Eczema in Children: Symptoms, Causes and How to Care for Your Child's Skin
Eczema, or atopic dermatitis, is the most common skin condition in childhood. According to the World Health Organization, about 10-20% of children worldwide have it. Many children in Thailand are affected as well, because of the hot climate and homes that may be full of allergens, so educating parents is very important. This article was written by a dermatologist and academic physician to help parents understand the causes, symptoms and correct care of a child with this condition.
What causes eczema in children?
Eczema in children results from several factors together:
Genetics: If a parent has an allergic condition, the child is more likely to develop eczema.
Skin barrier problems: In most affected children the skin does not work well as a protective barrier, so it loses water and becomes irritated easily.
External triggers: Dust mites, cockroaches, pets, soaps, or an environment that is too dry.
Certain foods: In some children, certain foods such as milk, eggs or seafood may trigger symptoms.
Key symptoms to watch for
A child with eczema often has the following symptoms:
Dry, itchy, red skin: The skin is dry, itchy and red, and may peel in flakes.
Common locations: It usually appears in the elbow creases, the backs of the knees, and on the face in young children.
Itching worse at night: Symptoms often get worse at night, making it hard for the child to sleep.
Cracked, weeping skin from scratching: Fluid may ooze or small bumps may appear when the child scratches.
Thickened, darker skin (lichenification): The skin becomes thick and darker in children who scratch repeatedly over a long period.
Diagnosis and standard treatment
A pediatric dermatologist makes the diagnosis using the Hanifin-Rajka criteria or the UK Working Party criteria. The main treatments are:
Moisturization: Apply a moisturizer regularly at least twice a day, especially after bathing, to restore the skin barrier.
Topical corticosteroids: Use them during flare-ups strictly as directed by your doctor, and reduce use as symptoms improve.
Antihistamines: These help reduce itching, especially at night.
Calcineurin inhibitors: Tacrolimus and Pimecrolimus are used on the face or thin skin, where steroids should not be used for long periods.
Dupilumab (biologics): Dupilumab is used for severe eczema in older children who do not respond to initial treatment.
Advice for parents
Parents play a very important role in managing this condition.
Avoid triggers: Such as sweating, bedding pillows, or creams with strong fragrance.
Bathe appropriately: Bathe with moderately warm water and do not scrub the skin hard.
Choose clothing: Dress your child in loose, clean cotton clothing at all times.
Keep nails short: Trim your child's nails short to reduce scratching and infection.
Choose gentle products: Use cleansing products that contain no allergens.
Keep seeing the doctor: Take your child to see the doctor regularly and do not stop medication on your own.
Long-term follow-up
Most children improve by school age, as the immune system matures and children understand better how to look after themselves. However, some children may continue to have eczema or have it on and off, so regular follow-up with a doctor is advised.
Frequently asked questions
What causes eczema in children? Eczema in children results from several factors together: a family history of allergic disease, problems with the skin barrier, external triggers such as dust mites, cockroaches, pets, soaps or an environment that is too dry, and, in some children, certain foods such as milk, eggs or seafood that may trigger symptoms.
Can eczema in children be cured completely? Most children improve by school age as the immune system matures, but some may continue to have it or have it on and off, so regular follow-up with a doctor is advised.
How important is moisturizer? Very important, because it is the main treatment that restores the skin barrier. Apply it regularly at least twice a day, especially after bathing, to reduce dry skin and flare-ups.
Are topical steroids dangerous for children? They are safe when used as directed by your doctor during flare-ups and reduced as symptoms improve. For the face or thin skin, where steroids should not be used for long, the doctor may choose calcineurin inhibitors such as Tacrolimus or Pimecrolimus instead.
If your child has a chronic itchy rash, dry red skin, or frequent flare-ups, do not buy medication to use on your own. Please consult a dermatologist at Siam Dermatology for diagnosis and a suitable care plan for your child. Call +66 61 448 7000 or LINE @siamderm
Written by Dr. Patara Voravutinon, Dermatologist · Last reviewed July 16, 2026
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