What are good moisturizers for a child with atopic dermatitis (eczema)?

Best Moisturizers for Children with Eczema

Fragrance-free emollients applied multiple times daily are the best moisturizers for children with eczema, preferably applied immediately after bathing to lock in moisture. 1, 2

Types of Moisturizers and Their Benefits

Recommended Moisturizer Characteristics:

• Fragrance-free: Avoid perfumes and fragrances that can irritate sensitive skin 2
• Non-herbal: Simpler formulations are generally better tolerated 3
• Consistency options:
  • Ointments: Provide maximum occlusion, best for very dry skin or wintertime use 1
  • Creams: Water-based, less greasy, good balance of hydration and acceptability 1, 4
  • Lotions: Higher patient satisfaction in some studies, though less occlusive 4
  • Gels: Well-accepted by patients in recent studies 4

Application Recommendations:

• Apply moisturizers 3-8 times daily, even when skin appears normal 2
• Increase frequency for moderate-to-severe eczema (2.8 times/day vs 1.8 times/day for mild cases) 3
• Apply immediately after a 10-15 minute lukewarm bath or shower for maximum benefit 1
• Use liberal amounts to affected areas 2

Evidence on Moisturizer Effectiveness

Recent research shows that all four main types of emollients (lotions, creams, gels, and ointments) are equally effective in managing childhood eczema, with no significant differences in Patient-Oriented Eczema Measure scores over 16 weeks 4. This suggests that the best moisturizer is one that the child and family will consistently use.

Moisturizers work by:

• Minimizing transepidermal water loss
• Improving stratum corneum hydration
• Reducing signs, symptoms, and inflammation in atopic dermatitis 1
• Increasing time between eczema flares 1

Regular use of emollients has both short-term and long-term steroid-sparing effects in mild to moderate atopic dermatitis 1.

Practical Considerations for Parents

Selecting the Right Moisturizer:

• Doctor recommendations remain the most important factor in moisturizer selection 3
• Consider the child's preference and comfort with the product to improve compliance 3
• White or transparent products are generally preferred by parents and children 3
• Pumps and bottles are preferred over tubs for ease of application 4

Common Pitfalls to Avoid:

• Allergenic ingredients: Many moisturizers contain potential allergens that can worsen eczema 1
• Inconsistent application: Irregular use reduces effectiveness 2
• Insufficient quantity: Apply liberally for best results 1
• Alcohol-based products: These can dry and irritate the skin 2
• Fragranced products: Can trigger flare-ups 2

Environmental Considerations:

• Maintain appropriate indoor humidity, especially in air-conditioned environments 3
• Avoid extreme temperatures 2
• Consider using air purifiers to reduce PM 2.5 exposure, which can trigger flares 2

Additional Management Strategies

Bathing Practices:

• Short (10-15 minute) lukewarm baths or showers 1
• Use gentle, pH-neutral synthetic detergents instead of soap 2
• Apply moisturizer immediately after patting skin dry 1

Clothing Recommendations:

• Choose fine cotton clothes over synthetic materials 2
• Avoid irritating fabrics and fibers 1

Infection Prevention:

• Keep nails short to prevent skin damage from scratching 2
• Consider antiseptic washes with aqueous chlorhexidine 0.05% if signs of infection are present 2

While there are many moisturizer options available, the most important factor is finding one that the child will tolerate and that parents will consistently apply. The evidence supports that regular application of any type of moisturizer is more important than the specific product chosen 4.