Can someone talk to me about hydrocortisone cream please!

[muppetgirl]

Hi my ds 2 -15 month has been diagnosed with impetigo on his nose and exzema. The exzema is on his face parts of his body and a large area on his left leg. He also has a little on his bum (poor chap!)

I was prescribed hydrocortisone cream for his face which my sil thinks is a big no no. I have read the reasons as to why it isn't used routinely on the face on the NHS website and one states that it can make impetigo a lot worse. I was told not to put it onto the impetigo but apart from the huge spot on his nose and the patches of exzema on his cheeks I can't tell whether the other spots are exzema or impetigo. I was told that it can be put on the face if prescribed.

Also I didn't see a Dr, ds 2 saw a practice nurse. Would this bother you? I've seen practice nurses before with ds 1 and they misdiagnosed impetigo for dermatitus (the Dr said impetigo a week later gave us some fab cream and it went in 2 days the nurse gave us emolliant and aqueous cream that did nothing at all!) Alos said that raised glands can be associated with dermatitus (as was tiredness + diahorreah) yet ds 1 was diagnosed with a form of Glandular fever.

I suppose I am worried about putting a very strong cream on ds 2's face when it says not to, I am unable to tell which is exzema/impetigo and this was prescribed by a nurse.

Please be kind, I am not trying to upset nurses I am just worried about ds 2!

Thanks!

[muppetgirl]

anyone?

[pointydog]

I'd go to the doctor.

You need antibiotics for impetigo, if I remember right - an antibiotic cream like fucidin and if that doesn't clear it then oral antibiotics.

Hydrocortisone is for eczema. If the eczema has become infected then you can get a hydrocortisone cream with antibiotices in it - fucidin H.

Children and adults with bad eczema use hydrocortisone on teh face, as well as the rest of the body. It would probably only be 0.5% or 1% for a child. Lots of people who have no experience of bad eczema look horrified at the thought of hydrocortisone (the leaflets warn of thinning the skin) but the sad fact is that the eczema can spread rapidly, become extremely uncomfortable and become badly infected if it is not kept properly under control.

See a doctor. Find out whether it is impetigo or eczema and get clear instructions for treatment.

[muppetgirl]

We have oral Ab's but he is just spitting it out. We have had the fucidin for ds 1 and that was fab. I did wonder why we had oral Ab's and not the cream...

[hazeyjane]

Sorry, that you are in such confusion about your ds. Dd1 had exczema like patches on her cheeks for a while, and like you we had conflicting advice about hydrocortisone cream. In the end, a practise nurse said the Doctor was wrong to have told us to use it on the face and prescribed us some Fucidin, which cleared it up really quickly. It has also helped when she gets spots on her bum (folliculitus I think), but doesn't help on other patches of exczema.

I think sometimes practise nurses are better than doctors (especially at actually talking to patient's), but it all depends on who you get.

Is there a doctor/nurse that you trust that you can ask in a phonecall?

Hope you sort something out soon

[pointydog]

if teh impetigo looks pretty bad, maybe they just wanted to be sure to clear it with oral abs?

If anything is itchy for your ds, I'd put some hc on it until you get to the doctor

[pointydog]

If it is eczema, you do not treat eczema with abs and fucidin is an ab. Abs should not be used on a regular basis.

[muppetgirl]

Thanks all
x

I am worrying stupidly I know but he's in such a pickle and we phoned NHS direct on Sat when it first appeared (the impetigo spot had been there for a while though the exzema appeared on sat) as there were cases of scarlet fever at ds 1's school I am prgt with dc 3 and we were going to a Christening (we didn't needless to say)

We were told to go and see our gp or go to the drop in centre if we felt it was getting worse. We went to the drop in centre and saw a nurse who said she didn't know what the spot was but the rash was impetigo. She didn't prescibe anything just told us to put moisteriser on it like e45. She also called in 2 collegues who also didn't know what it was so, 3 nurses all looking and no one knew what it was!

Today I phoned to make an app to see the dr and arrived to find it was the practice nurse. She said impetigo and exzema.

I think I will phone tomorrow and ASK to see a Dr...

[muppetgirl]

That's interesting pointydog, ds 2 had sticky eyes when he was born and we were prescribed ab's 6 weeks on the tro, ds 2 was only about 12 weeks and had been on Ab's for half his life...

Dh and I said no more (we'd tried creams, drops etc) as it just wasn't not working. We think it was blocked tear ducts in the end as it did clear up (took many months) and does come back occasionally)

[pointydog]

I don't know much about sticky eyes but I know about eczema

[ummadam]

Hydrocortisone is fine to use on the face under a doctors instruction but only for short periods. We use it quite a lot and it is very safe and effective when used correctly and for the right reasons.

Impetigo needs antibiotics and your DS needs to see a doctor so you can get some proper medical advice.

You did the right thing about the sticky eyes - it is very rarely an actual infection in babies and usually due to the tear duct not having developed the right drainage hole yet rather than being blocked and usually sorts itself out by about 1 year old.

Hope your DS is better soon.

[lexmum]

Hi

We have hydrocortisone to use on DS's face too for his eczema, he has a moisturiser (Epaderm) to use most of the time and just pop a bit of the hydrocortisone on when it flares up. Long term use of it can thin the skin but used sparingly is fine.

Not sure about using it to treat impetigo, i'm sure that needs anti bs rather than a steroid cream

[scienceteacher]

The old adage is:

If it's wet, dry it
If it's dry, wet it
If neither treatment works, use hydrocortisone.

[maretta]

I have found with the excema/ impetigo combo that if you don't clear the excema break out then it's hard to get rid of the impetigo. Impetigo likes broken skin etc. A good dose of hydrocortisone can be necessary for this,

I used perscribed hydrocortisone on my sons face when he was small. I think perhaps his teething used to set it off.
He's three now and his face is fine now, hasn't needed hc on his facevfor a year or so.

Contantly broken skin and infections can cause damage too, sometimes the hc is necessary.

[warthog]

def go back and see a doctor.

when dd2 was 5 weeks old she had a terrible rash that they thought was impetigo. were going to use an iv ab. 4 paediatricians didn't really know what it was. took a dermatologist to diagnose seborroaic (sp?) dermatitis. hydrocortisone and emollient did the job. she had it all over her head and body. cleared up after 2 weeks of putting it on twice a day.

my long ramble is to point out that the nurse didn't know, the doctor didn't know and FOUR paediatricians didn't know.

you need to see the right people.