Atopic eczema (atopic dermatitis) is one of the most common chronic skin conditions in childhood, affecting around 1 in 5 children in the UK. While many cases are mild, eczema can have a significant psychosocial impact on children and their families. Supporting families effectively requires not only managing the skin condition itself but also addressing emotional, practical, and lifestyle challenges that come with it.
Understanding the Burden
Eczema can cause persistent itching, sleep disruption, and visible skin lesions that affect a child’s comfort and confidence. For parents and caregivers, the daily routine of applying emollients, managing flare-ups, and navigating triggers can be exhausting. Studies have shown that parental stress and treatment fatigue are key contributors to poor adherence and treatment outcomes.
Primary care teams are often the first and most consistent point of contact for these families. Developing trusting relationships and providing consistent, evidence-based advice can greatly improve both symptom control and family wellbeing.
Key Elements of Support
1. Education and Empowerment
Parents need clear, practical education about eczema – what it is, what causes it, and what doesn’t. Misconceptions about steroid use, bathing, and allergies are common. Take time to demonstrate how to apply topical treatments effectively, discuss the difference between maintenance and flare-up regimes, and encourage questions.
Providing written or digital care plans – such as those available through NHS England’s “Eczema in Children” guidance – can reinforce understanding and promote consistency between parents, schools, and childcare providers.
2. Promoting Adherence to Treatment
Non-adherence is a major barrier to effective eczema control. Children and parents may stop using emollients when the skin looks better or fear side effects of topical corticosteroids. Reinforcing the concept of “maintenance therapy” and using analogies (e.g., “like moisturising the skin barrier”) can help normalise regular use.
Regular follow-up appointments, even brief ones, provide opportunities to review technique, update action plans, and reinforce confidence.
3. Addressing Psychosocial Impact
Children with eczema often experience itching that disrupts sleep and affects school performance. Visible symptoms may also lead to bullying or low self-esteem. Primary care professionals should routinely ask about the emotional impact of eczema on both the child and their caregivers.
Signposting to support organisations – such as The National Eczema Society (www.eczema.org) – can help families connect with others facing similar challenges and access trustworthy resources.
4. Coordinating Multidisciplinary Care
Some children require referral to dermatology, allergy, or psychological services. Criteria for referral include diagnostic uncertainty, severe or widespread eczema, recurrent infections, or suspected contact allergies. For persistent cases, early referral can prevent chronic distress and improve quality of life.
Collaborative working between GPs, health visitors, pharmacists, and school nurses ensures a holistic approach and reduces fragmented care.
Supporting Parents and Caregivers
Parental wellbeing is a key determinant of a child’s eczema management success. Encouraging self-care, validating their frustrations, and offering structured guidance can ease the emotional toll. Discussing sleep strategies, stress management, and routine planning are all beneficial.
Empathy and consistency go a long way – parents often cite feeling “dismissed” or “not believed” about the severity of their child’s eczema. Simple reassurance that their concerns are taken seriously can help rebuild trust and engagement with treatment plans.
Enhancing Skills Through Training
For primary care professionals seeking to improve their ability to support families and manage eczema effectively, Practitioner Development UK (PDUK) offers the course “Childhood Eczema: Diagnosis, Treatment & Support.” This CPD-accredited programme provides practical strategies for assessment, treatment, and communication, equipping clinicians with the confidence to guide families through the daily challenges of eczema care. Incorporating training like this into practice can improve adherence, reduce flare-ups, and enhance family wellbeing.
Conclusion
Effective eczema management goes beyond prescriptions – it’s about supporting the whole family. Primary care teams play a pivotal role in empowering parents, improving adherence, and recognising the wider emotional impact of eczema. By combining medical knowledge with compassionate, consistent support, clinicians can help children and their families live more comfortably and confidently with this chronic condition.
References
- Drucker, A.M., Ellis, A.G., Bohdanowicz, M., Mashayekhi, S., Yiu, Z.Z.N. and Rochwerg, B. (2021) ‘Systematic review of treatments for atopic dermatitis: An update and clinical implications’, Allergy, 76(11), pp. 3671-3686.
- McBride, D., Keil, T., Koller, D., Beckert, S., Langen, U., Glaeske, G. and Diepgen, T.L. (2022) ‘The impact of childhood eczema on family life and mental health: A European perspective’, Clinical and Experimental Dermatology, 47(4), pp. 624-632.
