Itchy, red, sometimes scaly eczema on the skin: The inflammatory skin disease neurodermatitis in children can pose a challenge not only to doctors but also to parents.

Because the tormenting itching is often accompanied by sleep disorders, which in the worst case can lead to a delay in the growth and development of the child.

This leads to desperate children – and parents.

Three researchers from McMasters University and the University of Nottingham have now published tips for successfully alleviating the symptoms of the disease in the "Canadian Medical Association Journal".

Neurodermatitis, also known as atopic dermatitis, is a hereditary, inflammatory skin disease in which the skin's barrier function is disrupted.

It affects about every fifth to sixth child in this country.

In infancy, it first becomes noticeable as "cradle cap" on the scalp, cheeks, behind the ears, on the forehead or on the neck.

The crooks of the elbows and the hollows of the knees are often only affected later in the course of the disease.

In principle, the prognosis is good, around 60 percent of affected children no longer have any symptoms by early adulthood, despite an existing hereditary predisposition.

Food intolerance is counterproductive

Since the disease cannot be cured, only the symptoms can be controlled.

Contrary to the belief of many parents, however, the treatment does not consist of omitting certain foods - the scientists emphasize that this can even lead to food intolerance.

The Canadian Pediatric Society recommends introducing allergenic foods at around six months of age with continued breastfeeding until two years of age, or even longer if possible.

Another myth is that sick children should not be vaccinated if possible - since a vaccination could trigger a flare-up of the skin disease.

Vaccination, on the other hand, makes a lot of sense because without the immune protection the child is only exposed to an additional risk.

Another common mistake: In the case of accompanying bacterial colonization of the skin, often with Staphylococcus aureus, antibiotics are often routinely administered.

However, this is only indicated in the case of systemic signs of infection such as fever.

The Canadian Pediatric Society now recommends introducing allergenic foods at around six months of age with continued breastfeeding up to two years of age, if possible even longer.

Moisture helps

This would clarify what parents should not do if their toddler suffers from neurodermatitis.

New studies have now shown what you can do: Any type of moisturizer - whether in the form of gel, lotion or balm - therefore helps to prevent flare-ups as long as it is used twice a day and as needed.

According to the study authors, softening bath additives had no additional benefit beyond directly moisturizing the skin, but could well be used as a soap substitute.

Most soaps are alkaline, meaning they have a pH well above the acidic pH of healthy skin.

Normally this is restored after a certain time.

In the case of neurodermatitis, however, the protective acid mantle is disturbed, which is why the pH value of the skin cannot easily return to normal after excessive soaping.

Effectively fight inflammation

However, moisturizing is not always enough.

Disease control therefore also includes treatment with anti-inflammatory creams, so-called topical corticosteroids, which are available in different strengths.

The following applies: Use as low a dose as possible, as high a dose as necessary to achieve an effect.

According to the scientists, once-a-day use is almost as effective as twice-a-day use.

The face should be avoided if possible, as the skin there is particularly sensitive.

A slightly different approach may be needed for recurring or persistent flare-ups, according to the study.

This involves trying to suppress the flare-up first by using a moderate corticosteroid (such as betamethasone valerate) or strong topical corticosteroid (such as mometasone furoate).

This is followed by a three-month treatment with moderate-strength corticosteroids or pimecrolimus ointment, on two consecutive days per week, for example at the weekend.