Atopic eczema in under 12s: diagnosis and management

National Institute for Health and Care Excellence


Key priorities for implementation

Assessment of severity, psychological and psychosocial wellbeing and quality of life

  • Healthcare professionals should adopt a holistic approach when assessing a child’s atopic eczema at each consultation, taking into account the severity of the atopic eczema and the child’s quality of life, including everyday activities and sleep, and psychosocial wellbeing (see stepped-care plan). There is not necessarily a direct relationship between the severity of the atopic eczema and the impact of the atopic eczema on quality of life

Identification and management of trigger factors

  • When clinically assessing children with atopic eczema, healthcare professionals should seek to identify potential trigger factors including:
    • irritants, for example soaps and detergents (including shampoos, bubble baths, shower gels and washing-up liquids)
    • skin infections
    • contact allergens
    • food allergens
    • inhalant allergens
  • Healthcare professionals should consider a diagnosis of food allergy in children with atopic eczema who have reacted previously to a food with immediate symptoms, or in infants and young children with moderate or severe atopic eczema that has not been controlled by optimum management, particularly if associated with gut dysmotility (colic, vomiting, altered bowel habit) or failure to thrive

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