Key points

• Eczema is a common condition that makes skin dry, red and itchy.
• There is no cure for eczema, but there are treatments to help with symptoms.
• It is normal for eczema to change over time, getting better and then flaring up. Try to control your child's eczema as soon as it gets worse.
• During an eczema flare-up, keep your child cool, moisturise their skin often and help them avoid things that irritate their skin.
• Steroid treatments help control eczema symptoms. They are safe for children when used as directed by a doctor or health professional.
• Cutting certain foods from your child’s diet is not an effective way to treat eczema unless a doctor or dietician has told you to.
• If your child’s eczema is hard to manage, ask their doctor to create an Eczema Action Plan.

What is eczema?

Eczema – also called ‘atopic dermatitis’ – is a common condition that causes dry, red and itchy skin. The affected skin can sometimes crack and ooze fluid (known as weeping) before scabbing over.

In most cases, eczema develops before a child is one year old. There is no cure for the condition, but there are many ways to help control it and make your child feel more comfortable.

Eczema is not contagious and cannot spread from person to person.

What causes eczema?

No one knows exactly what causes eczema.

If you or another member of your family has eczema, asthma or hay fever, then it is more likely that your child will have eczema. Some children with eczema may also get asthma or hay fever – this is a genetic tendency called ‘atopy.’

Eczema flare-ups

There are many different reasons why your child’s eczema may flare up. Some of the most common are:

• getting overheated with clothing, blankets or heaters
• dry skin
• irritation from soaps, detergents, rough fabrics or other chemicals
• allergies to environmental triggers, such as dust mites, plant pollens or animal fur
• viruses and other common infections.

Signs and symptoms of eczema

Eczema can cause parts of the skin to be:

• dry
• itchy
• red and scaly.

These eczema patches can also develop blisters or sores; if they get infected by viruses or bacteria, they may ooze watery fluid and crust over. Infections are more common when eczema is not well controlled.

If your child has eczema, do not let anyone with a cold sore kiss them, as the eczema could get infected with the cold sore virus.

Eczema in babies and children

The position of eczema tends to change as a child ages.

Babies with eczema

Babies with eczema tend to get a dry, red rash on their faces. They may also get eczema on their scalp, body, arms, legs, or behind their ears. The rash is often very itchy and can keep babies awake at night.

Toddlers and children

Eczema patches often appear on toddlers and older children in the skin creases around their knees, wrists, elbows, and ankles. It can even cover their entire body.

How to treat eczema

Eczema is a long-term (chronic) condition, which means it is normal for it to flare up and calm down over time. Many children with eczema must follow a skincare routine to manage their symptoms. Some grow out of eczema – especially if their symptoms are well controlled – but they usually still have dry and sensitive skin.

It is important to treat your child's eczema symptoms as soon as they flare up. Treatment will make your child more comfortable and reduce the chance of infection.

Avoid irritants

It may take time to work out what is making your child's eczema flare up. Things that cause eczema to get worse are called irritants.

Some common skin irritants are:

• dummies, dribbling or food around the mouth
• prickly materials like woollen or acrylic clothing, bedding, and car seat covers
• detergents, soaps, bubble bath liquid and antiseptic washes
• toothpaste (use a product without the ingredient ‘SLS’)
• environmental triggers like pet fur, pollen and dust mites.

If dummies, dribbling or food trigger your child’s eczema, try applying a thick moisturiser around their mouth. After your child eats, wash their mouth with a soft, wet towel and reapply moisturiser. You can also apply a barrier ointment around their mouth before they eat to protect their skin from contact with food.

Moisturise the skin

The best way to care for skin with eczema is to keep it moisturised. Apply a thick, plain moisturiser with no fragrance on your child’s skin once or twice a day – even if they do not have any eczema patches. Some children will need moisturiser applied more often.

Thick creams tend to control eczema better than lotions.

It is also best to:

• Use fragrance-free and soap-free products in the bath or shower.
• Avoid creams that contain plant and food products like coconut, milk and almonds.

Keep your child cool

Heat is the most common eczema trigger.

Keep your child cool by:

• dressing them in one or two thin layers of cotton clothing
• removing doonas and woollen blankets from their bed and using a cotton blanket or sheet instead
• setting your house temperature under 20°C during the day and their room at or below 15°C overnight
• telling their teachers or childcare educators how to dress them suitably.

