Everyday Life with Eczema

Managing eczema is not just about creams and medicine. It touches nearly every part of daily family life. This page covers practical situations that parents face regularly.

Swimming

Children with eczema can and should enjoy swimming. With the right routine, most children tolerate pool and sea exposure well.

Before swimming

• Apply a thick emollient or ointment (Aquaphor, petroleum jelly, or your usual thick moisturiser) generously to all exposed skin
• This acts as a barrier between the skin and chlorinated or salt water

After swimming

• Shower as soon as possible using a gentle fragrance-free wash
• Pat dry gently (never rub)
• Reapply moisturiser generously, more than usual

When to skip swimming

• If eczema is actively infected (weeping, crusted, pustular)
• If the skin is severely inflamed or broken
• Ask your clinician for advice if unsure

Salt water vs chlorine pools

• Some children do better with salt water; some tolerate chlorine fine
• A few children find brief chlorine exposure mildly helpful (antiseptic effect)
• The post-swim routine matters more than the water type
• Evidence: a 2024 systematic review (Weidinger et al., Acta Derm Venereol) found no strong evidence that swimming worsens eczema when appropriate skin care is applied before and after.

Water softeners

The SWET trial — a pragmatic randomised trial of household water softeners in 336 children with eczema (Ridd et al., JAMA Pediatr, 2021) — found no difference in eczema severity, quality of life, or emollient use between softened and unsoftened water groups. Water softeners are generally not recommended as an eczema intervention based on current evidence.

Sun protection

Sun and eczema

• Moderate sun exposure can improve eczema in some children (UV light has anti-inflammatory effects)
• This is one reason why some children improve in summer or during holidays by the sea
• However, sunburn makes eczema worse, and overheating causes sweating which is a trigger

Choosing sunscreen

Not all sunscreens are created equal for eczema skin:

• Use: mineral/physical sunscreens containing zinc oxide and/or titanium dioxide
• Zinc oxide has anti-inflammatory properties and does not sting eyes when sweating
• Avoid: chemical sunscreens (avobenzone, oxybenzone), products with fragrance, and alcohol-based formulations

Brands commonly tolerated by eczema-prone children:

• Vanicream sunscreen (often the best tolerated)
• Neutrogena Sheer Zinc Kids
• Thinkbaby Safe Sunscreen
• TruKid Eczema SPF 30

Always test a new sunscreen on a small area first.

Clothing and fabrics

What works

• Soft 100% cotton or cotton-blend fabrics
• Loose-fitting clothes that reduce friction and allow airflow
• Lightweight layers that can be removed to prevent overheating
• Wash new clothes before first wear (to remove finishing chemicals)

What to avoid

• Wool and rough synthetics
• Tight-fitting clothes
• Costumes or dress-up clothes made from synthetic materials (party/holiday events are a common flare trigger)

What the evidence says about therapeutic garments

The CLOTHES trial — a randomised trial in 300 children over 6 months (Thomas et al., BMJ, 2017) — tested silk therapeutic garments (DermaSilk) and found no benefit over standard care. These products are expensive and are not recommended as a treatment investment based on current evidence.

Laundry

Laundry products are one of the most commonly reported trigger categories:

• Use fragrance-free liquid detergent (powder detergent can leave irritating residue)
• Consider a double rinse cycle if your child seems sensitive
• Avoid fabric softeners and dryer sheets entirely (they coat fabrics with fragrance and chemicals)
• Use the minimum necessary amount of detergent
• Wash bedding regularly (to reduce dust mite, bacteria, and sweat residue)

Sleep

Sleep disruption is one of the most impactful aspects of childhood eczema for both children and families.

What helps

• Keep the bedroom cool (overheating is one of the most common night-time itch triggers)
• Use light cotton bedding
• Apply moisturiser and any prescribed treatments at bedtime
• Keep nails short and filed smooth
• Consider cotton mittens or sleep suits with built-in hand covers for young children
• A bedroom humidifier during dry months is one of the most consistently helpful interventions reported by parents (target 40-60% humidity)

The itch-scratch cycle at night

Children often scratch in their sleep without being aware of it. This can cause significant skin damage by morning. Strategies include:

• Consistent bedtime skin care routine
• Cool room temperature
• Soft cotton pyjamas that cover itch-prone areas
• Distraction techniques for older children (audiobooks, gentle music)
• Discussing itch management and antihistamine options with your clinician if sleep is severely disrupted

Daycare and school

What to communicate

Provide the daycare or school with:

• A clear written care plan (what to apply, when, and what to avoid)
• A supply of your child's moisturiser
• Information about triggers to avoid (specific products, materials, activities)
• Emergency contact information and signs that need urgent attention (especially eczema herpeticum warning signs)

Common school triggers

• Art materials (glue, paint, clay)
• Sand and water play
• Rough costumes for school plays
• Different soap in school bathrooms
• Outdoor play in extreme heat or cold

Helpful tips

• Apply a protective layer of moisturiser before messy activities
• Send your child with their own gentle hand wash
• Discuss with teachers that the child may need to apply moisturiser during the day
• Keep a change of clothes at school in case of sweating or irritant exposure

Pets

• Pet dander is a potential trigger for some children, but evidence does not support removing pets as a blanket recommendation
• If your child's eczema clearly worsens with pet contact, discuss with your clinician
• Keeping pets out of the child's bedroom and off soft furnishings can help reduce exposure
• Regular pet grooming and vacuuming reduces dander levels

Travel

Packing for travel

• Enough moisturiser for the entire trip plus extra
• All prescribed treatments
• Familiar gentle cleanser and fragrance-free products
• Cotton clothing and bedding (some hotels use harsh detergents)
• A portable humidifier for dry hotel rooms or dry climates

Managing climate changes

• Moving between climates (e.g., winter to tropical holiday) can trigger flares due to sweating, humidity changes, or sun exposure
• Maintain the regular skin care routine even during holidays
• Apply moisturiser more frequently in air-conditioned or heated environments
• Be prepared for a possible flare in the first few days of a climate transition

Emotional and social impact

On the child

• Eczema can cause embarrassment, social withdrawal, and difficulty concentrating
• Children with eczema are twice as likely to experience mental health difficulties
• Itching and sleep disruption affect mood, energy, and behaviour
• Older children may feel self-conscious about visible skin changes

On parents and caregivers

• Caregiver burnout is real: uncertainty, guilt, frustration, and exhaustion are common
• Mothers show higher rates of depression, anxiety, and stress than fathers
• Mental health impacts worsen during flares
• A 2024 report found clinicians ask about psychological distress only half the time

What helps

• Acknowledge that managing eczema is hard work and your feelings are valid
• Join parent support groups (online or local) — shared experience helps
• Eczema education programmes improve both treatment outcomes and mental health (Staab et al., Br J Dermatol, 2002)
• Ask your clinician about mental health screening for both you and your child
• Set realistic goals: good control, not perfection
• Take breaks from eczema management when possible (share care with partners, family)

Key references

• Thomas KS et al. (CLOTHES trial). "Silk garments plus standard care compared with standard care only for treating eczema in children." BMJ 359:j4422, 2017.
• Ridd MJ et al. (SWET trial). JAMA Pediatr 175(5):477–486, 2021.
• National Eczema Society. "Clothing and eczema." eczema.org
• Staab D et al. "Age-related educational programmes for children with atopic eczema." Br J Dermatol 146(3):405–12, 2002.
• NICE CG57. "Atopic eczema in under 12s: diagnosis and management."