Behavioural scratching - any tips?

[kwt]

6 month old ds has pretty bad eczema, but is currently under control. However, he has gotten so into the habit of scratching that whenever he is tired/bored/upset his hands immediately gravitate to his cheeks/ears and he starts going crazy with scratching, winding himself up more and more.

The rest of his body is fine, and when he is playing he doesn't seem itchy! We use scratchsleeves, but the rubbing still irritates his skin. I am having to hover over him constantly to hold his hands, which is difficult when I have to pay attention to his older siblings.

How did you deal with this, and does it get better? We are having to swaddle him at night or there would be a scratchfest!

[freefrommum]

Oh kwt I can so relate to your post! My DS (now 6) had terrible eczema as a baby and would scratch constantly. He wore scratch mitts permanently, even in the bath but would still rub his head frantically. Once we got to see the dermatology nurse, we finally managed to get his eczema under control. However, the scratching continued, particularly when we undressed him and particularly his head when he was tired or upset. Over time, the scratching decreased significantly but we do still have to stay 'stop scratching' on a daily basis and if he gets really tired or upset (which thankfully is pretty rare) he will always scratch his head. He obviously does still get itchy as he does still have eczema however it is also a habit, particularly when he scratches his head as he hasn't had any eczema on his head for years now.

I'm afraid I can't really offer any magic solution, just the hope that it will improve with time. In the meantime, it sounds like you're doing all the right things and as you said, you can only keep your eye on his scratching for so much of the time! I remember when it took 2 of us to bath him every night - one to hold his hands to stop him scratching and the other to wash him as quickly as possible! We had to cut a hole in his scratch mitts so that he could suck his thumb otherwise he would get really upset and rub his head even more. Good luck and hang in there - it will get better!

[kwt]

Thanks for your support! How is his eczema now, and when did it start to improve?
Did you find that anything in particular helped his skin?
I get worried that by having his mitts on constantly it's going to impede his development.

You are absolutely right, bath time is a 2 person job, but my husband often has to work late, and it is so hard to grease and dress a slippery crying baby and put on tight fitting comfifast garments, while stopping them from scratching.

[freefrommum]

I totally feel for you. I had exactly the same worries about impeding DS's motor skills (DH thought I was bonkers of course). I have to say, that it certainly doesn't seem to have done him any harm at all (his handwriting is beautiful for a 6yr old boy!) so please try not to worry about that. I did try to take his mitts off while he was playing and I was able to keep an eye on him but it was never for very long. And I soooo remember the perils of trying to keep hold of a greasy, wet, wriggly baby and wrestle them into a sleepsuit with foldover mitts while also stopping them from scratching .

DS's eczema improved dramatically within 2 weeks of seeing the dermatologist (I think he was about 9mths old). However, the scratching took a lot longer to improve as it had definitely become a habit by then plus the specialist explained that his skin will probably still be itchy most of the time, even when it looks clear due to the underlying eczema within the deeper layers of skin. We did lots of distraction techniques eg giving him something to hold on to (preferably in each hand) while in the bath or during nappy changes so that he was less likely to scratch. We also kept as much of his skin covered up as possible so even in the summer I would dress him in full length loose cotton/linen trousers rather than shorts as he would scratch his legs while sat in the buggy. I did put him in short sleeves when it was warm though as he didn't usually scratch his arms very much for some reason.

Things that help (or things we do that we hope are helping?):
-turn off radiator in his bedroom (occasionally in extreme cold weather, we turn it on for a few hours in the evening but turn it back off before bed)
-put a cup of water on a shelf somewhere in his bedroom to stop air drying out
-use non-perfumed non-bio washing powder (eg Surcare) and an extra rinse cycle on the washing machine
-loose cotton clothing
-apply emollient creams as often as possible (when he was a baby, this would be 5 times a day, now it's 2-3)
-never use any type of soap/shampoo etc (we use Dermol 600 in the bath and Dermol 500 as soap substitute)
-don't be afraid of using steroid ointments when eczema flares (we use Eumovate for 4-5 when bad then go down to hydrocortisone for a few more days to avoid it coming straight back)
-finding a suncream that doesn't irritate the skin can be tricky as reactions can often be delayed (after much trial & error we now use Sunsense Sensitive factor 50 - expensive but worth it)

That's all I can think of for now but if I think of anything else I'll come back

[gretagrape]

Same problem here but with my 6mo it's his legs that he can't leave alone - it started after his first immunisations and he's so used to scratching now that everytime I change his nappy his hands go straight to his legs and scratch - not pleasant if there is also an explosive nappy to try and get him to avoid getting his fingers near - feel like I need 4 hands sometimes!

Like the OP, it seems to be a behavioural thing rather than a reaction so even with all the creams we are using I just can't get him to break the association in his mind with having bare legs and scratching.

[freefrommum]

Have you tried giving something to hold in each hand while you're changing his nappy? Doesn't work every time but can sometimes be enough to distract them and break the cycle. I used to give DS pencils, keys, food, anything just to stop him being able to scratch while I changed him.

[gretagrape]

I've tried it but one time he got a bit excited, flung the toy into the poo in the millisecond before I get the nappy out of the way and then it ended up all over him.

Think I might just invest in some baby handcuffs!

[kwt]

It's really hard isn't it! He's not able to focus on holding onto things for long enough to do a full nappy change and creaming, I agree about the baby handcuffs, that would be perfect.

How are you coping, gretagrape?

[freefrommum]

Baby handcuffs - love it!

[gretagrape]

Nothing works consistently - a bag of cotton wool balls is fascinating enough to keep him occupied one day then looked at with disgust the next! I'm finding weirdly that if I put the cream on before nappy change it seems to make him scratch more, maybe it's the cold creaminess that makes him interested in touching it, so I just try to do everything in record time, then put the cream on afterwards when nappy is safely in place.

In the meantime, I'm trying to work on a design that is going to solve all our problems and make me a squillionaire!

[Neepandthedragon]

Tights worked a treat with my 4 year old! he wore them day and night for a few weeks which gave the skin enough time to heal without him getting at it (although had to change him pretty quickly as even a short spell gave him enough time to scratch himself to pieces). I also put him in white cotton gloves from cotton comfort although not sure how they would work on younger kids. They also do other clothing like dungarees with sewn in feet which helps keep little scratchy hands away from tummy and legs - I wish we had discovered them when he was younger.

good luck