Atopic dermatitis (AD) is a common red, scaly, itchy rash classically associated with a tendency toward dry skin, allergies, asthma and hay fever. For most, it starts in infancy/childhood and improves over time. However, it may persist into adulthood and for some, it may start in adulthood.
What follows is the typical regimen for treating diffuse eczema in an infant or child. It involves a bath, mild cleanser, topical prescription medication (usually a steroid) and a moisturizer. (I will use the term steroid, but various non-steroid medications may be recommended by your doctor.)
The skin should be dramatically better in five to seven days. If not, call your dermatologist. Once the skin starts to improve, you will be able to use more moisturizer and less steroid each time. Eventually, you will be able to use mostly the moisturizer and just a little bit of steroid for any "hot spots".
The daily use of a topical steroid for 7-14 days will not significantly thin the skin. But one to two months may--especially in areas of thin skin like the inner elbows, the groin, the face and neck. So avoid using the steroid in the same areas daily for more than a week or so at a time. Give the skin periodic breaks. "One week on, one week off," or "two days on, two days off," etc.
Minimizing exposure to skin products with perfumes or other possible irritants/allergens is recommended.
Wash all new clothes before wearing. This removes potentially irritating chemicals which are used during production and packing. Use dye-free and fragrance-free detergent. Wear garments that allow air to pass freely to the skin. Open weave, loose-fitting, cotton-blend clothing may be most comfortable. Avoid wearing wool.
Work, sleep and play in comfortable surroundings. Don't let your child get too hot or too cold. If the house is very dry, consider buying a humidifier.
Oral antihistamines such as Claritin (loratadine) and Benadryl (diphenhydramine) aren't that helpful for the itch of AD but may be beneficial if you have a component of hives. Note that Benadryl is sedating and so may help you sleep if taken right before bed. It is not however appropriate for babies and infants. Topical antihistamine creams, or creams that contain anesthetics, should be avoided. They can further irritate the skin.
Swimming is okay. In fact some have noted swimming can help eczema, perhaps by reducing bacterial counts. Just shower off well afterwards to remove any residual chlorine and then apply the steroid and/or moisturizer.
Watch for increased redness, pain, oozing, wetness, pus, honey-colored crust, cold-sores, or blisters on the skin. If you suspect infection, contact your doctor immediately.