Best Eczema Cream for Kids UK: A Dermatologist's Guide

Once eczema moves past the baby stage, the questions parents ask me change. Your child is at nursery or school, washing their hands ten times a day, swimming on a Thursday, and quite possibly refusing to stand still for cream. The products that suited them as a baby may not fit the way they live now.

This guide covers what matters when you choose an eczema cream for a toddler or school-age child, how much to use, and how to get it onto a child who would rather be doing anything else.

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The Short Answer

The best eczema cream for a child is a fragrance-free emollient they are happy to have on their skin every day, used generously: at least twice a day, and whenever the skin feels dry. The largest UK trial on this question found no difference in results between lotions, creams, gels and ointments. What made the difference was finding one the child would actually use.

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How Eczema Changes as Children Grow

In babies, eczema often appears on the cheeks and face. As children get older it tends to move to the creases: the inside of the elbows, behind the knees, around the wrists and ankles, and on the neck. The hands are often affected too. Patches that have been scratched for months can become thickened and leathery.

The encouraging news is that eczema usually gets better as children grow, and many grow out of it altogether. Until then, a good daily routine makes an enormous difference to how often flare-ups happen and how bad they get.

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What the Research Says: The Best Cream Is the One They'll Use

In 2022 the Best Emollients for Eczema (BEE) trial, run across 77 GP surgeries in England, gave 550 children aged six months to 12 years one of four types of moisturiser: a lotion, a cream, a gel or an ointment. After 16 weeks there was no difference in eczema severity between the four groups.

The researchers' conclusion was refreshingly simple: the right moisturiser for a child is the one they like to use. I see the same thing in clinic every week. A cream that sits on the shelf because it is too greasy, or stings, or feels horrible under school uniform does nothing at all. A cream your child doesn't mind, used two or three times a day, does a great deal.

In practice, creams suit daytime, nursery and school because they absorb quickly. Ointments are greasier and suit very dry skin and bedtime, but should not be used on weeping eczema. Many families use one of each. There's more on the differences in Emollients for Baby Eczema: Cream, Ointment or Lotion?

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What to Look For

Fragrance-free

Perfume is one of the most common triggers for a flare-up. That includes "natural" scents such as lavender, tea tree and citrus oils, which can still irritate. Look for "fragrance-free" or "unperfumed" on the label, not just "gentle" or "sensitive".

Rich in lipids

Eczema skin is short of the natural fats (lipids) that hold the skin barrier together. Creams rich in plant lipids, such as sunflower, shea, avocado and jojoba oils, help to replace them.

No sodium lauryl sulphate (SLS)

SLS is a foaming agent that can damage the skin barrier. It is found in many washes, and it is the reason aqueous cream is no longer recommended as a leave-on moisturiser for eczema.

A size that fits the day

A large pump bottle at home and a small one that lives in the school bag. A cream that's to hand is a cream that gets used.

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What to Avoid

• Perfumed bubble baths and shower gels. Wash with a soap-free, fragrance-free product instead.
• Aqueous cream as a moisturiser. It can irritate eczema-prone skin.
• Essential oils and "natural fragrance". Natural doesn't mean non-irritating.
• Stopping when the skin looks clear. This is the most common reason eczema comes back.

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How Much and How Often

Children with eczema need far more cream than most parents expect. NICE guidance suggests children with atopic eczema may need 250g to 500g of emollient a week. A younger child with a few patches will be at the lower end; an older child with widespread eczema will be nearer the top.

• At least twice a day: morning, and after the evening bath, every day
• Whenever the skin feels dry or itchy: there is no upper limit for a plain emollient
• Within a few minutes of bathing: pat the skin dry and apply while it is still slightly damp
• Smoothed on, not rubbed in: stroke it on in the direction of hair growth

For more on timing, see How Often Should You Moisturise Eczema-Prone Skin?

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Hand Eczema in Children

Hands have the hardest time at school. Frequent hand washing, hand sanitiser, paint, play dough and cold playgrounds all strip the skin. If your child's eczema is mostly on their hands:

• Pack a small bottle of their cream and ask staff to let them use it after hand washing
• Use a soap substitute at home, and ask whether school will let them bring their own
• Apply a thicker layer at bedtime; some families use thin cotton gloves overnight
• Gloves outside in cold weather make a real difference

Alcohol hand gels sting cracked skin. If your child has to use one, moisturise as soon as you can afterwards. There's more on working with staff in Managing Your Child's Eczema at Nursery or School.

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When Your Child Hates Having Cream Put On

This is one of the most common problems I hear about, and it's a real one. A routine that ends in tears twice a day doesn't last. Things that help:

• Let them choose between two or three suitable creams. Children are far more willing to use something they picked.
• Let them do it themselves from around three or four, with you finishing the bits they miss.
• Make it part of the routine, at the same point every day: after the bath, before the story.
• Warm it between your hands on cold mornings so it doesn't feel like a shock.
• If it stings, tell your GP. Stinging can mean the skin is very inflamed or infected, or that the product doesn't suit them.

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When to See Your GP

A good emollient routine is the foundation, but it isn't always enough on its own. See your GP if:

• The eczema is affecting your child's sleep, schoolwork or mood
• Flare-ups keep coming back despite moisturising every day
• You think a particular food is making it worse. Please don't cut foods out of your child's diet without advice.

Get urgent advice from your GP or NHS 111 if the skin becomes blistered, crusty or weepy, has pus-filled spots, feels hot or painful, or suddenly gets much worse, or if your child has a high temperature or seems unwell. These can be signs of infection.

If your GP prescribes a steroid cream for flare-ups, keep using the moisturiser alongside it. Here's which to apply first and how long to wait.

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About Ovée Baby & Child Moisturising Cream

I developed the Ovée Baby & Child Moisturising Cream for children as well as babies: a fragrance-free, paraffin-free, steroid-free daily cream with oat, sunflower, jojoba and avocado oils. The 50ml size comes in an airless pump bottle that fits in a school bag or PE kit. You can see the whole Baby & Child range here.

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Dr. Tim Clayton is a Consultant Paediatric Dermatologist, President of the British Society for Paediatric and Adolescent Dermatology, and Co-Founder of Ovée Skin Health.