What first-line treatments are recommended for managing eczema flare-u

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

The recommended first-line treatments for managing eczema flare-ups in paediatric patients are:

Emollients should always be used, even when atopic eczema is clear, and should be applied in larger amounts and more often than other treatments on the whole body during flares .
Start treatment for flares as soon as signs and symptoms appear, and continue treatment for approximately 48 hours after symptoms subside .
Use mild-potency topical corticosteroids for mild eczema, and moderate-potency topical corticosteroids for moderate eczema during flare-ups .
Offer children a choice of unperfumed emollients for daily moisturising, with large quantities prescribed for use at nursery, pre-school, or school .
Show children and carers how to apply emollients correctly, including smoothing rather than rubbing them in .

Additional treatments such as topical calcineurin inhibitors are considered second-line and are not first-line options .

What first-line treatments are recommended for managing eczema flare-ups in paediatric patients?