Protopic - excema cream

[anotherdebbie]

I've just been prescribed protopic (a non-steroid excema ointment) by a (trusted) dermatologist for my daughter's excema - she has had a particularly bad flare up. I know there is some controversy over use of this cream in the US especially for children under 2(she is 13 months). If I google it, I get all sorts of links which terrify me. Has anyone else here used it?

[QueenPeaHead]

Hi debbie. Yes, I've used it on two of my children, one at 3.5 yrs about 5 years ago (when it was very new), and once on a 5 mth old about 2.5 years ago. John Harper at GSOH prescribed both times, he is (or was at least) a big fan.
I must say it was very effective, and I really only used it for a couple of weeks both times I think, from memory - it was effective to break the cycle of extremely bad ezcema and to get it to the stage where it could be managed by emollients and weak HC. I used it in conjunction with antibiotic creams, oral antibiotics, emollients and HC both times.

I know there have been questions about it recently, but I'm ashamed to say that I haven't read any of it, on the basis that they've already used it and I'd rather not know! So I'm not sure how helpful this post is. Sorry!

[misdee]

i thought its use over here for children had been discontinued. [puzzled]

[anotherdebbie]

Thanks for your replies. I must say I am not at all happy about it, but I hope that it will break the bad excema cycle as it did for your two (my 2 older children only had v mild excema until they were about 1). I am going back to see the dermatologist next week, so I'm hoping that I'll only end up needing to use it until then. The dermatologist I saw also seems to be a big fan. By the way, did your children grow out of their excema?

[QueenPeaHead]

by the way was it protopic or elidel? I had protopic for hte first and then by the second he said elidel was better, kinder, etc etc so we had that.
yes, both have no ezcema now (apart from the odd patch behind the knee everyso often) and my ds at 5 mths was so awful his whole face looked like a burns victim. when we walked into harper's consulting rooms he said "goodness me! I must take a photo" and I burst into tears

he looks lovely now!

[anotherdebbie]

It was protopic this time, but she was prescribed Elidel for the excema on her face in the summer by a consultant allergist (we had just discovered that she is allergic to egg). I only used it a couple of times before a friend told me that it had been withdrawn in the US and to be honest the excema on her face wasn't that bad, just three patches. It has since completely disappeared from her face and is only on her body, which is what we were told would happen.

[sea123]

Having been through the eczema hell for 14 months ds finally diagnosed with milk egg allergy etc but main success came with support of visiting paediatric nurse. Wet wrap with ichthamol paste - it is what they use in hospiatal - zinc oxide and ichthammol. I think it is not so commonly used because it really is horribly messy and wrecks clothes etc but if you persevere it is wondeful and no steroids!!! I was wrapping head to toe every day but now maybe a dab of paste once a fortnight - completely clear. I nearly cries the first time ds wore short sleeved t shirt without scratching.

[anotherdebbie]

That sounds great. She was diagnosed as egg allergic at 6 months but all the other food allergies were negative (milk, soya, wheat, fish and nuts). I often wonder about taking her off dairy, ever though she isn't technically allergic. I've just been back to the dermatologist and although her excema is better she still has a rash all over her body. Although he's v experienced (30 odd years I think) he'd not seen anything like this rash (little red bruise like spots all over her arms, legs and trunk) which are now more obvious as the excema has cleared a lot). If she wasn't so otherwise well and happy it looks like miningitis! We were at the Royal Free Hospital so he called in 3 other dermatologist and none of them were sure what it was - they discounted a load of things and the best they could come up with was that it was a post viral rash. So I'm now to use nothing but emollient and come back in 2 weeks.

[Chandra]

Just seen this And I thought of mentioning that there was quite a problem with Protopic a couple of years ago. As links to the development of skin cancer where identified less than 3 years after the medicine hit the market. There were several threads with good links about this then, it's worth it to search for them.

As a result of that, measures where taken to avoid it being pescribed to under 2s. But many doctors just don't listen. This medicine has the same active element as the medicines given to people who are to receive or have been received a transplant and it's use should be left for extreme eczema cases where any other medicines have failed, and certainly a flare restricted to the face is not extreme at all.

There are also a number of interactions that you should be careful about: No ibuprfen based medicines (i.e. Nurofen) should be taken if she has been using protopic as it could cause organ damage. You also need to take care not to use it around the days she is going to receive a vaccine.

As for the trusted dermatologist... I thought my dermatologist was God when he prescribed Protopic to DS at 9m, now I think he was an idiot. Unfortunately, there are many doctors still prescribing it , even to sort craddle cap.

[misdee]

also make sure you dont go out in strong sun light when using this cream as it increases risks of burning.

i knew the tracolimis (excuse my spelling) looked familar (i was looking at drugs dh will need after his transplant). its a immuno suppressant.

[anotherdebbie]

Thanks for the advice - I didn't know about the nurofen, but I had read about vaccinations in the warnings - I guess I will be asked to take dd for her MMR in the next couple of months. The flare up was all over her body except her face so it was pretty bad - her face has been relatively clear now for the last couple of months. In the event I only used the ointment on her for 5 days, so I hope no harm has been done. At the moment I'm just using Dermol twice a day - her skin is looking much better I have to say, the rash has nearly gone and her excema is now much better. Just got to keep it under control.......

[Chandra]

I think it will be fine, we used it very few times, however, I wish someone had told me about the nurofen before we started.

BTW, forgot to add, if the skin is infected don't use it, it will supress the inmune reaction and make the infection far worse.