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

Consider referring a patient with atopic eczema to a dermatologist if the diagnosis is uncertain, management has not controlled the eczema satisfactorily, or if there are adverse reactions to treatments, including emollients ¹.

Refer urgently (within 2 weeks) if eczema is severe and has not responded to optimal topical therapy after 1 week, or if treatment of infected eczema has failed ¹.

Refer children with atopic eczema for specialist advice if contact allergic dermatitis is suspected, or if atopic eczema on the face has not responded to treatment ¹.

Additionally, refer if the eczema is causing significant social or psychological problems, or if there are recurrent infections such as deep abscesses or pneumonia ¹.

For suspected food allergy, refer children for specialist investigation and management ¹.