Eczema problems

Eczema, or atopic dermatitis, is a very common inflammatory skin condition in children. It usually causes dry, itchy, sensitive skin and can flare on the cheeks, around the joints, on the hands, or more widely across the body. In many children, it starts in infancy or early childhood and tends to come and go over time.

Eczema does not have one single cause. It usually develops from a combination of factors: a naturally weaker skin barrier, a tendency toward allergy or asthma in the child or family, immune overactivity, dryness of the skin, irritation from soaps or fragrances, overheating, sweat, infections, and sometimes environmental triggers. In some children, food allergy can coexist with eczema, but food is not the cause in most cases, and unnecessary elimination diets can do more harm than good.

A useful way to think about eczema is that the skin barrier is “leaky.” When the skin barrier is not functioning well, moisture escapes more easily and irritants can enter more easily. This leads to itch, scratching, inflammation, and more skin damage, creating the well known itch–scratch cycle. Good eczema care therefore focuses both on calming inflammation and on repairing and protecting the skin barrier.

The foundation of standard eczema treatment is regular use of emollients or moisturisers. This part of treatment in my experience is given far too little attention and often standard emollients are used as opposed to emollients specifically suited to each individual child.

During flares, doctors commonly prescribe topical corticosteroids to calm inflammation. When used correctly, these are an important and effective part of treatment. The strength chosen depends on the child’s age, the area of skin involved and how severe the eczema is. On delicate areas such as the face, milder steroid treatments are usually preferred.

At Dr Buskin’s clinic, eczema is approached integratively but safely. Conventional paediatric care remains the basis of treatment, especially when the skin is significantly inflamed, infected, painful, or affecting sleep and quality of life. Integrative care is used as an addition, not a replacement, with the aim of understanding the child’s overall health : skin, allergy background, feeding, sleep, stress, and environmental factors.

The first aim is to restore the skin barrier and reduce triggers. This includes a clear daily skincare routine, careful bathing and moisturising, avoiding fragranced products, and reviewing clothing and detergents. Parents are supported in recognising patterns such as heat, sweat, infection, or scratching during tired moments. Emollients are advised daily, even when the skin looks better, as they are central to maintaining a healthy skin barrier.

At the Clinic for Children, complications and aggravating factors such as infections, persistent itching, irritants, and, where relevant, associated allergies are carefully assessed and taken into account. An integrative consultation may also explore dietary issues, reflux, digestive health, sleep difficulties, recurrent infections, or possible food reactions. When food allergy is suspected, this is evaluated carefully, as unnecessary dietary restriction can lead to stress and nutritional problems. Where needed, collaboration with allergy specialists is part of care.

Families often ask about supplements and complementary treatments. The evidence is mixed. Some children may benefit from vitamin D or certain probiotics.

In practice, our approach is guided by five key principles:

The clinic has developed a high level of expertise in the treatment of eczema. For more complex dermatological conditions, referrals can be made to specialised dermatology clinics in the area or, when necessary, to the Sophia Children’s Hospital in Rotterdam.

There is growing interest in the relationship between eczema, food allergy, and the skin microbiome. Research in recent years supports the idea that a damaged skin barrier may contribute to allergic sensitisation in some infants. This is one reason why eczema should be taken seriously and managed proactively, especially in babies with early onset disease.

On the integrative side, probiotics, symbiotics, vitamin D and nutrition based approaches remain promising but not yet definitive. Some 2024 to 2025 reviews report potential benefit, but larger and more consistent studies are still needed before they can be recommended broadly for all children.

Here are links to articles related to this topic:
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