Childhood eczema (atopic eczema)

What is childhood eczema?

Childhood eczema (atopic dermatitis) typically causes dry skin, itching and recurring periods of eczema. Symptoms vary from mild dry skin to more widespread skin changes that can affect sleep, well-being and daily life.

Childhood eczema is not contagious and is not caused by poor hygiene. The condition is often seen in children with a hereditary tendency to eczema, asthma or allergies.

At Charlottenlund Private Hospital, we offer assessment and treatment of childhood eczema in infants, children and adolescents.

Symptoms of childhood eczema

The most common symptoms are itching, dry skin, redness, rash, scaling, cracking of the skin and sleep disturbances due to itching.

Itching is often the most bothersome symptom. Itching can lead to scratching, which further irritates the skin and can worsen the eczema.

Childhood eczema and the skin's barrier function

Childhood eczema (also known as atopic dermatitis) is a chronic inflammatory skin condition in which the skin's protective barrier does not function as effectively as it should. A significant proportion of children with moderate to severe atopic eczema have a mutation in the gene that controls the production of filaggrin—a protein that is central to the skin's ability to retain moisture and keep irritants out. When this barrier is compromised, allergens and microorganisms can penetrate the skin more easily, triggering an inflammatory reaction.

Childhood eczema often does not occur in isolation. Many children with atopic eczema also develop other atopic conditions, such as asthma and hay fever—a relationship known as the "atopic triad." It is important to emphasize that food allergies are not the cause of childhood eczema, though they frequently occur as a coexisting condition.

What does childhood eczema look like?

The appearance varies with the child's age.

In infants, eczema is often seen on the cheeks, forehead, scalp, arms and legs.

In older children, eczema is most commonly seen on the elbows, knees, wrists and neck.

Eczema can be intermittent with alternating good and bad periods.

Why do children get eczema?

The cause is not fully understood, but the disease is caused by a combination of hereditary and environmental factors.

Children with eczema often have a weakened skin barrier, which makes the skin more susceptible to irritation and dryness.

Factors that can worsen eczema include:

• Dry air
• Cold
• Heat and sweat
• Frequent washing
• Irritating skin products
• Infections
• Stress in older children and adolescents

How is the diagnosis made?

The diagnosis is usually made through a dermatological assessment of symptoms and skin changes.

There is no single blood test or test that can detect childhood eczema. In some cases, further tests may be needed if allergies or other skin conditions are suspected.

The treatment

Treatment depends on the severity of the symptoms and the child's age.

Basic treatment typically consists of:

• Moisturizer

Daily use of moisturizer is an important part of treatment. The aim is to strengthen the skin barrier and reduce dryness and itching.

• Medicated creams

During flare-ups, medicated creams may be needed, including corticosteroid creams or other anti-inflammatory treatments.

• Avoid triggers

It may be relevant to identify and limit factors that worsen eczema.

Preventing flare-ups

The aim of treating childhood eczema is to bring the disease to a standstill and prevent new periods of exacerbation. There is no curative treatment, but with correct and sustained efforts, most children can achieve good symptom control.

Regular use of moisturizer is the most important preventive measure. Creams with a high fat content are recommended, preferably fragrance-free, and should be applied at least twice daily — even during periods of calm without active symptoms. Baths should be short and in lukewarm water, as frequent washing and hot water can further dry out the skin and weaken the barrier function.

Identifying individual triggers is also an important part of treatment. Wool directly on the skin, certain cleaning products, furry animals and house dust mites can aggravate eczema in some children.

When should you seek medical attention?

It may be relevant to have the child evaluated by a dermatologist if:

• Eczema does not improve despite treatment
• Does the itching affect sleep or well-being?
• Recurrent flare-ups occur
• There is doubt about the diagnosis
• The skin becomes oozing or shows signs of infection

Childhood eczema and sleep



Itching is the symptom that most often affects sleep in children with atopic dermatitis. Itching typically worsens in the evening and at night, as skin temperature rises and the skin loses moisture. Sleep disturbances can affect the child's well-being, concentration and behavior in everyday life — and in severe cases can also affect the rest of the family's sleep.

Treatment that reduces itching and calms the eczema contributes to better sleep quality. The temperature in the sleeping environment should be kept cool, and wool clothing directly against the skin should be avoided. In periods of severe itching and sleep disturbance, a dermatologist can assess whether additional treatment measures are needed.

Childhood eczema in everyday life

Childhood eczema can affect a child's everyday life in daycare and school. Itching and visible skin changes can make it difficult to concentrate at times, and some children experience that their surroundings react to the appearance of the eczema.

It is a good idea to inform caregivers and teachers about your child's condition, especially during periods of active outbreaks. Many children need access to their moisturizer throughout the day.

Eczema is not contagious, and the child can generally participate in normal activities — including swimming, although chlorinated water can irritate the skin in some children. It is a good idea to apply cream thoroughly after swimming in the swimming pool.

Can children grow out of childhood eczema?

Yes. Many children find that symptoms become less pronounced with age. Others may continue to have dry and sensitive skin or periods of eczema later in life.

Although eczema may not necessarily disappear completely, most children can achieve good symptom control with proper treatment and skin care.