If you can, try bathing your child at least once a day in a cool bath – no hotter than 30°C. Add one or two capfuls of plain, fragrance-free bath oil or wash to the water.

Control the itching

Eczema can be very itchy, but scratching only makes it itchier and can cause infection.

There are several great ways to help relieve your child’s itching:

• Apply a soft, cool, and wet towel to your child's itchy areas and leave it on for five to 10 minutes. Then, remove the towel and apply a thick layer of moisturiser.
• Put a wet dressing on your child’s itchy areas at bedtime. This is usually only needed for three to five nights while the eczema is flaring up.
• Dress your child in a wet t-shirt or singlet underneath a thin layer of cotton clothing – both during the day and overnight. Wet clothing also helps with redness.
• Spray your child’s itchy areas with a mineral salt spray from the pharmacy.
• Keep your child’s fingernails short and clean.
• Try to distract your child when they are itching.

Eczema and diet

Children with eczema may develop food allergies, just like they may develop hay fever and asthma in the future. This is a pre-disposition called ‘atopy.’ It is important to note, however, that food allergies are not the cause of the eczema, and these present in a different way. Food allergies cause immediate symptoms after eating a food, such as hives, swelling, vomiting, and in severe cases, difficult breathing or coughing. If your child has these symptoms after eating a food, then you should speak to your doctor as you may need to see an allergist.

Older children may have skin reactions in contact with acidic foods and preservatives, which can cause eczema breakouts around the mouth. However, contact skin reactions are not food allergies.

It is best to consider all foods ‘safe’ for your child to eat until proven otherwise. Cutting out foods or food groups is ineffective in treating most eczema and may affect your child’s growth. Speak with your child’s doctor, an allergist or a dietician before restricting any foods.

If your child has widespread eczema and does not get better with any treatments your doctor prescribes or suggests, they may need to see a specialist, such as a dermatologist, paediatrician or allergist.

Remove any scabs

If your child’s eczema becomes crusted or scabs over, you should remove the scabs. Treatments will not help the affected skin if scabs are in the way.

To remove scabs carefully, bathe your child in cool water for 30 minutes. The water will soften the scabs so you can wipe them off with a soft, wet towel. Then, you can apply any creams, sprays or dressings, including topical steroids.

Cortisone or steroid treatments

Cortisone is a natural hormone made by the body. It is great at controlling eczema symptoms and safe for children when used correctly. Your child’s doctor may prescribe or recommend cortisone or steroid-based creams or ointments for their eczema-affected areas. These are called ‘topical’ products because you put them on the affected parts of the body. Weaker products are best for the face, while stronger products are usually better for the body.

It is important to apply topical treatments to all areas of eczema – even if the skin is open and cracked. Put any topical treatments on first, then use moisturiser.

You can buy weaker steroid creams without a prescription. However, it is best to speak with a doctor or pharmacist before buying an over-the-counter topical steroid to ensure it is suitable for your child and you know how to use it.

When to see a doctor for eczema

If you think your child is getting eczema for the first time or is having a flare-up that is hard to control, it is a good idea to speak with their doctor.

You should also speak to your child’s doctor if:

• your child shows signs of infection, such as weepy, crusted or broken areas of eczema
• you are worried about your child’s skin or general health for any reason.

Your child may need antibiotics if their eczema has become infected by bacteria. Some doctors may also suggest a bleach bath, whereby you bathe your child in water with a very small amount of bleach. Bleach baths are a safe and effective way to kill bacteria on the skin.

In rare cases, children with severely infected eczema may need to go to hospital.

If your child’s eczema flares up often or is hard to manage, ask their doctor to create an Eczema Action Plan.

Common rashes and skin conditions in kids

For more information

• Speak to your child’s doctor or maternal and child health nurse
• Kids Health Info: Asthma
• Kids Health Info: Hay fever
• Kids Health Info: Allergic and anaphylactic reactions
• The Royal Children’s Hospital Dermatology Department: Knowing your child’s eczema
• Eczema Association of Australasia: Empowering Australians living with eczema
• Australian Society of Clinical Immunology and Allergy (ASCIA): Eczema (Atopic Dermatitis)
• Australasian College of Dermatologists: Position statement: Steroids and children’s eczema, 2022

Developed by The Royal Children’s Dermatology department, with input from the Allergy and Immunology department. We acknowledge the input of RCH consumers and carers.

Reviewed April 2025

Please always seek the most recent advice from a registered and practising clinician.