Paediatric Dermatology

Paediatric Eczema Treatment in Singapore

Dr. Liew Hui Min

accredited consultant dermatologist

Watching your child struggle with itchy, inflamed skin can be distressing for any parent. Paediatric eczema affects many children in Singapore, causing discomfort that can impact sleep, play, and overall quality of life.

Our clinic provides care tailored to young patients. Dr Liew Hui Min offers comprehensive paediatric eczema treatment options designed to soothe symptoms and help your child enjoy healthier skin.

Pediatric Eczema Specialist in Singapore

Types Causes Symptoms When to See a Doctor Diagnosis Treatment Complications Prevention FAQ Conclusion

What is Paediatric Eczema?

Paediatric eczema, also known as atopic dermatitis, is a chronic inflammatory skin condition that typically begins in infancy or early childhood. The condition causes dry, itchy, and inflamed patches of skin that can appear anywhere on the body. In Singapore, approximately 20% of children experience eczema, with most cases developing before age five. While eczema often improves with age, proper management during childhood is crucial for preventing complications and minimising long-term skin damage.

Types of Paediatric Eczema

Infantile Eczema (0-2 years)

Infantile eczema typically appears on the cheeks, forehead, and scalp in babies. The affected areas often look red and weepy, sometimes forming crusty patches. This type commonly affects the extensor surfaces of arms and legs as babies begin crawling.

Childhood Eczema (2-12 years)

As children grow, eczema patterns change. The rash typically moves to skin folds like the inner elbows, behind the knees, neck, wrists, and ankles. The skin becomes drier and may develop a thickened, leathery texture from repeated scratching.

Adolescent Eczema (12+ years)

Teenage eczema often continues in the same locations as childhood eczema but may also affect the hands, feet, and eyelids. Stress and hormonal changes during puberty can trigger flares, making management particularly important during these years.

Causes & Risk Factors

Causes

The exact cause of paediatric eczema involves multiple factors:

Genetic mutations affecting the skin barrier protein filaggrin
Immune system dysfunction causing overreaction to triggers
Skin barrier defects allowing moisture loss and irritant penetration
Environmental factors interacting with genetic predisposition

Risk Factors

Several factors increase a child’s likelihood of developing eczema:

Family history of eczema, asthma, or allergic rhinitis
Living in urban areas with higher pollution levels
Exposure to cigarette smoke during pregnancy or early life
Dietary factors during pregnancy and breastfeeding
Climate conditions in tropical Singapore (heat and humidity)

Signs & Symptoms

Mild Symptoms

Dry, rough patches of skin
Occasional itching, especially at night
Light red or pink discolouration
Small bumps on cheeks, arms, or legs
Slight skin flaking or scaling

Moderate Symptoms

Intense itching disrupting daily activities
Red, inflamed patches spreading to multiple areas
Skin thickening from repeated scratching
Sleep disturbance due to nighttime itching
Oozing or weeping from affected areas
Formation of small, fluid-filled blisters

Severe Symptoms

Widespread rash covering large body areas
Severe sleep disruption affecting growth and development
Bleeding from excessive scratching
Signs of skin infection (yellow crusting, pus, fever)
Significant impact on child’s mood and behaviour
Failure to respond to standard treatments

Symptoms in children often follow a pattern of flares and remissions. Triggers like heat, sweat, certain foods, or stress can cause sudden worsening, while proper treatment helps achieve clearer skin periods.

When to See a Doctor

Seek immediate medical attention if your child experiences severe symptoms like widespread rash, signs of infection, or extreme distress from itching. Schedule a consultation when eczema interferes with sleep, daily activities, or doesn’t improve with basic moisturising. Early intervention prevents complications and establishes effective management strategies.

During your first visit, our dermatologist will examine your child’s skin, review medical history, and discuss triggers. We create a welcoming environment for young patients, addressing both parent and child concerns. The consultation includes developing a customised treatment plan suited to your child’s specific needs and lifestyle.

