Eczema in childhood is almost always
atopic eczema, a common disease with huge impact on the quality of life of the child and family. Although
atopic eczema constitutes part of the atopic syndrome, avoidance of
allergens is never enough for disease control. Treatment of
eczema in childhood has the same components as in adults.
Emollients constitute the preventive background
therapy in all stages of
eczema, and topical
corticosteroids are still the mainstay of treatment. Infectious exacerbation may require the use of a short course of topical or systemic antimicrobials. UV
phototherapy should be considered as an adjunctive treatment to assist topical
corticosteroids after an acute exacerbation of the disease.
Cyclosporine can also be used in the treatment of childhood
eczema in severe cases. Maternal
allergen avoidance for disease prevention, oral
antihistamines, Chinese herbs,
dietary restriction in established
atopic eczema,
homeopathy, house-dust mite reduction,
massage therapy,
hypnotherapy,
evening primrose oil,
emollients, and topical
coal tar are other temporarily used treatment modalities, without, however, firm evidence of efficacy from proper controlled trials.
Calcineurin inhibitors constitute a new generation of drugs for both adult and childhood
eczema already marketed in some countries. It is postulated that they will replace topical
corticosteroids as first-line treatment of
eczema.