KixCare parent handout: understanding and managing eczema in your child, including age-specific guidance, moisturizer dosing, steroid application technique, skin type education, and when to seek care.
Understanding & managing your child's eczema
A KixCare parent guide · Aligned with Eczema Society of Canada guidance
A reassuring note to start: Eczema is one of the most common conditions in Canadian children, about 1 in 5 children are affected. The good news is that most children significantly improve or outgrow eczema by around age 3–4, and many are clear by adolescence. It is not contagious, not caused by poor hygiene, and with the right daily routine, it is absolutely manageable.
What is eczema?
Eczema (atopic dermatitis) is a chronic inflammatory skin condition where the skin barrier does not work as well as it should, letting moisture escape and making skin dry, itchy, and sensitive to irritants. It comes and goes, with periods of flares (red, rough, itchy skin) followed by periods of remission (calmer skin). Over time, flares become less frequent and less severe. The goal of management is to shorten flares by controlling inflammation, relieving itch, keeping skin moisturized, and avoiding triggers.
Genetic & inheritedIf a parent has eczema, asthma, or hay fever, there is a higher chance their child will develop eczema. It runs in families.
The atopic marchEczema often appears first. Some children later develop food allergies, asthma, or allergic rhinitis. Early good skin care may help reduce this risk.
Flares & remissionGood days and bad days are normal. Flares are triggered by irritants and environmental factors. Identifying your child's personal triggers is key.
Outgrowing eczemaUp to 60–70% of children see major improvement by age 3–4. Many are clear by adolescence. Even when it persists, it typically becomes milder with time.
Eczema & skin type — what to know
Eczema looks and behaves differently across different skin tones. Knowing what to look for in your child's skin type helps you catch flares earlier.
Lighter skin tones
Typically appears as pink or red patches with visible inflammation. Redness is easier to spot early. Affected areas may look raw or weepy during flares.
Medium & olive skin tones
May appear as darker brown, purple, or greyish patches rather than red. Post-inflammatory hyperpigmentation (darker marks after a flare) is common and will fade.
Darker skin tones
Often appears ashen, grey, or brown rather than red. Follicular eczema (bumpy skin around hair follicles) is more common. Flares may be missed as they don't look "red."
Important for all skin typesDark marks left after a healed flare are NOT scars. They fade over weeks to months. In darker skin tones, eczema may be under-diagnosed. If your child has persistent itching and rough or bumpy skin, ask your care team even if the skin doesn't look "red."
Managing eczema by age & stage
Infants (0–12 months)
Most common onset period · typically starts on the face and scalp
What it typically looks likeStarts on the cheeks, forehead, and scalp. Skin looks red, dry, and rough. Oozing or crusting is common during flares. Infants often rub their face against bedding to relieve itch.
Moisturize, moisturize, moisturize. Apply a thick, fragrance-free moisturizing cream all over the body at least twice daily, right after a warm bath while skin is still slightly damp. For infants, expect to use about 500 g every 14 days.
Baths daily, but brief. 5–10 minutes in lukewarm water. No bubble baths, no soap. A fragrance-free gentle cleanser is fine 1–2 times per week. Do not use washcloths or brushes. Pat dry gently.
Dress for comfort. Soft, 100% cotton clothing next to skin. Avoid wool or synthetic fabrics. Wash all new clothes before use with a fragrance-free, dye-free detergent. Rinse clothes twice. No fabric softener or dryer sheets.
Keep nails short and filed to reduce skin damage from scratching. Scratch mittens can help at night.
Breastfeeding does not cause eczema. There is no strong evidence that a breastfeeding parent's diet causes infant eczema. Do not restrict your own diet without medical advice.
Topical steroids are safe when used as prescribed. Mild hydrocortisone 1% is typically used for infants and is well-studied for short-term flare management.
Early food introduction. Current evidence supports introducing allergenic foods (e.g., peanuts) early in infants with eczema to help reduce food allergy risk. Ask your KixCare provider for guidance.
Avoid cigarette smoke. Second-hand smoke is a strong eczema trigger. Keep your infant's environment smoke-free.
Reassurance: Infant eczema, while distressing to see, is very common and does not mean your baby will have it forever. Many infants with eczema are significantly clear by 12–18 months with consistent skin care.
Toddlers (1–3 years)
Often moves to creases, elbows, and knees · itch becomes more bothersome
What it typically looks likeShifts from face to flexures (inside elbows, behind knees, wrists, ankles). Skin can become thickened and leathery from repeated scratching. Itch can be intense and disrupt sleep.
