From the Guidelines
For a one-year-old with an eczema flare, the most effective treatment approach is to start with gentle, fragrance-free moisturizers and topical corticosteroids, while avoiding potential triggers and optimizing skin care. When considering treatment options, it's essential to prioritize the use of topical corticosteroids, as they are the mainstay of treatment for atopic eczema, according to 1. The basic principle is to use the least potent preparation required to keep the eczema under control.
Some key considerations for managing eczema in a one-year-old include:
- Using gentle, fragrance-free moisturizers like Vanicream, CeraVe, or Eucerin applied at least twice daily, especially after bathing
- Applying a low-potency topical steroid such as 1% hydrocortisone cream thinly to affected areas twice daily for up to 7 days
- Avoiding medium or high-potency steroids on a baby's delicate skin unless specifically prescribed by a doctor
- Keeping the child's fingernails short to minimize damage from scratching and dressing them in soft, breathable cotton clothing
- Identifying and avoiding potential triggers such as harsh soaps, certain foods, dust mites, pet dander, or extreme temperatures
It's also important to note that dietary restriction is of little or no benefit in adults and should only be considered in selected infants under professional supervision, as stated in 1. Additionally, optimizing skin care is crucial before considering avoidance of suspect allergens from the maternal diet, according to 1. If the eczema doesn't improve within a week, shows signs of infection, or if the child develops a fever, it's essential to consult a healthcare provider promptly.
From the FDA Drug Label
Directions for itching of skin irritation, inflammation, and rashes: ... children under 2 years of age: ask a doctor Uses temporarily relieves itching associated with minor skin irritations, inflammation, and rashes due to: eczema The treatment for eczema flare in a one year old is to ask a doctor for advice, as the child is under 2 years of age 2.
- The drug label for hydrocortisone (TOP) does not provide specific dosage instructions for children under 2 years of age 2.
- It is recommended to consult a doctor for guidance on treating eczema in a one year old child 2.
From the Research
Treatment for Eczema Flare in a One-Year-Old
- The treatment for eczema flare in a one-year-old typically involves the use of topical corticosteroids, as they are considered a first-line treatment for atopic dermatitis flare-ups 3.
- Topical corticosteroids are classified by strength, and the risk of adverse effects increases with prolonged use, large area of application, higher potency, occlusion, and application to areas of thinner skin 4.
- For children, lower potencies and shorter durations of topical corticosteroids should be used 4.
- The American Academy of Dermatology recommends the use of topical corticosteroids as the first-line treatment for atopic dermatitis flare-ups, and pimecrolimus and tacrolimus can be used in conjunction with topical corticosteroids as first-line treatment 3.
Application and Dosage
- The quantity of corticosteroid prescribed depends on the duration of treatment, frequency of application, skin location, and total surface area treated 4.
- Correct patient application is critical to successful use, and patients can be taught application using the fingertip unit method 4.
- Topical corticosteroids can be applied once or twice per day for up to three weeks for super-high-potency corticosteroids or up to 12 weeks for high- or medium-potency corticosteroids 4.
Safety and Efficacy
- The long-term safety of topical corticosteroids in atopic dermatitis has been evaluated, and evidence suggests that intermittent use of topical corticosteroids probably results in little to no difference in risk of growth abnormalities, non-skin infections, impaired vaccine response, and lymphoma/non-lymphoma malignancies 5.
- However, many knowledge gaps remain, and further studies are needed to fully understand the safety and efficacy of topical corticosteroids in the treatment of atopic dermatitis 5.
- The order of application of topical regimens, including topical corticosteroids and emollients, may change drug absorption, efficacy, and distribution, and is an important consideration in pediatric dermatology 6.