NICE stepped-care for eczema

GPs should use stepped-care plans to improve control of atopic eczema in children, says NICE.

In a guideline published this week, NICE recommends a stepped approach to treatment, with GPs taking into account severity of atopic eczema, the child's quality of life, including everyday activities and sleep, as well as psychosocial wellbeing.

Potential triggers including soaps and detergents, skin infections or food allergens and inhaled allergens should also be considered and identified.

GPs should also create a stepped-care plan for parents and carers to follow, including what to do if eczema flares up and how to recognise infection or eczema herpeticum.

The guideline is hoped to provide a clearer guide for GPs on how to treat all severities of atopic eczema in children from birth to the age of 12. Around one in five children in the UK suffer from the condition.

NICE recommended widespread use of emollients in children with atopic eczema, even when the skin is clear.

Treatment should focus on a range of emollients for moisturising and washing. At least one needs to be easy to use at nursery or school.

Topical corticosteroids, often given to reduce inflammation and irritation, should only be used if the skin is infected.

Potency of corticosteroids needs to be tailored to severity and location of eczema, says NICE.

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