Diagnosis & Testing Methods

Diagnosing paediatric eczema involves clinical examination and medical history. Our dermatologist looks for characteristic rash patterns, skin texture changes, and distribution of affected areas. We assess the “atopic triad” – checking for concurrent asthma or allergic rhinitis, which commonly occur with eczema.

Allergy testing may help identify specific triggers in some children. Patch testing reveals contact allergens, while specific IgE blood tests can identify food or environmental allergies. Not all children with eczema require extensive testing. Skin swab cultures are performed if secondary infection is suspected. Results guide treatment adjustments and help parents understand their child’s specific triggers.

Treatment Options Overview

Topical Corticosteroids

Prescription corticosteroid creams remain the primary treatment for controlling eczema flares in children. These medications reduce inflammation and itching when applied to affected areas. Our dermatologist prescribes appropriate potency levels based on your child’s age, affected body areas, and severity. Treatment involves applying medication once or twice daily during flares, with careful monitoring to prevent side effects.

Topical Calcineurin Inhibitors

These non-steroidal medications offer an alternative for sensitive areas like the face and skin folds. Tacrolimus, pimecrolimus and crisaborole work by modulating the immune response in the skin. They’re useful for long-term maintenance therapy in children over two years old, helping prevent flares without the concerns associated with prolonged steroid use.

Moisturisers and Emollients

Regular moisturising forms the foundation of paediatric eczema care. Heavy ointments and creams restore the skin barrier and lock in moisture. Application immediately after bathing maximises effectiveness. Our dermatologist recommends specific formulations suited to Singapore’s climate and your child’s skin type, with fragrance-free options to minimise irritation risk.

Wet Wrap Therapy

This treatment involves applying medication and moisturiser, then covering with wet clothing or bandages. The technique enhances medication absorption and provides cooling relief for severe eczema. Parents receive detailed instruction on proper wet wrap application, ensuring safe and effective home treatment during difficult flares.

Phototherapy

Controlled ultraviolet light exposure can benefit older children with widespread eczema not responding to topical treatments. Narrow-band UVB therapy reduces inflammation and itching through regular clinic sessions. Treatment requires commitment to multiple weekly visits but offers a systemic treatment option without oral medications.

Oral Medications

Severe cases may require systemic treatment with oral medications. Antihistamines help control itching, particularly for nighttime relief. Short courses of oral corticosteroids address severe flares, while immunosuppressants like cyclosporine are reserved for challenging cases. Our dermatologist carefully weighs benefits against risks when considering systemic treatments for children.

Biologic Therapy

Newer biologic medications target specific immune pathways involved in eczema. Dupilumab, approved for adults and children six months and older with moderate-to-severe eczema, offers an option for cases not responding to conventional treatments. These injectable medications require careful patient selection and monitoring but can improve quality of life for severely affected children. Oral JAK inhibitors are also approved treatment for eczema, in adults and children from the age of 12 years old.

Complications if Left Untreated

Untreated paediatric eczema can lead to complications affecting your child’s health and development. Chronic scratching causes skin thickening and permanent scarring. Open wounds from scratching increase infection risk, particularly with Staphylococcus aureus bacteria. Some children develop eczema herpeticum, a serious viral infection requiring immediate treatment.

Sleep disruption from nighttime itching impacts growth, learning, and behaviour. Children may experience social difficulties due to visible skin changes, affecting self-esteem and peer relationships. The chronic inflammation associated with uncontrolled eczema may increase the risk of developing other atopic conditions like asthma and food allergies. Early, consistent treatment prevents these complications and supports normal childhood development.

Prevention

While genetic factors cannot be changed, several strategies may reduce eczema risk or prevent flares in susceptible children. Breastfeeding for at least four months may provide protective benefit. Introducing solid foods according to current guidelines, without unnecessary delays, might reduce food allergy development.

