In most cases of dermatitis in children, the skin condition can either be completely treated or kept under control, so if you suspect your child has dermatitis, make an appointment to see your GP as soon as possible.
Dermatitis is a common inflammatory skin condition and a form of eczema - of which the most common type, atopic eczema, affects one in five children in the UK, according to the National Eczema Society.
For parents who already have a dermatitis diagnosis for their child, we spoke to senior paediatric consultant Dr José Costa, Dr Anita Sturnham, a GP with a special interest in dermatology, and Dr Ross Perry, a GP with a special interest in dermatology, for the latest evidence-based advice on caring for children with dermatitis, and they answered some of the most common questions about the skin condition.
The information in this article is for general purposes only and does not take the place of medical advice. It is essential to be guided by your GP or a dermatologist, who will devise a treatment plan that is specifically suited to your child’s condition. Additionally, take note of official NHS advice - such as these guidelines compiled by Great Ormond Street Hospital - and seek medical advice immediately if the symptoms worsen, new ones appear, an infection develops or if your child becomes particularly distressed.
What is the difference between dermatitis in children and in adults?
The main difference between dermatitis in children and adults is how it presents. "Dermatitis can present in newborn and young babies as red, raised bumpy skin - initially on the cheeks - which then extends to other body areas, such as the backs of knees, ankles and wrist creases," explains Dr Sturnham. "Toddlers tend to experience red, dry, itchy skin in the flexor surfaces of their arms and legs."
In adults, dermatitis will present slightly differently. "In adults there will be fewer lesions, which tend to appear more on the head, neck and hands," says Dr Perry.
"While in babies and toddlers [dermatitis] can be a long-term chronic skin condition that starts from as young as three to six months, in a number of cases children grow out of it," points out Dr Perry. For those who continue to experience symptoms throughout their life, the focus is on managing flare-ups under the direction of a doctor.
What is the difference between eczema and dermatitis?
"The term dermatitis is synonymous with eczema - they essentially mean the same thing," explains Dr Sturnham.
"Dermatitis is simply a word used for ‘inflammation of the skin’, whereas eczema is used to describe a group of skin conditions where the skin is sore, dry, itchy and inflamed," explains Dr Perry.
"Dermatitis sits under the umbrella of a group of what are known as ‘eczematous’ skin disorders," explains Dr Costa. "It is essentially a form of eczema, with two main types - contact dermatitis and allergic contact dermatitis."
Although there are two main types of eczema as explained by Dr Costa (contact dermatitis and atopic dermatitis) there are other different types such as neurodermatitis, stasis dermatitis and seborrheic dermatitis.
“Like eczema itself, the symptoms [of dermatitis] can include weeping, coarse skin, itching, redness, dryness, scaling and changes in skin colour - called hypopigmentation or hyperpigmentation," Dr Costa explained.
What triggers dermatitis in children?
There are many different factors that can cause a child to get dermatitis, and these range from genetics to environmental factors and immune system responses.
"Children with atopic dermatitis may have certain allergies such as to foods, pets, dust, mites, pollens and grasses," says Dr Perry. "Other symptoms may simply be down to genes whereby it is passed from a parent to a child."
Dr Perry adds, "Additionally, the condition may also be caused by immune systems which aren’t fully developed - and therefore may affect how much protection the skin can give - as well as external factors such as cold conditions or dry, hot temperatures, as well as using water that’s too hot in baths and showers, and particular soaps or detergents."
Dr Costa explains that the cause of dermatitis may also differ depending on the type of dermatitis your child has. "Irritant contact dermatitis is triggered by ongoing contact with a substance that is harmful to the skin," he explains. "Saliva, acidic juices, detergents, bath creams or strong soaps, some topical medication, urine or stools - in nappies for example - can all be a trigger."
"Meanwhile, allergic contact dermatitis happens when an allergen comes into contact with the skin," Dr Costa continues. "The most common allergens are nickel - often found in jewellery. Topical medications and cosmetics can also contain allergens - look out for ingredients such as neomycin and thimerosal, as well as some antihistamines, anaesthetics and preservatives."
Dermatitis can also be triggered by everyday items such as clothing and shoes. Dr Costa explains that these can be, "made with allergens such as antioxidants, accelerators in the rubber and chromium salts," which can trigger a skin reaction. “Look out for reactions to plants - the most common being poison ivy, poison sumac and poison oak," he adds.
Other common triggers include “changes in temperature or humidity, and stress," explains Dr Sturnham, but children whose parents have dermatitis are also more likely to experience the skin condition too. “Sufferers are thought to have inherited genetics that mean that their skin struggles to make enough of its own moisturising lipids - which are needed for a healthy skin barrier. As a result, their skin does not hold on to moisture well, so it dries out easily and becomes itchy and inflamed. The weakened skin barrier also allows bacteria and organisms to enter into the skin easily, further adding to inflammation."
Advice for parents on how to support children with dermatitis
If you suspect your child may have dermatitis or another skin condition, it is vital to take your child to see a GP. The doctor can then create a personalised treatment plan for you and make necessary referrals. "If you notice your child’s skin is inflamed and broken, it is important to seek guidance quickly," insists Dr Sturnham. "In my experience, the quicker the treatment is started the better the outcome."
