Will I/my child need to see a specialist?

Will I/my child need to see a specialist?

Current guidelines recommend referral to a specialist for patients with atopic eczema in certain cases, especially if:1,2

  1. there is a possibility that the diagnosis may be incorrect
  2. treatment prescribed by your GP has not controlled eczema symptoms adequately (including on the face), e.g. you/your child is still having frequent flares or adverse reactions to emollients 
  3. your GP feels that you might benefit from specialist advice on treatment application such as bandaging techniques
  4. contact allergic dermatitis is suspected 
  5. the eczema is having serious effects on your family life, sleep, school/work and may be affecting you/your child psychologically
  6. you/your child has severe and recurrent infections, especially deep abscesses or pneumonia
  7. your child has a suspected food allergy 
  8. your child may not be growing as expected 

Immediate (same-day) referral for specialist dermatological advice is advised if eczema herpeticum is suspected, urgent (within 2 weeks) referral for specialist dermatological advice is recommended for children with atopic eczema if the eczema is severe and has not responded to optimum topical therapy after 1 week or treatment of bacterially infected eczema has failed.


  1. National Institute for Health and Care Excellence. Atopic eczema in under 12s: diagnosis and management. Clinical Guideline 57. December 2007. Available at: www.nice.org.uk/guidance/cg57. Last accessed: August 2016.
  2. Scottish Intercollegiate Guidelines Network. Management of atopic eczema in primary care. March 2011. Available at: (http://www.sign.ac.uk/pdf/sign125.pdf). Last accessed: August 2016.

UK/GEN/16/0051 Date of preparation: October 2016