Atopic eczema is a dry skin condition that may be red, sore and dry. Its chief characteristic is the ‘itch’, which at times can become almost unbearable, causing a child to want to scratch constantly, especially at night, thereby interfering with sleep. If a child has moderate to severe atopic eczema, they may have red patches of skin (inflammation) and scratch until their skin bleeds. However, since the skin is very dry, it can also crack and bleed of its own accord. Any cracked, raw or bleeding areas are especially vulnerable to infection.
Atopic eczema usually appears during the first few months of life, often starting on the face and scalp. It can be present on any area of the body, but in white children it usually affects the skin creases, neck, back of knees and inside of elbows. There may also be roundish, 50p-shaped areas of eczema, known as ‘discoid eczema’.
Children from Asian, African or Afro-Caribbean families often have different patterns to white children with eczema. These include eczema around the front of the knees and the back of the elbows (called the ‘reverse flexural pattern’) as well as in the creases, as seen on white skin. A papular pattern, which appears as fine bumps over the chest and tummy, is also common.
If a child has infected eczema, it may be very red and weepy and there may be small blisters. If the eczema has been persistent, the skin may feel and look thickened in areas where there has been lots of rubbing and scratching. There may be cracks and splits, which can be very painful, especially on the hands, making it difficult to hold a pen or pencil.
Atopic eczema can vary in severity between different children. Some children have dry skin and eczema that can be kept under control with simple treatments, while others may need a variety of more complex treatments. You will get to know what your child’s eczema looks like, what treatments will be needed for flares (when the skin becomes hot, inflamed, itchy and sore) and when your child needs to visit a healthcare professional. However, if the eczema gets worse or looks different, you should always ask for medical help.
For more information on managing eczema in children, please see our Childhood Atopic Eczema booklet