From the Guidelines
Over-the-counter treatment options for pediatric eczema include moisturizers, gentle cleansers, colloidal oatmeal baths, and low-potency hydrocortisone creams, with the foundation of eczema management being regular moisturizing with fragrance-free, hypoallergenic products. The most recent and highest quality study, 1, published in 2022, provides a stepwise treatment algorithm for pediatric atopic dermatitis, emphasizing the importance of moisturizing and gentle skin care. According to this study, adjunct therapy such as oral antihistamines can be considered for each phase, but the primary focus should be on restoring the skin barrier and reducing inflammation.
Some key over-the-counter options for pediatric eczema include:
- Moisturizers like CeraVe, Vanicream, Eucerin, or Aquaphor, which should be applied at least twice daily and within three minutes after bathing to lock in moisture
- Gentle cleansers like Dove Sensitive Skin or CeraVe Hydrating Cleanser, used with lukewarm water for 5-10 minutes
- Colloidal oatmeal baths, such as Aveeno, to soothe irritated skin
- Low-potency hydrocortisone creams, like 1% hydrocortisone cream, applied thinly to affected areas twice daily for up to seven days, but not on the face, genitals, or in skin folds without medical guidance.
It's essential to note that while antihistamines may be considered for adjunct therapy, the study 1 from 2015 suggests that their effectiveness in improving sleep and reducing pruritus is limited, and they may have anticholinergic side effects. Therefore, the primary approach to managing pediatric eczema should focus on moisturizing, gentle skin care, and avoiding triggers, rather than relying on antihistamines or other medications. Parents should dress children in soft, breathable fabrics like cotton, avoid known triggers, keep fingernails short to prevent damage from scratching, and seek medical attention if OTC treatments don't improve symptoms within two weeks or if signs of infection develop, as recommended by the study 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Over-the-Counter Options for Pediatric Eczema
- Topical corticosteroids are commonly used to treat eczema, but their long-term use can lead to side effects such as skin thinning and pigmentation changes 2
- Topical calcineurin inhibitors, such as tacrolimus and pimecrolimus, are alternative treatment options that can be used to control eczema symptoms without the potential side effects of topical steroids 3, 4
- Emollients are also an essential part of eczema treatment, helping to hydrate and protect the skin, and can be used in conjunction with other treatments 5
Treatment Options
- Tacrolimus ointment has been shown to be more effective than pimecrolimus cream in treating patients with atopic dermatitis who have previously used corticosteroids 6
- Pimecrolimus cream is less effective than moderate and potent corticosteroids and 0.1% tacrolimus, but may still be a useful treatment option for some patients 4
- Topical phosphodiesterase-4 (PDE-4) inhibitors, such as crisaborole, are also available for the treatment of eczema, but may be less effective than other treatment options 2
Considerations for Pediatric Patients
- Treatment regimens for pediatric patients with eczema should be severity-based and implemented in a stepwise approach, starting with gentle skin care and escalating to more potent anti-inflammatory treatments as needed 5
- Early treatment of eczema in children is essential not only for treating the skin disease, but also for preventing the development of additional atopic diseases, such as food allergy, asthma, and allergic rhinitis 5