' eczema.
- 'Steroid-free' products marketed by exaggerating the risks of prescribed steroids.
- Unproven food allergy or intolerance testing offered to explain eczema.
- Expensive 'natural' regimes that replace effective, evidence-based treatment.
- Claims that one product alone will end all flares.
Choosing a specialist safely
- Check the specialist is on the GMC Specialist Register for this area.
- Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
- You're entitled to time to consider and to have your questions answered before you agree — the specialist who looks after you should explain it, not a salesperson.
- Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
- You're entitled to your total cost in writing — including any follow-up — before you decide.
Questions to ask your medical professional
Take this to your consultation. A good specialist will welcome every one of these.
- Exactly which emollient and which steroid strength should I use, where, and for how long?
- How do I step treatment up during a flare and down as it settles?
- How can I tell if the eczema is infected, and what should I do?
- What triggers should we try to reduce for my child?
- Is a food allergy likely to be involved, or is testing unnecessary here?
- Should my child see a dermatologist, and when?
- Can I have a written eczema plan, and how do I get repeat prescriptions in good time?
- Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
- Will you be the specialist who carries out my treatment, and who looks after me afterwards?
- What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
- What does a realistic result look like — and what can this treatment not achieve?
- What are my options, including waiting, doing nothing for now, or choosing a different approach?
- Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
- What is the total cost in writing, including any follow-ups, and how much time do I have to decide?
Frequently asked questions
Are steroid creams safe for my child's eczema?
How much emollient should I use?
Is my child's eczema caused by a food allergy?
Will my child grow out of eczema?
How do I know if the eczema is infected?
Can eczema be cured?
Where can I get urgent advice if my child's eczema flares badly or looks infected?
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How we made this page
Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →
Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.
Sources & standards: NHS — Atopic eczema NICE CG57 — Atopic eczema in under 12s: diagnosis and management NICE CKS — Eczema (atopic) British Association of Dermatologists — Atopic eczema patient information nidirect — Urgent and emergency care services (NI) nidirect — GP out-of-hours service (NI)
Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.
Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.
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