When should I consider referring a patient with atopic eczema to a dermatologist?

Consider referring a patient with atopic eczema to a dermatologist if:

• the diagnosis is, or has become, uncertain ¹.
• management has not controlled the atopic eczema satisfactorily, based on a subjective assessment by the child, parent or carer (for example, the child is having 1 to 2 weeks of flares per month or is having adverse reactions to many emollients) ¹.
• atopic eczema on the face has not responded to treatment ¹.
• the child or their parents or carers may benefit from specialist advice on how to apply treatments (for example, bandaging techniques) ¹.
• contact allergic dermatitis is suspected (for example, persistent atopic eczema or facial, eyelid or hand atopic eczema) ¹.
• the atopic eczema is causing significant social or psychological problems for the child or their parents or carers (for example, sleep disturbance or poor school attendance) ¹.
• atopic eczema is associated with severe and recurrent infections, especially deep abscesses or pneumonia ¹.
• if atopic eczema is responding to optimal management but the child's quality of life and psychosocial wellbeing has not improved, refer them for psychological advice ¹.
• children with moderate or severe atopic eczema and suspected food allergy should be referred for specialist investigation and management ¹.
• children with atopic eczema for growth concerns if they are not growing at the expected trajectory ¹.