Being parents of an eczema child usually means that you have a “mini pharmacy” at home. Knowing about the different types of creams, shampoo, skincare and medications for your eczema child and how and when to use them can be very useful and prevents one from panicking when faced with a child covered in red and inflamed rashes and lesions.

INTRODUCTION

Eczema (atopic dermatitis) is a chronic skin condition that leads to dryness, itching, redness, and inflammation. Managing eczema effectively requires a combination of daily skin care, prescription medications, and lifestyle adjustments. Doctors prescribe different treatments based on the severity of the condition, the presence of infections, and individual skin needs.

This guide provides a quick overview of the various creams, shampoos, and medications commonly recommended for eczema patients, as well as additional care tips to help manage symptoms.

1. Moisturizers (Emollients) – Essential for Daily Eczema Care

Moisturizers, also known as emollients are the first line of defense against eczema. They help prevent dryness, strengthen the skin barrier, and reduce flare-ups.

Types of Moisturizers:

• Lotions: Contain a high water content and are lightweight, making them suitable for mild eczema or humid climates. However, they may not be moisturizing enough for severe dryness.

• Creams: Thicker than lotions, providing longer-lasting hydration. They are ideal for moderate eczema.

• Ointments: Oil-based and the most effective for severe dryness, but may feel greasy. Best used at night or on extremely dry areas.

• Barrier Creams: Designed to reinforce the skin’s natural barrier and protect against allergens, irritants, and excessive water loss.

Application Tips:

• Apply immediately after bathing to lock in moisture.
• Use generously and frequently throughout the day.
• Choose fragrance-free, hypoallergenic formulations to avoid irritation.

2. Anti-Inflammatory Treatments – Reducing Redness and Itching

a) Topical Corticosteroids (Steroid Creams and Ointments)

Steroid creams are one of the most commonly prescribed treatments for eczema flare-ups. They reduce inflammation, redness, and itching but should be used with caution due to potential side effects like skin thinning if overused.

Steroid Potency Levels:

• Mild Steroids: Suitable for sensitive areas such as the face, neck, and underarms. Eg Hydrocortisone

• Moderate Steroids: Used for eczema that does not respond to mild steroids.

• Strong Steroids: Prescribed for severe cases, particularly on thickened skin (e.g., hands, feet).

• Very Strong Steroids: Reserved for short-term use in the most severe cases under strict medical supervision. Eg Dermovate

Best Practices for Steroid Use:

• Apply a thin layer once or twice daily, only on affected areas.
• Avoid long-term use without a doctor’s supervision.
• Gradually taper off use instead of stopping suddenly to prevent flare-ups.

b) Non-Steroidal Anti-Inflammatory Creams (Steroid-Free Options)

For patients who need long-term treatment or those with steroid sensitivity, doctors may prescribe non-steroidal creams (calcineurin inhibitors) that help regulate the immune response and reduce inflammation. These are particularly useful for delicate areas like the face and eyelids. Examples are Protopic and Elidel.

3. Medicated Shampoos for Scalp Eczema

Eczema can also affect the scalp, causing dryness, flaking, and itching. Medicated shampoos help control symptoms and prevent secondary infections.

Types of Medicated Shampoos:

• Anti-Dandruff Shampoos: Contain antifungal ingredients such as ketoconazole to control yeast overgrowth that can worsen scalp eczema.

• Coal Tar Shampoos: Help reduce inflammation, scaling, and itchiness.

• Salicylic Acid Shampoos: Assist in removing dead skin and reducing flaking.

• Steroid Scalp Lotions: Prescribed for severe inflammation and itching.

Tip: Use lukewarm water and gentle massaging motions when washing the scalp to avoid irritation.

4. Bath Treatments for Eczema Relief

Bathing correctly can significantly help manage eczema symptoms. Soaking in the right ingredients can soothe inflammation, reduce bacteria, and prevent excessive dryness.

Recommended Bath Additives:

• Colloidal Oatmeal: Soothes itching and irritation while moisturizing the skin.

• Bath Oils: Prevent excessive drying and help lock in moisture.

• Potassium Permanganate Soaks: Used for infected or weeping eczema to dry out affected areas and prevent bacterial growth.

• Bleach Baths: A diluted bleach bath (under medical supervision) can help kill bacteria that may worsen eczema.

Bathing Tips:

• Use lukewarm water instead of hot water, which can strip natural oils.
• Limit bath time to 10–15 minutes.
• Always apply a moisturizer immediately after patting the skin dry.

5. Medications for Secondary Infections

Eczema-prone skin is more vulnerable to bacterial, fungal, and viral infections. When infection occurs, additional medications may be needed.

a) Antibiotics (Oral and Topical):

If the skin becomes infected with bacteria, doctors may prescribe:
• Topical Antibiotics: For mild, localized infections.
• Oral Antibiotics: For widespread or severe infections with symptoms like oozing, crusting, or fever.

b) Antifungal Treatments:

Fungal infections, such as yeast overgrowth in skin folds, can worsen eczema. Treatment includes:

• Antifungal Creams: Applied directly to affected areas.
• Oral Antifungal Medications: Used for widespread or severe fungal infections.

c) Antiviral Treatments:

Eczema herpeticum, a viral infection caused by the herpes simplex virus, requires immediate medical attention and antiviral medications such as Acyclovir.

6. Anti-Itch Medications for Comfort

a) Antihistamines:

These are sometimes prescribed to reduce itching, especially for patients who experience nighttime scratching.

• Sedating Antihistamines: Help patients sleep better by reducing itchiness at night.

• Non-Sedating Antihistamines: Used during the day to minimize itching without causing drowsiness.

b) Topical Anti-Itch Creams:

Certain creams contain menthol or other cooling agents to temporarily relieve itching.

Avoid Scratching: Keeping nails short and wearing cotton gloves at night can prevent skin damage from scratching.

7. Additional Skin Treatments

a) Wet Wrap Therapy:

This involves applying moisturizer or medication, followed by a damp layer of bandages, and then a dry layer on top. This helps lock in moisture, reduce itching, and enhance medication absorption.

b) Saline Solution for Wound Care:

Saline (saltwater) is used to cleanse wounds, particularly in cases of weeping eczema, to prevent infection.

c) Probiotics and Vitamin D Supplements:
Some studies suggest that probiotics and vitamin D supplementation may help reduce eczema severity, although results vary between individuals.

Avoiding Triggers:

• Use fragrance-free, hypoallergenic skincare and laundry products.
• Avoid harsh soaps and detergents.
• Identify and eliminate allergens (dust mites, pet dander, pollen, or certain foods) that may trigger flare-ups.

FINAL THOUGHTS:

Managing eczema requires a personalized approach that includes daily moisturization, anti-inflammatory treatments, and infection control. In addition to medical treatments, maintaining a gentle skincare routine, using medicated shampoos when needed, and avoiding common irritants can significantly improve symptoms.

If eczema symptoms persist or worsen, consult a dermatologist for tailored advice and treatment options