Maintain the daily bath-and-moisturize routine even when skin looks clear. Consistency is more important than perfection. Toddlers need about 500 g of moisturizing cream every 10 days.
Distract from scratching. Toddlers cannot control the urge to scratch. Redirect with toys, cool cloths, or gentle patting. Avoid scolding; they cannot help it. Keep nails trimmed and clean.
Wet wrap therapy for bad flares. Apply prescribed cream, then a damp cotton layer, then a dry layer on top. Leave on for a few hours or overnight. Your KixCare team can walk you through this technique.
Bleach baths may be recommended by your provider for children with recurrent skin infections. A very dilute bleach solution (like pool water) reduces bacteria on the skin. Ask your care team if this is right for your child.
Watch for infection. Yellow or honey-coloured crusting, clear or yellow oozing, or sudden worsening may mean bacterial infection. Contact your care team promptly.
Sleep environment. Keep the bedroom cool (18–20°C). Use dust-mite-proof mattress and pillow covers. Wash bedding weekly in hot water. Avoid pets in the bedroom.
The "3–4 year rule." Many toddlers with eczema see dramatic improvement around ages 3–4 as their immune system matures. This is well-documented and worth holding onto.
Daycare age (2–4 years)
New environment, new triggers · communicating needs begins
New challenges at daycareExposures to different soaps, art supplies, pets, sand, and grass. Increased sweat during play. Group settings can increase stress. Caregivers may not recognize eczema or may apply scented products.
Write a short eczema care plan for your daycare: which moisturizing cream to apply and when, any prescription creams, and what a flare looks like for your child.
Pack your child's own products. Send labelled fragrance-free wipes, soap, and moisturizing cream. Ask staff not to apply scented products, sunscreens with fragrance, or other creams without your consent.
Dress your child in protective layers. Loose-fitting, breathable cotton clothing. Lightweight long sleeves can prevent direct contact with grass, sand, or other irritants during outdoor play.
Art supplies. Water-based, non-toxic paints are usually fine. Rinse hands and arms promptly after activities. Some clays and playdough contain wheat, relevant for sensitive children.
Build simple language early. Even at 2–3, children understand "your skin feels itchy, let's put on cream to make it feel better." This helps them communicate their needs at daycare.
Eczema is not contagious. Reassure daycare staff and other parents. Your child does not need to be excluded from any activities because of eczema.
School age (5–11 years)
Independence grows · emotional and social impacts become significant
What changes at this stageChildren become aware of their skin and how peers see it. Bullying or self-consciousness can emerge. Sports and physical activity bring sweat and friction. Schoolwork and stress can trigger flares.
Teach self-care independence. Work with your child to apply their own moisturizing cream and recognize early flare signs. Self-management builds confidence and reduces anxiety.
School care plan. Connect with the school nurse or office to ensure your child can access moisturizing cream during the day and that staff know what to do during a flare.
Physical activity is encouraged. After sports or PE, rinse off sweat and reapply moisturizing cream. Swimming is usually fine with a thorough rinse and moisturize after. Eczema is not a reason to sit out.
Sleep and school performance. Poor sleep from itch can affect concentration and behaviour. Note: sedating antihistamines are sometimes prescribed for nighttime itch but may affect next-day school performance. Discuss timing and dosage carefully with your provider.
Address emotional impact. Ask your child how they feel about their skin. Validate their frustration and normalize it. Connect with other families through the Eczema Society of Canada.
For moderate to severe eczema not well-controlled with topicals, ask for a specialist referral. Dupilumab (Dupixent) is approved for children 6 months and older and is highly effective.
Older children & teens (12+ years)
Eczema in adolescence · new treatments and new pressures
What changes in adolescenceHormonal changes can trigger flares. Peer pressure around skin appearance intensifies. Teens may resist treatment routines. Body image, dating, and mental health are all affected.
Respect teen autonomy. Involve teens in their own treatment decisions. When they feel in control, adherence improves. Let them choose fragrance-free products they actually like using.
Mental health matters. Adolescents with eczema have significantly higher rates of anxiety and depression. If your teen seems withdrawn or low, bring this up with your care team. It is a legitimate part of eczema management.
New advanced treatments are available. Dupilumab (Dupixent), or oral JAK inhibitors like upadacitinib (Rinvoq) or abrocitinib (Cibinqo) for teens 12+, are specialist-prescribed options for moderate to severe eczema not controlled by topicals.
Skin care with acne. Many teens have both eczema and acne. Some acne products (retinoids, benzoyl peroxide) can worsen eczema. Work with your care team to manage both safely.
