Everything you need to know about managing childhood eczema

By Sandra Lawton, Nurse Consultant and Clinical Lead Dermatology Rotherham NHS Foundation Trust

Sandra is Nurse Consultant Dermatology and Clinical Lead, The Rotherham NHS Foundation Trust and Past Chair of BDNG (British Dermatological Nursing Group) 1998-2000. She is also a specialist advisor for CQC. She qualified as a general nurse in 1981 and as a children’s nurse in 2001. She started her nursing career in 1975 prior to her general training at Nottingham Eye Hospital and gained the Ophthalmic Nursing Diploma. Sandra has worked in dermatology for 35 years previously at Nottingham University Hospitals NHS Trust and developed the role of dermatology liaison sister in 1990, the first post of its kind in the UK. Her areas of interest include paediatric dermatology, care of children and their families with atopic eczema, nurse led services and vulval skin conditions. She has contributed to the field of dermatology through her publications, presentations and research at national and international level. She was awarded Public Servant of the Year in 2003, the title of Queen’s Nurse in 2007, Stone Award presented by the British Dermatological Nursing Group in 2010, Alumni Laureate Award from The University of Nottingham in 2011,Fellow of Queen’s Nursing Institute in 2012 and an OBE for services to nursing in 2014. In 2015 she was also named one of The Most Inspirational People in Nottinghamshire.

Atopic eczema (atopic dermatitis) is a common dry, itchy skin condition which usually develops in early childhood, around 70–90% of cases occur before 5 years of age, with a high incidence of onset in the first year of life (NICE CKS 2021) and with as many as one-fifth of children in developed countries now suffering from the condition (Flohr and Mann, 2014). Eczema can have a huge impact on the infants, children, young people and their families’ quality of life due to the persistent itching, pain, sleep disturbance and need to apply treatments to maintain control.


Eczema diagnosis and severity should be based on a detailed history, the clinical presentation, and diagnostic criteria (Box1). The history should include the following and be supported with the Patient Oriented Eczema Measure (POEM) / RECAP (my Eczema Tracker) tool available on the app store, age specific Dermatology Qualityof- life tools (see resources) and visual analogue scales (0 to 10) capturing the child’s and/or parents’ or carers’ assessment of severity, itch and sleep loss over the previous 7 days and nights for monitoring the severity of the eczema, quality of life and response to treatment (NICE 2021).