How should I approach the management of a child with suspected eczema who has not responded to standard emollient therapy?

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 14 August 2025Updated: 14 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

If a child with suspected eczema has not responded to standard emollient therapy, consider referring them for specialist dermatological advice to assess the diagnosis and management plan .

Review the treatment approach, and if appropriate, escalate to other therapies such as topical corticosteroids, calcineurin inhibitors, or bandages, especially if the eczema is moderate to severe .

Ensure that the child and carers are correctly applying emollients and consider switching to alternative emollients or application methods if irritation or acceptability issues persist .

In cases of persistent or severe eczema, consider additional treatments like phototherapy or systemic therapy under specialist supervision .

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