Prognosis Fifty percent of eczema has gone by the age of eleven and sixty-five percent of eczema has gone by the age of sixteen. In some patients, whose eczema has disappeared in teens, it may come back in adult life. Careers Children with atopic eczema, even if it disappears by the teens, are more likely to develop primary irritant dermatitis in certain occupations. If the mother herself has had atopy or has another child with atopic eczema, it is advised that she herself should avoid peanuts while pregnant and possibly consider withdrawal of milk and eggs. However, advice on diet will be required to ensure adequate calcium intake.
Breast feeding a baby for at least six months is advised.
Dermatitis Much of the advice already given is applicable but, in general, more potent topical corticosteroids will be required and therefore closer supervision will also be required. Always prescribe moisturisers for the bath, shower and direct to the skin and usually prescribe topical corticosteroid ointments rather than creams. Both are potent steroids and are long acting and only require daily application. They are rapidly metabolised and so the risk of suppression of pituitary adrenal axis is reduced. They are, however, as potent as Betnovate and patients should be monitored closely for atrophy.