Childhood Eczema: Causes, Triggers and How It's Managed

Peer reviewed by Dr. Shireen Marzouk, Consultant Paediatrician & Allergist

Dry, red, itchy patches on a child's skin can be distressing for the whole family. If your child scratches through the night or their skin flares without warning, you are not alone. Eczema is one of the most common skin conditions in childhood, affecting an estimated one in five children worldwide, and Dubai's climate of air-conditioned interiors and hot, humid outdoors can make it particularly stubborn.

The reassuring news is that childhood eczema is well understood, very manageable, and in most cases improves significantly as a child grows. This guide explains what eczema is, what causes it, the triggers that make it flare, and how it is typically managed, so you can feel more confident about keeping your child comfortable.

Circle Care Clinic's eczema and allergic skin service in Dubai brings together paediatric allergy and dermatology expertise under one roof, so the underlying causes and the skin itself are both addressed.

What Is Childhood Eczema?

Childhood eczema, also known as atopic dermatitis, is a chronic inflammatory skin condition that causes dry, itchy, and sometimes cracked or weeping patches on the skin. It is the most common form of eczema in children and typically appears in the first year of life, though it can develop at any age. Eczema is not contagious.

The word "atopic" means there is an inherited tendency to develop allergic conditions. Children with eczema often have, or go on to develop, related conditions such as food allergy, hay fever or asthma. This progression is sometimes called the "atopic march", though not every child follows it, and having eczema does not mean your child will inevitably develop asthma or allergies.

In babies, eczema commonly appears on the cheeks, scalp, and outer surfaces of the arms and legs. In older children, it tends to settle in the creases of the elbows, behind the knees, around the wrists, and on the neck. The itch can be intense, and scratching often makes the skin worse, creating a cycle of itch and inflammation that is hard for a young child to break on their own.

What Causes Eczema in Children?

Eczema is caused by a combination of genetic factors and environmental factors. Children with eczema typically have a weakened skin barrier, often linked to variations in the filaggrin gene, which means their skin loses moisture more easily and lets irritants and allergens in more readily. The immune system then overreacts, producing inflammation.

The strongest risk factor is family history. If one or both parents have eczema, asthma or hay fever, a child is significantly more likely to develop eczema. This does not mean the condition is anyone's fault, and it is important for parents to understand that eczema is not caused by poor hygiene, diet alone, or anything they did or did not do.

In some children, food allergies can play a role in driving eczema, particularly in babies and toddlers with moderate to severe disease. The most common culprits are cow's milk, egg, wheat, soy and peanut. However, food allergy is not the cause of eczema in every child, and removing foods without specialist guidance can do more harm than good by affecting nutrition and growth. If food allergy is suspected, a consultation with a paediatric allergist in Dubai can help establish whether allergy testing is appropriate.

What Triggers Eczema Flare-Ups?

Triggers are factors that do not cause eczema but make it worse. In Dubai, the interplay between extreme outdoor heat and cold, dry air conditioning is one of the most common aggravating patterns parents notice. Recognising your child's triggers is a key part of managing flare-ups, though it can take time, and triggers may change as a child grows.

Common triggers in the Dubai environment include:

• Air conditioning and low indoor humidity. Extended time in air-conditioned spaces dries out the skin barrier, which is already compromised in eczema-prone children.
• Heat and sweating. Hot, humid conditions outdoors cause sweating, which irritates inflamed skin and provokes itching.
• Dust and dust mites. Indoor dust levels in Dubai can be high, and dust mites thrive in soft furnishings, bedding and carpets. They are a well-recognised trigger for both eczema and respiratory allergies.
• Harsh soaps, bubble baths and fragranced products. These strip the skin's natural oils and worsen dryness.
• Synthetic or rough fabrics. Wool and some synthetics can irritate sensitive skin; soft cotton is generally better tolerated.
• Chlorinated swimming pools. Chlorine can dry and irritate eczema-prone skin, though some children tolerate it well with a good moisturising routine before and after.
• Stress and tiredness. Eczema commonly flares when a child is unwell, overtired, or starting a new school or nursery.
• Infections. Bacterial skin infections, particularly from Staphylococcus aureus, can trigger or worsen eczema flares.

A diary noting when flares worsen, what your child ate, and what products were used can be a helpful tool to share with your doctor.

How Is Childhood Eczema Diagnosed?

Eczema is diagnosed clinically, which means a doctor reaches the diagnosis by examining the skin and taking a detailed history. There is no single blood test or biopsy that confirms eczema. The diagnosis is based on the pattern and distribution of the rash, the presence of itch, the child's age of onset, and family history of atopic conditions.

A paediatric allergist or dermatologist may recommend allergy testing if the eczema is moderate to severe or if there is a pattern suggesting that a particular food or environmental allergen is making it worse. Our guide to paediatric allergy testing in Dubai explains when testing is helpful and what to expect.

In most cases, especially mild eczema, testing is not needed and the focus is on getting the skin management right.

How Is Childhood Eczema Managed?

Eczema management centres on three pillars: repairing and protecting the skin barrier, reducing inflammation when it flares, and identifying and minimising triggers. The approach is stepped, meaning treatment is adjusted up or down depending on how the skin is at any given time. Most children with eczema can be managed very well with a consistent daily routine.