Fragrances and personal care. Many teen products (body wash, deodorant, hair products) contain allergens. Switch to fragrance-free alternatives. There are now many appealing options widely available.
Stress management. Stress is a significant eczema trigger. Help your teen build coping strategies including physical activity, good sleep, reading, and mindfulness as part of their care toolkit.
Daily skin care — the foundation of control
1
Bathe once daily — brief and lukewarm
5–10 minutes in warm (not hot) water. No bubble baths. Use a fragrance-free gentle cleanser 1–2 times per week only, and rinse thoroughly. Do not use washcloths or brushes as they irritate skin. Pat dry gently, never rub.
2
Moisturize within 3 minutes of bathing
Apply moisturizing cream while skin is still slightly damp to lock in moisture. This "soak and seal" method is significantly more effective than moisturizing on dry skin. Apply in large circular motions — arms and legs, then trunk (front and back), then face — in the same order each time so you don't miss a spot.
3
Choose the right moisturizing cream — and use enough of it
Thicker is better: ointments > thick creams > regular creams > lotions. Fragrance-free, dye-free. Look for the Eczema Society of Canada Seal of Acceptance. The most important thing is that your child will actually use it — encourage them to try a few to find one they like.
Moisturize at least 2–3 times daily, including after every bath. There is no such thing as too much moisturizing cream. Once skin is red and inflamed, moisturizing cream alone is not enough — prescription cream is also needed.
4
Apply prescription treatments before moisturizing cream
On areas with active eczema: apply prescribed cream/ointment first to the red and rough areas, then seal with moisturizing cream on top. On clear skin areas: moisturizing cream only. Wash your hands before applying any cream.
5
Laundry and clothing
Use fragrance-free, dye-free detergent. Rinse all clothing twice. Do not use liquid fabric softener or dryer sheets. Wash all new clothes before first use. Choose soft cotton and avoid wool or rough synthetics directly against the skin.
Understanding your child's treatments
About topical steroids — the most common prescriptionTopical corticosteroids are safe and effective when used correctly. Fear of steroid creams is common but usually not warranted. Skin thinning only occurs with prolonged high-potency use in the wrong areas (like the face). Use them as prescribed, on active areas only. Continue for 2 days after the red and rough skin has resolved as stopping too early leads to relapse. All red and rough areas can be treated at the same time.
1 fingertip unit
How much steroid cream to use — the fingertip unit guide
Squeeze a line of steroid cream from the tip of an adult-sized finger to the first crease. This one "fingertip unit" of cream is enough to cover an area equal to two adult palms. Apply to red and rough areas only, not normal-looking skin. Apply 2 times per day for up to 14 days, or until 2 days after the skin clears, whichever comes first. If not improving, contact your care team.
For frequent flares in the same spot: After the flare clears, apply the steroid cream to those specific areas 2 times per week (e.g., Saturday and Sunday) to prevent flares coming back. Ask your KixCare provider if this "weekend therapy" is right for your child.
Mild eczema
Moisturizing cream first approach. Generous, frequent fragrance-free moisturizing cream. Mild hydrocortisone 1% for face/folds or desonide 0.05% for body. Continue 2 days after skin clears.
Moderate eczema
Topical steroids plus non-steroid options. Moderate-potency TCS (e.g., Elocom) for body. Desonide for face and folds. Wet wrap therapy for flares. Referral to dermatology likely needed.
Moderate to severe eczema
Specialist-guided therapy. Dupilumab (Dupixent), a biologic injection approved for children 6 months and older, is highly effective and well-tolerated. Oral JAK inhibitors for teens 12+ (upadacitinib, abrocitinib). Your KixCare provider can refer to a pediatric dermatologist. Phototherapy (narrowband UVB) is another specialist option for children 6+.
Non-steroid prescription optionsTacrolimus (Protopic) and pimecrolimus (Elidel) are steroid-free creams excellent for face, neck, and skin folds. Crisaborole (Eucrisa) is a non-steroid ointment for children 3 months and older. Ruxolitinib cream (Opzelura) is approved for children 2 years and older. Ask your provider which is appropriate for your child.
For nighttime itch disrupting sleepA non-sedating antihistamine such as cetirizine (Reactine) may be recommended to help manage itch. For more severe nighttime disruption, a sedating antihistamine such as hydroxyzine (Atarax) may also be prescribed short-term. These are not a long-term treatment for eczema. In school-age children, sedating antihistamines may affect next-day alertness — discuss timing and dosage with your provider carefully.
