Managing eczema from infancy to adolescence

Eczema (atopic dermatitis) is a chronic inflammatory skin disease characterised by dry, itchy, and inflamed skin (Chu et al, 2023a). Approximately 70–90% of cases occur before 5 years of age, although most children present with symptoms in the first year of life (National Institute for Health and Care Excellence [NICE], 2023).

In 25% of cases, the disease will persist into adulthood (De Lusignan et al, 2021). De Lusignan et al (2020) show that although the prevalence of active eczema is greatest in children aged 1–4, there is a significant increase in the fourth and fifth decades of life.

Atopic eczema is characterised by pruritus (itchy), inflamed skin and resultant changes, and a personal or family history of other atopic conditions, commonly asthma and allergic rhinitis (NICE, 2024). Under-2-year-olds usually present with acute itchy papules, serous exudate and crusting, and sometimes poorly defined erythema usually affecting the face, but sometimes extensor surfaces, trunk or nappy area. Children aged 2–12 years old may present with dry skin, erythema and lichenified papules and plaques that can affect the flexor surfaces, hands, feet, and face, particularly around the eyes and lips (Begum et al, 2024).