Daily bathing in lukewarm water followed by immediate moisturising helps maintain skin barrier function. Choose fragrance-free, hypoallergenic products for your child’s skin and laundry. Keep fingernails short to minimise scratch damage. Identify and avoid specific triggers like certain fabrics, foods, or environmental allergens. Maintain comfortable room temperatures and moderate-low humidity levels, using air conditioning wisely in Singapore’s climate. Teaching children proper skincare habits early establishes lifelong healthy practices.

Frequently Asked Questions

Will my child outgrow eczema?

Many children see improvement as they grow older. Studies show that approximately 60-70% of children with eczema experience resolution or marked improvement by adolescence. Some continue to have sensitive skin or occasional flares into adulthood. Early, consistent treatment and good skincare habits improve long-term outcomes. Regular follow-ups with our dermatologist help adjust treatment as your child grows and their skin changes.

Is eczema contagious? Can my child attend school?

Eczema is not contagious and cannot spread from person to person through contact. Children with eczema can fully participate in school and social activities. Visible rashes may cause concern among other parents or children. Our dermatologist can provide a letter explaining the condition for schools if needed. We help develop management strategies to minimise flares during school hours and address any activity restrictions.

What foods should my child avoid?

Food triggers vary between children, and not all children with eczema have food allergies. Common triggers include cow’s milk, eggs, peanuts, tree nuts, and shellfish. Unnecessary dietary restrictions can impact nutrition and growth. Our dermatologist may recommend allergy testing if food triggers are suspected. We work with families to identify specific triggers through careful observation and, when needed, supervised elimination diets rather than broad food avoidance.

How often should I bathe my child with eczema?

Daily bathing is recommended for most children with eczema. Short, lukewarm baths help hydrate the skin and remove irritants, bacteria, and allergens. Limit bath time to 5-10 minutes, use gentle cleansers, and apply moisturiser within three minutes of patting skin dry. Our dermatologist provides specific bathing instructions tailored to your child’s needs and severity of eczema.

Are steroid creams safe for children?

When used as directed by our dermatologist, topical corticosteroids are safe and effective for children. We prescribe appropriate strengths for different body areas and age groups, with clear instructions on application frequency and duration. Concerns about steroid side effects often lead to undertreatment, which can worsen eczema and may end up with high amounts of topical steroid use.. Regular follow-ups ensure proper use and monitor for any side effects. We incorporate steroid-sparing treatments to minimise long-term steroid exposure.

Can alternative treatments help my child’s eczema?

Some complementary approaches may support conventional treatment. Probiotics show mixed results in research but may benefit some children. Traditional Chinese medicine herbs require caution due to potential contamination or undisclosed steroids. Always inform our dermatologist about any alternative treatments you’re considering. We can advise on safety and potential interactions with prescribed medications while respecting your preferences for your child’s care.

Conclusion

Paediatric eczema presents challenges for children and families, but effective management is achievable with proper medical care. Understanding the condition, identifying triggers, and following a consistent treatment plan helps minimise flares and supports your child’s comfort and confidence. Dr Liew Hui Min specialises in paediatric skin conditions, offering evidence-based treatments tailored to each child’s needs. With the right approach, most children with eczema can enjoy active, happy childhoods while learning to manage their skin health.

Dr Liew Hui Min

Dually Accredited Dermatologist In Singapore and the UK

Dr. Liew Hui Min is an accredited consultant dermatologist from the Ministry of Health and the General Medical Council UK.

Her clinical interest includes:

Paediatric Dermatology,
Women’s Dermatology,
General Adult Dermatology.

Having trained in major London Hospitals, Dr Liew returned to Singapore in 2014 as a Consultant at KK Women’s and Children’s Hospital (KKH) where she specialised in paediatric, women, obstetric and vulva dermatology. Currently, Dr Liew practices at The Skin Drs. clinic located at Gleneagles Hospital.

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