Eczema in Children

Atopic eczema is the most common paediatric skin condition seen in our dermatology clinic. It often presents as itchy red rashes that are rough and scaly, typically affecting the face, neck, elbow and knee creases. The rashes may develop blisters or become infected. The skin condition, if not well controlled, may also affect sleep or school work.

We recommend seeing a dermatologist early in order to make an accurate diagnosis and to receive effective treatment. We will be able to confidently walk you through any potential exacerbating factors, identify any allergens, and advise on how to avoid triggers.

Effective treatment includes:

• Gentle cleanser and moisturisers to restore the skin barrier
• Appropriate strength steroid creams or steroid free anti-inflammatory creams for effective control
• In severe cases, antibiotics, anti-itch tablets, oral steroids, wet wraps, phototherapy or oral anti-inflammatory medicines may be required.
• The newest therapies such as oral JAK inhibitors and Dupilumab ( Dupixent) injections are also available for appropriate patients.

Eczema can often be frustrating to treat with intermittent flares. We will help you to understand your child’s condition and educate you on how best to manage and prevent flares effectively.

Moles and Birthmarks

Children may be born with many different types of birthmarks. Common birthmarks include moles, café-au-lait macules, Mongolian spots, Naevus of Ota or vascular (red) birthmarks.

Birthmarks may present in many different colours, shape or size. It is important to see a trained dermatologist to accurately diagnose the birthmark so that advice can be given about the progression of the birthmark and whether treatment or further investigations are required.

• Moles – any moles changing in shape size or colour must be examined and a biopsy (sample of skin) will be taken if necessary
• Café-au-lait macules – harmless brown patches that will persist. Responds well to laser but may recur.
• Mongolian spots – blue gray patches common on back and buttocks of Asian children. Large majority fade completely as the child gets older.
• Vascular (red) birthmarks – Haemangiomas may enlarge rapidly in the first year before gradually shrinking. Port wine stains persist and darken with age. As they can sometimes cause complications or be associated with other conditions, it is important to get these red birthmarks assessed. There are also effective treatments available for such vascular birthmarks.

Skin Infections in Children

Viral infections

Viral warts, molluscum contagiosum, hand foot and mouth disease (HFMD) are common viral infections affecting children.

• Viral warts - harmless, but may be unsightly, uncomfortable and contagious. They may take on different appearances and it is best to have suspected lesions assessed by a dermatologist. Treatment is usually by medicated solutions, freezing with liquid nitrogen, shave and electrocautery or CO2 laser. We have different numbing strategies to ensure the treatment is as comfortable as possible for your child.
• Molluscum contagiosum - small dome shaped bumps on the skin with a little depression in the middle. Common in young children and spreads easily, especially after scratching. Treatment may include prescribed medicated creams, pricking or freezing.
• Hand, foot and mouth disease (HFMD) – small red spots appear on palms, soles, and buttocks with painful mouth ulcers. Very contagious and spreads easily to other young children. Commonly associated with fever, sore throat and loss of appetite. Have your child diagnosed early so that symptomatic treatment can be given and they can rest at home till all the rashes clear up.

Bacterial infections

Bacterial infections such as folliculitis or impetigo are common in children. Folliculitis appears as multiple small “pimples” around hair-bearing areas. Impetigo present as crusted, scabbed over patches that may be weepy or sore. This is more often seen in children with eczema. Such infections can spread to other children easily, therefore early treatment is recommended. Treatment is by topical or oral antibiotics, antiseptic washes and good hygiene.

Fungal infections

Fungal infections are common in our hot, humid climate. Candida infections are often seen in moist, warm areas such as the nappy area. The affected areas can become red, painful with surrounding red spots. These can sometimes be mistaken for “pimples” and wrongly treated with antibiotics. Another common fungal infection seen is pityrosporum folliculitis, which may look like back acne to the untrained eye. This can cause itchy red spots on the chest and back, which worsen in hot, sweaty environments. Treatment is by topical and oral anti-fungal medicines, in addition to keeping cool and dry.

Cradle Cap

Infantile seborrheic dermatitis

Lots of newborn babies suffer from scaling of the scalp commonly known as cradle cap or infantile seborrheic dermatitis.
This usually presents as greasy appearing scaly patches that may sometimes become quite thick.
It may also spread to affect the face or body. The baby often appears undisturbed by the rash, even when the rash is widespread. Occasionally, the rash can clear up spontaneously.

TREAMENT & CARE FOR Cradle Cap

Oils or ointments can be applied to soften the scales prior to shampoo.
Gentle medicated shampoos may be prescribed to loosen and remove the scales.
A mild steroid lotion may be applied for a short course if necessary.

Diaper Rash

This is a very common skin irritation seen in many infants, specifically affecting the areas covered by nappies or diapers

This is due to irritation of the delicate baby skin from prolonged contact with urine, faeces or over occlusion.
Occasionally, there may be an intercurrent fungal infection as well.

TREAMENT & CARE FOR Diaper Rash

Simple hygiene measures can sometimes clear the skin irritation.

If it remains persistent, do consult your dermatologist early. Treatments may include gentle cleansers, skin emollients and mild prescription topical creams.