# Atopic Eczema in Children - Category: chronic - Review status: reviewed (every claim checked against a document named on this page) - Sources: NICE Guideline CG57 Atopic Eczema in Under 12s 2007 · Hydrocortisone 1% cream SmPC section 4.2 (eMC product 13103) · No labelled dose - emollient applied liberally and as often as needed, to effect - Verified date: 2026-08 ## Verified against - No labelled dose - emollient applied liberally and as often as needed, to effect - Hydrocortisone 1% cream SmPC section 4.2 (eMC product 13103) ## Treatment metadata - Liquid paraffin — topical - Hydrocortisone — topical ## Complete treatment card ```text ATOPIC ECZEMA IN CHILDREN Sources: NICE Guideline CG57 Atopic Eczema in Under 12s 2007 · Hydrocortisone 1% cream SmPC section 4.2 (eMC product 13103) · No labelled dose - emollient applied liberally and as often as needed, to effect Review status: REVIEWED against 2 sources listed above (2026-08) IS IT THIS? - reference only, to read alongside your own examination SYMPTOMS - what the patient reports (3) - Ask when it began, where it sits, how bad the itch is, and whether it wrecks sleep [itching] - Look for atopy in the child or the family, and for contact allergy - Triggers to hunt: dust mite, animal dander, soap, fragrance, polyester, hot showers, sweating, food [sweating] SIGNS - what you find (5) - In babies: swollen papules and plaques, sometimes blistered or crusted, over scalp, face and outer limbs [crusting · papules · plaques] - In children: drier patches and plaques sitting in the elbow and knee creases [plaques] - In adults: long-standing thickened skin with exaggerated markings, often on the hands - By stage: acute swollen red papules with blisters, subacute redness and scale, chronic thick lichenified plaques [blisters · papules · plaques · redness] - The nappy area is rarely involved; a rash there is more often thrush or seborrhoeic dermatitis [rash] TESTS (4) - Diagnosis rests on the clinical picture expected at that age and subtype - Keratosis pilaris found alongside supports the diagnosis - Skin biopsy, where it is done, shows an eczematous pattern - For a child not responding, IgE immunoassay or skin prick may name allergens, but a positive one need not be a real trigger IF NOT THIS - what else fits (4) - Contact allergy to something touching the skin can mimic it - Scabies and tinea are the infective mimics to rule out - Psoriasis, lichen simplex and lichen planus can look much the same - Seborrhoeic dermatitis belongs on the list as well Source StatPearls "Atopic Dermatitis" - disease-level clinical article Status traced to the source above 1. LIQUID PARAFFIN [1st line] Adult Apply emollients liberally to all affected areas at least 2-3 times daily - long-term continuous maintenance Peds Apply liberally and frequently (at least 250-500g weekly) in direction of hair growth Source No labelled dose - emollient applied liberally and as often as needed, to effect Why Emollient mixtures (liquid/white soft paraffin) serve as foundation of skin barrier repair in eczema. Caution Emollients are the cornerstone of management; continue even when skin is clear. Warn about fire hazard when fabric comes into contact with paraffin-based products. Use soap substitutes rather than standard soaps. Egypt ADCOCARE CREAM 20 GM ARAB DRUG COM... 12.00 EGP -> ! also contains glyceryl monostearate, propylene glycol, urea DERMOLAN CREAM 50 GM HI-CARE > EMI... 19.00 EGP -> ! also contains allantoin, glycerol, glycolic acid, panthenol, salicylic acid, urea, vitamin c, zinc oxide ADCOCARE CREAM 40 GM ARAB DRUG COM... 21.75 EGP -> ! also contains glyceryl monostearate, propylene glycol, urea CARE MIX PLUS HAIR CREAM 50 GM VITA PHARM > ... 29.50 EGP -> ! also contains cetostearyl alcohol, lanolin, panthenol, wheat protein, white soft paraffin PROPOLIS CREAM 15 ML LUNA FOR PERF... 30.00 EGP -> ! also contains cera alba, glycerin, propolis PROPOLIS CREAM 30 ML LUNA FOR PERF... 55.00 EGP -> ! also contains cera alba, glycerin, propolis HEALTHPOINT NAPPY CREAM 100 GM HEALTHPOINT L... 70.00 EGP -> ! also contains benzyl alcohol, cetearyl alcohol, glyceryl stearate, lanolin, peg-100 s, water, zinc oxide HERCUL WHITENING CREAM 60 GM LEADER FOR CO... 74.75 EGP -> ! also contains alpha arbutin, diemthicone, glycerin, licorice ext, octyl methoxy, titanium dioxide, vit.c 2. HYDROCORTISONE [2nd line] Adult To be applied sparingly to the affected skin two or three times daily - Courses of treatment in children should generally be limited to not more than seven to ten days. Peds Prolonged use in infants and children and on the face should be avoided. Source Hydrocortisone 1% cream SmPC section 4.2 (eMC product 13103) Why Low-potency topical corticosteroid used to settle the inflammation of an active eczema flare; applied after emollient, and stopped once the flare resolves rather than continued indefinitely. Caution Apply steroid 15-30 minutes after emollient. Stop topical steroid once flare resolves. Watch for secondary bacterial infection (crusting, weeping, pustules) requiring oral flucloxacillin. Limit a course in a child to 7-10 days, and remember the face and scalp absorb far more than limb skin. Hydrocortisone Cream is contra-indicated in patients with bacterial, viral or fungal infections of the skin, urticaria, rosacea, ulcers and local infection. Hydrocortisone Cream is contra-indicated in patients with bacterial, viral or fungal infections of the skin. Urticaria, rosacea, ulcers and local infection are also contra- indications. Egypt NOVACORTIN 1% CREAM 15 GM PHAROPHARMA 4.75 EGP NOVACORTIN 1% OINT. 15 GM PHAROPHARMA 4.75 EGP MICORT 1% CREAM 20 GM MISR 12.50 EGP HYDROCORTISONE 1% OINT. 20 GM MISR 21.00 EGP Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy. ``` --- Dawaa Reference is a reference for prescribers, not a medical device, and does not replace clinical judgement. [Privacy policy](/privacy)