Specialist paediatric dermatology treatment

Eczema is the most common skin condition seen in children, affecting around one in five children in the UK at some point. It is a chronic inflammatory skin condition characterised by dry, itchy, red and sometimes weeping or crusted skin, most often affecting the skin creases, face, neck and hands. Eczema tends to flare and remit, with periods of good control interrupted by flares triggered by infections, irritants, allergens or environmental factors.

Although eczema often improves with age, it can persist into adulthood, and in some children it is severe enough to significantly affect sleep, concentration, school attendance and quality of life. Management involves a combination of daily emollient (moisturiser) use, topical anti-inflammatory treatments (steroid and non-steroid options), trigger avoidance and, in more severe cases, systemic treatments. At Clinica London, our consultant dermatologists take time to review the full picture, adjust treatment, provide written management plans and address the concerns families often find are glossed over in brief GP appointments.

We see children with eczema of all severity levels, from mild skin dryness to severe or treatment-resistant eczema. For children whose eczema is not responding to standard topical treatment, a specialist paediatric skin review can identify whether triggers, secondary infection, contact allergy, or inadequate treatment application are contributing factors.

Acne is the most common skin condition in teenagers, affecting the vast majority of young people to some degree during adolescence. It occurs when hair follicles become blocked with sebum and dead skin cells, leading to comedones (blackheads and whiteheads), inflammatory spots (papules and pustules), and in more severe cases, nodules and cysts that can lead to scarring.

Although acne is often trivialised as a normal part of growing up, its impact on teenagers can be profound, and is strongly associated with reduced self-esteem, social withdrawal, anxiety and depression. Effective treatment exists for all grades of acne, and early treatment reduces the risk of scarring.

At Clinica London, our consultant paediatric dermatologists assess acne thoroughly, considering severity, distribution, skin type and previous treatments, and provide a personalised treatment plan. Options range from topical treatments (retinoids, benzoyl peroxide, topical antibiotics) through to oral antibiotics, hormonal treatment in female patients, and isotretinoin (Roaccutane) for severe or resistant acne, with the full monitoring and support this requires.

Molluscum contagiosum is a very common viral skin infection in children, caused by the molluscum contagiosum virus (a poxvirus). It presents as small, firm, dome-shaped papules with a characteristic central dimple, most commonly appearing on the trunk, arms, legs and face. It is spread by direct skin contact and is common in young children in close physical contact at school or nursery, and in swimming pools.

Most cases in otherwise healthy children resolve without treatment over six to eighteen months, and watchful waiting is often appropriate. However, in children with widespread or persistent infection, in those with eczema, or where the infection is causing significant distress or social difficulties, treatment can be offered, including cryotherapy, topical treatments and other in-clinic approaches.

When molluscum contagiosum is near a child's eyes or on the eyelids, our Consultant Oculoplastic Ophthalmologist Miss Jane Olver will be the best person to consult.

Verrucae (plantar warts) are caused by the human papillomavirus (HPV) and affect the soles of the feet, often developing at pressure points and growing inward rather than outward, which can make them painful when walking or standing. Common warts can appear anywhere on the body and are equally common in children.

Warts and verrucae are very common in school-age children, spread by direct contact with the virus on surfaces such as swimming pool floors and shared sports equipment. Many will resolve spontaneously over one to two years, but persistent, painful or spreading lesions are worth treating with cryotherapy, salicylic acid-based topical treatments, or other approaches for resistant lesions.

Itchy or red skin in children has a wide range of causes, and accurate diagnosis is the most important first step. Urticaria (hives) presents as raised, itchy welts that appear and disappear within hours, and can be triggered by allergens, infections, medications or physical stimuli. Contact dermatitis presents as a localised red, itchy or blistered rash at the site of contact with an irritant or allergen. Seborrhoeic dermatitis in infants (cradle cap and nappy area involvement) is common and usually benign. Psoriasis, though less common in children than adults, does occur in childhood and can be mistaken for eczema.

Many children are brought to us after an itchy or red rash has not been adequately explained or treated through primary care. A specialist dermatology consultation provides the time and knowledge to examine the rash carefully, take a thorough history, consider the differential diagnosis and, where needed, arrange investigations such as patch testing or skin swabs.