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Conditions We Treat

Eczema Belfast

Eczema (atopic dermatitis) affects around 1 in 5 children in the UK. With the right specialist management, most children can achieve excellent skin control and a significantly improved quality of life.

Child with eczema receiving specialist paediatric care in Belfast

Overview

Eczema (atopic dermatitis) is a chronic inflammatory skin condition characterised by dry, itchy, inflamed skin. It is the most common chronic skin condition in childhood, affecting up to 20% of children in the UK. Eczema is closely linked to the other atopic conditions — food allergy, asthma and allergic rhinitis — and children with eczema are at significantly increased risk of developing these. The condition follows a relapsing-remitting course, with flares triggered by a range of environmental, dietary and immunological factors. Early, effective management reduces the risk of sensitisation to food allergens and improves long-term outcomes.

Expert paediatric assessment in Belfast — Dr Mugilan Anandarajan (FRCPCH) provides thorough, evidence-based evaluation and management for children aged 0–16. No GP referral required.

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Common Symptoms

  • Dry, itchy skin — often worse at night, disrupting sleep
  • Red, inflamed patches — typically on the face, scalp, behind the knees and inside the elbows
  • Weeping, crusting or oozing skin during flares
  • Thickened, leathery skin (lichenification) from chronic scratching
  • Skin infections — bacterial (Staphylococcus aureus), viral (eczema herpeticum) or fungal
  • Pale patches (post-inflammatory hypopigmentation) after flares settle
  • Disturbed sleep due to itch — affecting the whole family
  • In infants: dry, scaly patches on the cheeks, scalp and outer limbs
  • In older children: flexural involvement (elbow creases, behind knees, wrists, ankles)

Causes & Triggers

  • Genetic predisposition — mutations in the filaggrin gene (FLG) impair the skin barrier
  • Family history of eczema, asthma or hay fever (atopic triad)
  • Skin barrier dysfunction — allows allergens and irritants to penetrate and sensitise the immune system
  • Staphylococcus aureus colonisation — triggers and perpetuates skin inflammation
  • Food allergens — particularly cow's milk, egg, wheat, soy and peanut in young children
  • Environmental allergens — house dust mite, pet dander, pollen
  • Irritants — soaps, detergents, synthetic fabrics, heat and sweat
  • Emotional stress and anxiety — can trigger or worsen flares
  • Hard water — associated with increased eczema prevalence in some studies

Diagnosis & Testing

Dr Anandarajan takes a comprehensive history covering the pattern, severity and triggers of eczema, sleep disruption, previous treatments tried, and any associated allergic conditions. He uses validated severity scoring tools (EASI, SCORAD) to objectively assess disease severity. Where food allergy is suspected as a trigger — particularly in young children with moderate-to-severe eczema — skin prick testing and specific IgE blood tests are performed. Patch testing may be recommended for older children where contact allergy is suspected. The assessment also considers whether the eczema is complicated by infection, which requires specific treatment.

  • Skin prick testing (SPT) — for IgE-mediated food and environmental allergens
  • Specific IgE blood tests (ImmunoCAP) — particularly useful in infants with widespread eczema
  • Component-resolved diagnostics (CRD) — for complex multi-sensitised children
  • Patch testing — for suspected contact allergic dermatitis in older children
  • Skin swabs — to identify bacterial or viral infection requiring treatment
  • SCORAD / EASI scoring — objective assessment of eczema severity to guide treatment
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Management & Treatment

Management of childhood eczema is stepwise and tailored to severity. The foundation is optimal emollient therapy — applying large quantities of the right emollient frequently throughout the day and after bathing. Topical corticosteroids (TCS) are the mainstay of anti-inflammatory treatment for flares, used at the appropriate potency for the body site and age. Topical calcineurin inhibitors (tacrolimus, pimecrolimus) are used for sensitive areas and as steroid-sparing agents. For moderate-to-severe eczema not controlled by topical therapy, Dr Anandarajan will discuss systemic options including dupilumab (a biologic targeting the IL-4/IL-13 pathway), which is now licensed for children aged 6 months and above. Trigger identification and avoidance — including food allergens where relevant — is an important component of long-term management.

