Treatments for Atopic Dermatitis and Eczema in Children

At Boston Children's Hospital, we are uniquely qualified to determine the best course of care for children with skin problems. We're known for our science-driven approach – we're home to the most extensive research enterprise located in a pediatric hospital in the world, and we've partnered with a number of top biotech and health care organizations – but our physicians never forget that your child is a child, and not just another patient.

 Although there is no cure for atopic dermatitis, treatment can decrease your child's skin dryness and irritation, making her more comfortable. In severe cases, your child's physician may prescribe your child medications to help alleviate her atopic dermatitis symptoms. Common medications include:

  • steroid creams and ointments
    • topical medications to help decrease skin inflammation
    • examples are hydrocortisone, mometasone or triamcinolone
  • antibiotics
  • topical calcineurin inhibitors such as topical tacrolimus or pimec
  • antihertamines
    • help decrease itching
    • diphenhydramine (Benadryl) or hydroxyzine (Atarax)
  • Oral immunomodulators are a last resort treatment that may reduce symptoms of atopic dermatitis, but they are used sparingly since they may also affect the immune system or cause cancer.
  • oral corticosteroids
    • oral corticosteroids are to only be used as a short term solution, as there are potential serious side effects
      • cataracts
      • osteoporosis
      • muscle weakness
      • high blood pressure
      • thinning of skin

What can I do at home?

  • Bathe your child frequently and use moisturizers, baths are preferred over showers.
  • Use mild soaps and limit the use of soap.
  • Make sure your child's fingernails are short, as scratching may worsen atopic dermatitis.
  • Dress your child in lightweight clothes to reduce sweating.
  • Apply cool wet bandages or dressings to the affected areas.
  • Let your child play outside in the sun, but not for too long, as prolonged sun exposure can increase the risk of skin cancer.
  • Have your child avoid contact with irritants, as determined by your child's physician.
  • Use a humidifier in your home to help keep your child's skin moist but keep the humidity less than 40%.  High humidity promotes dust mite growth.
  • Use a fan or air conditioner in your child's room to keep the room cool, to help avoid sweating.

What is the treatment plan if a food allergy is triggering the atopic dermatitis?

  • Once the food allergen is identified, it is removed from your child's diet at the same time your child receives treatment for skin inflammation.

How long will treatment take?

  • Many children with atopic dermatitis have an underlying skin barrier defect that requires them to take special care of their skin for their whole lives. They need to avoid irritants and may need to use moisturizers daily, which helps to decrease itching and flaking.The length of treatment depends on the severity of the case of atopic dermatitis. Patients with severe atopic dermatitis in childhood are at greater risk of having atopic dermatitis in adulthood.

How can I help prevent my child from getting skin infections from scratching?

  • It is difficult and unlikely to completely prevent your child from doing any scratching, so it is helpful to cut your child's nails so she can't dig into the skin. Additionally, her fingernails can be dirty, so cutting them removes bacteria that may infect the area affected by atopic dermatitis.   

How can I help my child stop scratching?

  • Developing a strategy to stop the itch-scratch cycle can be helpful.  Cover your child's skin with long sleeve clothing, long pants or tights so she can't get to the lesions.  Hands on activities such as games or toys or cool compresses can be good distractions.  In older children, relaxation tapes or music work well.
    Managing food allergies: A chef's perspective
     About 25 percent of children with atopic dermatitis have food allergies. Eating out at restaurants for families of children with food allergies can be a stressful experience, rather than a relaxing time outside the home. Learn how restaurants are taking mandated measurements to accommodate children and families with food allergies. Here, you can get a chef's perspective on the importance of food allergies awareness.

Coping & support

Because atopic dermatitis is usually a visible condition (affecting a child's skin), your child may feel the effects of her condition socially and psychologically, as well as physically. In addition to the anxiety of fighting the urge to itch, children with facial atopic dermatitis may develop school avoidance if they are teased, and they may not want to go to school.

Boston Children's Hospital's Atopic Dermatitis program has a psychologist, Jennifer LeBovidge, PhD, who spends a lot of time with families and developing strategies to help decrease the scratching, help with the sleep schedule and cope with any teasing that may occur at school.

In cases that a patient develops a more severe mental illness, they'll be referred to the medical Behavioral Medicine Clinic, a multi-disciplinary team of pediatric psychologists, psychiatrists and other mental health professionals providing effective, compassionate evaluation, education, counseling and therapy to help you and your child cope with atopic dermatitis.

There's a lot of support available here at Children's for you and your family, and here are some of the ways we can help:

Patient education: Our nurses will be on hand to walk you through your child's treatment and help answer any questions you may have. They will also reach out to you by phone, continuing the care and support you received while at Children's.

Parent to parent: Want to talk with someone whose child has been treated for atopic dermatitis? We can often put you in touch with other families who have been through similar experiences and can share with you their experience at Children's.

Faith-based support: If you are in need of spiritual support, we will help connect you with the Children's chaplaincy. Our program includes nearly a dozen clergy representing Episcopal, Jewish, Lutheran, Muslim, Roman Catholic, Unitarian and United Church of Christ traditions who will listen to you, pray with you and help you observe your own faith practices during your hospital experience.

Social work: Our clinical social workers have helped many other families in your situation. Your social worker can offer counseling and assistance with issues such as coping with your child's diagnosis, stresses relating to coping with illness and dealing with financial difficulties.

Visit our For Patients and Families page for all you need to know about:

  • getting to Children's
  • accommodations
  • navigating the hospital experience
  • resources that are available for your family
    "Helping Your Child with Medical Experiences: A Practical Parent Guide"

     Download a free booklet, “Helping Your Child with Medical Experiences: A Practical Parent Guide”(.pdf) and read about topics including:

    • talking to your child about her condition
    • preparing for surgery and hospitalization
    • supporting siblings
    • taking care of yourself during your child's illness adjusting to life after treatment