See also –

NICE guidelines for

Management of eczema in under 12’s (www.nice.org.uk/CG057)


Consider Referral to Allergy clinic for:

  • Infants < 6 months with moderate-severe eczema on optimal eczema management with a clear suggestion of a cow’s milk protein or egg allergy
  • All infants and children with significant atopic eczema where IgE mediated food allergies are suspected via the history (some are referred by the Dermatology team internally)


NB infants and young children with faltering growth in conjunction with severe eczema should be seen in the Dietetic or General Paediatric clinics in the first instance 


No need to refer:

  • Patients with eczema and no obvious temporal relationship between ingesting certain foods known to be common allergens (e.g. milk, egg) and worsening of condition
  • Flare ups (of facial eczema in particular) caused by acidic foods such as tomatoes, citrus fruits, pineapple, vinegar etc. Reassurance should be given in Primary Care. Often the history is that some brands (e.g. of Ketchup) are worse than others.

Dermatology Referral should be considered for all cases of severe, difficult to control eczema



Date                            January 2022

Review Date               January 2023

Authors:                     Simon Bedwani, Consultant Paediatrician, RCHT

                                    Dr S Burns GP RMS


Version No.        1.2