Daily moisturising (emollients)

The foundation of eczema care is regular, generous use of a fragrance-free emollient. This softens the skin, locks in moisture, and helps repair the damaged barrier. Emollients should be applied at least twice a day, and more often during flares or after bathing. In Dubai's air-conditioned environment, frequent reapplication is often necessary.

The choice of emollient matters. Lighter lotions may not be enough for eczema-prone skin; ointments and thicker creams tend to be more effective. Your child's doctor can recommend the right formulation.

Bathing routine

A lukewarm bath of about 10 to 15 minutes, using a soap-free wash or emollient cleanser, helps hydrate the skin. Pat dry gently and apply emollient within a few minutes while the skin is still slightly damp, to lock in the moisture.

Topical anti-inflammatory treatments

When eczema flares, topical corticosteroids (steroid creams) are the standard treatment to reduce inflammation quickly. They are safe and effective when used correctly, at the right strength, for the right duration, on the right area of the body. Many parents worry about steroid creams, but undertreating a flare often leads to more skin damage, more scratching and more distress than a short, appropriate course of treatment.

For sensitive areas such as the face, neck and skin folds, or for children who need frequent treatment, non-steroidal alternatives such as calcineurin inhibitors (tacrolimus or pimecrolimus) may be recommended. Your child's specialist will explain the options.

Managing the itch

Itching is the hallmark of eczema and the symptom that most disrupts sleep and quality of life. Keeping nails short, using cool compresses, and applying emollient to itchy areas can help. Antihistamines are sometimes used at night for their sedative effect, though they do not directly treat eczema itch. Wet wraps, where damp layers are applied over emollient and medication, can help during severe flares under medical guidance.

When more is needed

For moderate to severe eczema that does not respond to standard treatment, a specialist may consider phototherapy (light therapy) or systemic treatments. These are used in a small proportion of children and are always managed by a specialist.

Does Childhood Eczema Go Away?

Many children outgrow eczema. Research suggests that around 60 to 70 per cent of children who develop eczema in infancy will see significant improvement or complete clearing by the time they reach their teenage years. The younger eczema starts, and the milder it is, the more likely it is to resolve.

However, some children continue to have eczema into adolescence and adulthood, and a proportion may develop other atopic conditions such as hay fever or asthma. There is no way to predict exactly which path a child will take, which is why ongoing specialist input can be valuable, particularly for moderate to severe cases.

Even in children whose eczema persists, the condition typically becomes easier to manage over time as parents and children learn to recognise triggers and respond to flares early.

When Should You See a Doctor About Your Child's Eczema?

Most mild eczema can be managed with a good skincare routine. However, you should seek a medical consultation if:

• The eczema is widespread, persistent, or not responding to over-the-counter emollients
• Your child is scratching excessively, losing sleep, or distressed by the itch
• The skin looks infected: increased redness, warmth, crusting, oozing, or yellow discharge
• You suspect a food or environmental trigger is making the eczema worse
• You are unsure about how to use prescribed treatments, particularly topical steroids
• Your child is a baby under three months with a new rash

Infected eczema can worsen quickly and may need oral antibiotics, so prompt review is important if you notice signs of infection.

Childhood Eczema Care at Circle Care Clinic

At Circle Care Clinic, childhood eczema is managed through our paediatric allergy and dermatology services in Dubai, with Dr. Shireen Marzouk leading the paediatric allergy side and the wider team providing joined-up care across skin, allergy and, where relevant, respiratory health. Because eczema so often overlaps with food allergy, asthma and hay fever, having these specialties under one roof means the full picture is considered.

Frequently Asked Questions

What is the main cause of eczema in children?

Childhood eczema is caused by a combination of a weakened skin barrier, often genetic, and an overactive immune response. Family history of eczema, asthma or hay fever is the strongest risk factor. Environmental triggers such as dry air, dust and irritants can worsen it, but they do not cause the underlying condition.

Is eczema in children linked to food allergies?

In some children, particularly babies and toddlers with moderate to severe eczema, food allergies can make the skin worse. However, food allergy is not the cause of eczema in every child. Removing foods without specialist guidance is not recommended, as it can affect a child's nutrition and growth.

Can you prevent childhood eczema?

There is no guaranteed way to prevent eczema. Evidence suggests that early, regular moisturising from birth may reduce the risk in babies with a strong family history, though research is still evolving. Early introduction of common allergens during weaning, guided by a paediatrician, may also help reduce the risk of food allergy, which can overlap with eczema.

How long does childhood eczema last?

Many children see significant improvement or complete clearing by their teenage years. Around 60 to 70 per cent of children who develop eczema in infancy will outgrow it. Some continue into adulthood, but the condition typically becomes easier to manage over time.

Should I avoid bathing my child if they have eczema?

No. A daily lukewarm bath of 10 to 15 minutes with a soap-free wash is generally recommended. The key is to apply a generous layer of emollient within a few minutes of bathing while the skin is still slightly damp, to lock in moisture.

Is childhood eczema contagious?

No. Eczema is not an infection and cannot be passed from one child to another. It is an inflammatory skin condition driven by genetic and immune factors.

A Calm Next Step

Childhood eczema is common, manageable, and in many cases outgrown. With the right daily routine and specialist support when needed, most children with eczema can be comfortable and get on with being children. If you have concerns about your child's skin, a consultation with a paediatric allergist or dermatologist at Circle Care Clinic in Dubai can help. Our team practises at our Al Thanya, City Walk and Dubai Science Park locations and welcomes families across all life stages.