Common triggers to watch for
Cold dry air
Dust mites
Pet dander
Heat & sweat
Wool / synthetics
Soaps & detergents
Pollen & mould
Stresser
Chlorine (rinse after)
Second-hand smoke
A note about foodMost children with eczema do not have food allergies. Do not restrict your child's diet (eggs, dairy, wheat, soy, nuts) without a confirmed diagnosis from an allergist. Unnecessary restrictions risk nutritional gaps and do not improve eczema in children without a true food allergy. If you suspect a food trigger, ask your KixCare provider for an allergy referral.
Helping your child sleep
Cool the roomKeep bedroom at 18–20°C. Use a humidifier in dry winter months. Overheating is one of the most common nighttime flare triggers. Avoid pets in the bedroom.
Cotton sleepwearLoose-fitting 100% cotton pyjamas only. Wash all bedding weekly in hot water (60°C). Dust-mite covers on mattress and pillows. Avoid wool blankets directly against skin.
Control itch at nightKeep nails trimmed and filed. Try cool compresses on itchy areas. Ensure evening moisturizing cream and any prescribed creams are applied at bedtime. Scratch mittens for infants.
Emotional wellbeing & keeping your child connected
Eczema affects more than skin. It can touch a child's confidence, friendships, and sense of belonging. One of the most important things you can do as a parent is keep your child fully included in everyday life. Daycare, school, sports, birthday parties, playdates — these experiences are essential for healthy development and self-esteem, and eczema should not be a reason to hold back.
The goal: participation, not protectionShielding your child from activities out of worry about their skin can unintentionally send the message that eczema makes them fragile or different. The aim is to manage eczema around life, not to manage life around eczema.
How to advocate for your child without holding them back
Inform, don't isolate. Share a brief written summary of your child's eczema with daycare workers, teachers, coaches, and other caregivers — what it looks like, what their triggers are, and what to do if skin flares.
Send your child prepared. Pack their moisturizing cream, any prescription creams, and a clean change of clothes if needed. A prepared child is a participating child.
Acknowledge feelings without feeding fear. "I know it feels uncomfortable sometimes. Lots of kids have eczema and it doesn't stop them from doing anything." Then move forward together.
Normalize eczema at home. Skin care routines are just part of the day, like brushing teeth. Children who grow up seeing their care routine as normal are more confident managing it independently.
Let other trusted adults help. Daycare workers, teachers, coaches, and family members can all be part of your child's support team. Give them clear, simple instructions and trust them to follow through.
Daycare & early childhood
Provide a one-page care plan. Ask staff to use your child's own products and avoid scented wipes or lotions. Your child should join all activities — water play, sandbox, crafts — with simple protective measures like cotton sleeves or a prompt rinse after.
School & extracurriculars
Connect with the school nurse or office so your child can access moisturizing cream during the day. Inform sports coaches about sweat as a trigger. Eczema is not a reason to skip PE, swimming, or team sports.
Family & social gatherings
A calm, brief explanation goes a long way: "She has eczema. It's not contagious, just itchy sometimes. We keep her moisturized and she's totally fine to play." Simple language reduces stigma and keeps your child included.
Watch for signs of struggle
If your child begins avoiding activities they used to enjoy, or expresses distress about their skin, this is worth discussing with your KixCare provider. Emotional support is a genuine part of eczema care at every age.
Connect with other familiesThe Eczema Society of Canada (eczemahelp.ca) offers peer support communities, family resources, and events. Hearing from other parents and children living well with eczema can be one of the most powerful sources of reassurance.
When to contact the KixCare team or seek urgent care
Honey-coloured or yellow/golden crusting, clear or yellow oozing from the skin — may indicate bacterial infection (impetigo)
Painful clusters of blisters or punched-out sores that spread rapidly — may be eczema herpeticum (HSV infection). Seek urgent care the same day. If near the eye, go to emergency immediately.
Fever (38.5°C / 101.5°F) with a skin flare
Skin irritation that looks different from previous flare-ups
Eczema not improving after 1–2 weeks of prescribed treatment
Significant impact on sleep, school, eating, or mental health
You are unsure whether it is eczema — a diagnosis should always be confirmed by a healthcare provider
General health information only. This handout provides general pediatric health and wellness education about eczema. It is not a substitute for professional medical advice, diagnosis, or treatment for any individual child. Every child's skin is different, and recommendations may vary based on age, severity, skin type, and other health factors. If you have concerns about your child's eczema or their response to treatment, please speak with a qualified medical professional, including a KixCare pediatric provider, your family physician, or a dermatologist. In an emergency, call 911 or go to your nearest emergency department.
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