  • Personalised emollient therapy — type, quantity and application technique
  • Topical corticosteroids (TCS) — appropriate potency, frequency and wet wrapping technique
  • Topical calcineurin inhibitors (tacrolimus / pimecrolimus) for face and flexures
  • Proactive (maintenance) therapy to prevent flares in frequently affected areas
  • Antihistamines for itch relief and sleep support during flares
  • Antibiotic treatment for secondary bacterial infection (Staphylococcus aureus)
  • Antiviral treatment for eczema herpeticum (a medical emergency)
  • Dupilumab (biologic) for moderate-to-severe eczema — licensed from 6 months
  • Food allergen elimination and reintroduction where food allergy is confirmed
  • Allergen avoidance advice (house dust mite, pet dander) where relevant

When to Seek a Specialist Opinion

Your child's eczema is not controlled with over-the-counter treatments
Eczema is significantly disrupting your child's sleep or daily activities
You suspect a food allergy may be triggering or worsening the eczema
Your child has frequent skin infections on top of their eczema
You are concerned about steroid use and want expert guidance
Your child has widespread, severe eczema affecting quality of life
You want to explore newer treatments such as dupilumab
Your child has eczema alongside asthma or food allergy
Eczema is causing significant psychological distress or school absence
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Common Questions

Frequently Asked Questions

Questions parents commonly ask about eczema in children — answered by Dr Mugilan Anandarajan, Consultant Paediatrician, Belfast.

Yes — in young children (particularly under 2 years), food allergy — most commonly to cow's milk, egg, wheat, soy or peanut — can trigger or worsen eczema. However, food allergy is not the cause of eczema in most children. Dr Anandarajan will assess whether food allergy testing is appropriate based on your child's age, eczema severity and clinical history. Unnecessary dietary restriction without specialist guidance can cause nutritional deficiencies.
Topical corticosteroids (TCS) are safe and effective when used correctly. The key is using the right potency for the right body site, for the right duration. Mild steroids (e.g. 1% hydrocortisone) are appropriate for the face; moderate-to-potent steroids may be needed for the body during flares. Dr Anandarajan will provide clear written guidance on which steroid to use, where, how much and for how long — and will explain proactive therapy to prevent flares.
Dupilumab (Dupixent) is a biologic medication that targets the IL-4/IL-13 signalling pathway — the key driver of atopic inflammation. It is given as a fortnightly injection and is highly effective for moderate-to-severe eczema. It is now licensed in the UK for children aged 6 months and above who have inadequately controlled eczema despite optimised topical therapy. Dr Anandarajan will assess whether your child meets the criteria for dupilumab and discuss the referral pathway.
Many children do improve significantly as they get older — around 60–70% of children with eczema will have minimal or no symptoms by their mid-teens. However, some children continue to have eczema into adulthood, particularly those with severe early-onset disease, filaggrin gene mutations, or multiple atopic conditions. Effective early management reduces the risk of long-term skin damage and sensitisation to allergens.
Far more than most parents realise. For a child with moderate eczema, you should be using at least 250g of emollient per week — applied generously at least twice daily and after every bath or shower. The emollient should be applied in the direction of hair growth, not rubbed in vigorously. Dr Anandarajan will advise on the best emollient for your child's skin type and how to apply it effectively.
No. You can book directly at Kingsbridge Private Hospital or Ulster Independent Clinic without a GP referral. Dr Anandarajan sees children aged 0–16 with eczema of all severities.
Wet wrapping involves applying topical treatment (emollient and/or diluted steroid) to the skin and then covering with a layer of damp tubular bandage, followed by a dry layer. It is used for short periods during severe flares to intensively rehydrate the skin and enhance the effect of topical treatments. It can provide rapid relief of severe itch and inflammation. Dr Anandarajan will demonstrate the technique and provide written instructions.

Have a question not answered here? Contact the clinic or call 028 9066 2878.

Areas We Serve

Eczema Treatment for Families Across Northern Ireland

Families travel from across Northern Ireland to see Dr Anandarajan at Kingsbridge Private Hospital, Belfast. Easily accessible from the M1, M2 and A1 with free on-site parking. No GP referral required.

BelfastLisburnBangorNewtownardsHolywoodCarrickfergusAntrimCraigavonNewryArmaghBallymenaLondonderry / DerryOmaghEnniskillenDownpatrickNewtownabbeyNorth DownArds PeninsulaCounty DownCounty AntrimCounty ArmaghNorthern Ireland

Get expert help for Eczema in Belfast

Dr Mugilan Anandarajan (FRCPCH) provides specialist paediatric allergy assessment at Kingsbridge Private Hospital and Ulster Independent Clinic. No GP referral required. Most major health insurers accepted.

Book a ConsultationAbout Our Specialist

Kingsbridge Private Hospital, 811–815 Lisburn Road, Belfast BT9 7GX

Why parents choose Belfast Allergy Clinic

  • Consultant Paediatrician (FRCPCH)
  • 25+ years clinical experience
  • Children aged 0–16 years
  • No GP referral required
  • Allergy testing available
  • Face-to-face and video consultations
  • Recognised by major insurers
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