Atopic Dermatitis in Children
What is atopic dermatitis?
Atopic dermatitis is also known as eczema. This is a skin disorder that is most often seen in
children, but can also affect adults. Think of your skin as the armor that protects your body.
Eczema is a condition where the skin is not able to protect itself from irritants in the
environment. Your body is unable to keep your skin from drying out. The exact cause of eczema
is not known, although it is most often seen in people with environmental allergies, hay fever,
food allergies, and/or asthma. You cannot catch eczema from other people, it is not contagious.
What are the symptoms?
Atopic dermatitis is the “itch that rashes”. The main symptom is severe itching which results in
scratching. Scratching the skin then leads to a rash and more itching, an “itch-scratch” cycle that
is hard to break. The skin can become red, swollen, cracked, and/or weepy. This can lead to
crusting and scaling.
What can trigger atopic dermatitis?
ξ Things a person is allergic to such as foods, animal dander or dust mites
ξ Skin irritants such as soap, perfumes, chemicals, rough or poorly fitting clothing
ξ Sweating or become too warm
ξ Temperature extremes which may be very hot, very cold, dry or humid air
What is the treatment for atopic dermatitis?
The main goal is to heal the skin and prevent flare ups.
ξ Daily bathes in plain lukewarm water, 15 minutes or longer. Be sure all affected skin is
under water. A damp washcloth can be placed on the face and upper back.
o No bubble bathes or soaps with perfumes or dyes. It is fine to use soap at the end
of the bath, rinse well, and get out right away. Good soap options are unscented
Dove or Ivory, Vanicream, Aveeno, or Cetaphil. Bath oils are not helpful.
o Pat, do not rub, the skin.
ξ Within 3 minutes after getting out of the bath water, apply a moisture cream or ointment.
Options includes: Aveeno, Vanicream, Cetaphil, Eucerin cream and Vaniply or Aquaphor
ointment. This step helps moisturize the skin by sealing in the water and also creates a
barrier against drying and irritation.
ξ Avoid the use of thinner lotions as they can contain alcohol, which can often dry the skin.
ξ Medicated creams or ointments may be prescribed to be used daily.
ξ Keep fingernails short to prevent damage from scratching
ξ Avoid known allergy triggers, such as dust mites or furred pets.
ξ Use dye and scent free laundry soaps, such as Dreft or All Free.
ξ Avoid fabric softeners in the washer or dryer.
ξ Wear loose fitting clothing
ξ Wear sunscreen with a SPF 15 or greater when outdoors
ξ Swimming in chlorinated pools is fine, just be sure to rinse well after swimming and
apply a moisture cream or ointment right after showering.
Step up care during skin flare ups:
ξ Wet wraps 1-2 times a day. After bathing and applying creams, cover the skin with wet
cotton clothing, socks, or wet gauze. Leave on for at least 15 – 30 minutes. If you can, try
to keep wet wraps on overnight. Wet cotton gloves can be used on the hands. It is helpful
to cover the wet wraps with dry clothing for warmth. Wet wraps help:
o To heal and soothe the skin.
o To reduce itching
o The skin creams and medicines work better.
o Lead to more restful sleep.
ξ Bleach baths 1 – 2 times a day, only if suggested by your provider.
o Put ¼ cup of bleach in a half tub of water or ½ cup of bleach into a full tub of
water. Soak for 15 minutes, rinse well, pat skin dry, and apply a cream or
ointment. These can be very helpful if you are prone to skin infections from
Medicines used to treat atopic dermatitis:
ξ Steroid creams or ointments are usually used. Milder creams such as hydrocortisone
can be bought without a prescription. There are many different strengths of
prescription steroid creams, the stronger ones should not be used on the face or
genital area. Long term use of the stronger steroid creams should be avoided as this
can lead to thinning of the skin.
ξ Elidel cream and Protopic ointment are steroid-free and can safely be used to any part
of the body
Atopic dermatitis and quality of life:
This can affect the entire family, not just the child with the disease. When skin is flaring,
children can become fussy and demanding. Daily skin care can become a battle. It may be hard
to keep up with daily skin care but it can reduce the number of flare ups and improve the child’s
quality of life.
When to call your provider:
• Unable to sleep due to itching
• Rash is not improving or is getting worse
• Rash appears to be infected (painful, red, and warm to the touch, pimples or pus areas)
Helpful and trusted websites:
National Eczema Association
American Academy of Allergy Asthma and Immunology
Your health care team may have given you this information as part of your care. If so, please use it and call if you
have any questions. If this information was not given to you as part of your care, please check with your doctor. This
is not medical advice. This is not to be used for diagnosis or treatment of any medical condition. Because each
person’s health needs are different, you should talk with your doctor or others on your health care team when using
this information. If you have an emergency, please call 911. Copyright ©4/2015. University of Wisconsin Hospitals
and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#5386.