Consider referring a patient with atopic eczema to a dermatologist if the diagnosis is uncertain, management has not controlled the eczema satisfactorily, or if there are adverse reactions to treatments, including emollients NICE CG57.
Refer urgently (within 2 weeks) if eczema is severe and has not responded to optimal topical therapy after 1 week, or if treatment of infected eczema has failed NICE CG57.
Refer children with atopic eczema for specialist advice if contact allergic dermatitis is suspected, or if atopic eczema on the face has not responded to treatment NICE CG57.
Additionally, refer if the eczema is causing significant social or psychological problems, or if there are recurrent infections such as deep abscesses or pneumonia NICE CG57.
For suspected food allergy, refer children for specialist investigation and management NICE CG57.