Overall, we found that inadequate reporting made assessing risk of bias challenging in many of the included bias , performance and detection bias was unclear in the majority of the included studies: two studies had adequate sequence generation, none reported allocation concealment ; two studies had adequate blinding of participants and personnel and one had high risk of bias ; one study blinded outcome assessors. Attrition bias was low in 8/12 studies and reporting bias was unclear in 11 studies and high in one study .
A common mistake is to be too cautious about topical steroids. Some parents undertreat their children's eczema because of an unfounded fear of topical steroids. They may not apply the steroid as often as prescribed, or at the strength needed to clear the flare-up. This may actually lead to using more steroid in the long term, as the inflamed skin may never completely clear. So, you may end up applying a topical steroid on and off (perhaps every few days) for quite some time. The child may be distressed or uncomfortable for this period if the inflammation does not clear properly. A flare-up is more likely to clear fully if topical steroids are used correctly.