If your child has seen a doctor and you already have a dermatitis diagnosis for their skin condition, one of the key ways that parents can help their child with dermatitis is by trying to identify triggers for flare-ups. Things like keeping a food diary can help you keep a note of what causes your child’s dermatitis to flare up and therefore help them avoid those triggers in the future.
In general, Dr Sturnham explains that maintaining a consistent skincare routine is crucial. "Keeping your child’s skin well-hydrated and well moisturised - in both morning and evening - and choosing dermatological-approved, hypoallergenic products designed and tested for use on children with sensitive skin," can help manage symptoms, she suggests.
If your child is in a lot of discomfort, Dr Costa recommends, "prevent itching by covering the area affected and apply moisturiser frequently."
To soothe dermatitis symptoms and ensure you aren’t aggravating your child’s skin when bathing them, Dr Perry suggests using, “warm water rather than hot with unperfumed body washes (or options for sensitive skin) and not rubbing the skin too vigorously after washing.”
Dr Sturnham also advises that your child should "avoid wearing tight, restrictive clothing and give artificial fabrics - such as polyester as well as nylon - and itchy fabrics, like wool, a miss." Instead, she suggests buying your child clothes made from natural fabrics - such as cotton and linen - and also opting for these materials for your child’s bedding too. You can also try switching to an unperfumed laundry detergent to wash your child’s bed linen and clothes.
Additionally, be wary of central heating systems, since these dry out the air so that it lacks moisture, which can be a trigger.
It can take some time to eliminate possible causes and identify triggers of dermatitis. “A lot of this will be trial and error, much of which may make little or no difference at all,” cautions Dr Perry. So it’s important to try different things to see what works for your child and make a note of anything that you think is causing a flare up. Keep a record of potential triggers, questions or concerns to share with your doctor or GP.
Answers to frequently asked questions about dermatitis in children
Can my child go to school with dermatitis?
"As long as your child is not unwell and symptoms are under control, they can go to school as normal," says Dr Costa. "Apart from flare-ups due to a viral or bacterial infection, dermatitis is not contagious."
Dr Perry adds,"Make sure they are comfortable wearing soft, cotton clothing and use barrier cream to avoid further irritation." Parents may need to inform teachers and other staff members about timing and application of products, and which known triggers should be avoided to prevent flare-ups.
How do you bathe a child with atopic dermatitis?
"Unless there is a specific reaction to bath bubbles, shower creams or shampoos, a child should be bathed as normal," says Dr Costa. "However, using dermatologically-approved, hypoallergenic products is recommended, as evidence shows that placing an allergen in contact with the skin of an eczematous child might lead to sensitisation and the development of an allergy in the future."
Dr Perry advises, "A barrier cream - from the GP - can be put onto the skin prior to bathing." He suggests keeping bath times to a minimum and soaking the skin gently using a wash cloth.
Once your child has finished bathing, pat the skin dry instead of rubbing recommends Dr Sturnham. "Ensure the skin creases are dried thoroughly too," she adds. "Moisturise immediately to help lock in hydration and prevent skin dryness."
Why is my child's dermatitis worse at night?
"Dermatitis symptoms in children may worsen at night due to increased skin temperature, sweating and prolonged contact with bedding materials," says Dr Sturnham. This will make the skin even more itchy.
However, there are some helpful tweaks you can make to your child’s bedtime routine. Dr Perry suggests: "Keep bedrooms cool, and use nightwear that is made from cotton and loose."
Is it true that certain foods can aggravate dermatitis?
"While a food allergy does not normally cause dermatitis, we do know that sufferers are more prone to other allergic conditions such as asthma and hayfever, meaning that a food allergy may also be a factor," explains Dr Sturnham. "Certain items, such as dairy, eggs, nuts and wheat, have been implicated in flare-ups in some children."
As with other triggers, Dr Perry suggests that parents can help their child try to identify if certain items on their plate could be aggravating their dermatitis using a food diary to keep track. However, it is important to consult with a nutritionist or dietitian if you are considering cutting entire food groups out of their diet.
Disclaimer
GoodtoKnow consults a range of medical experts to create and fact-check content. Please note, this is general information only - for more personalised medical advice, always speak to your GP or seek urgent medical attention if needed.
Our experts
Dr Anita Sturnham is a GP working in the NHS and private practice, with specialist training in dermatology. She has extensive knowledge and expertise in diagnosing and treating various skin conditions, and is also involved in research and education. Dr Sturnham is currently working with award winning British brand Childs Farm.
Dr José Costa is a senior consultant paediatrician, specialising in research and medical guidance on eczema, as well as childhood food allergies, hayfever and asthma. With over 16 years of experience in paediatrics and 12 years in paediatric allergy, he has worked in both the NHS and the private sector, as part of his own specialist Children’s Allergy Clinic.
Dr Ross Perry is a GP with a special interest in dermatology. After qualifying from Guy’s & St Thomas’ Hospital Medical School, he pursued a surgical career that now comprises NHS skin cancer reconstruction and private skin treatments. He is the founder and medical director of Cosmedics Skin Clinics.
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