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eczema crisis point

(38 Posts)
topmum1 Tue 18-Jun-13 19:26:16

Help! I'm new to mumsnet but need some advice. I have a 16 month old toddler who has had ezcema pretty much since he was born. I have been to the doctors several times about this but feel i'm just getting fobbed off with 'it will go eventually'. That's not good enough!
I have tried several creams (aveeno, double base, really thick stuff at bed time) and steroids (two types). I give him a bath every other night with just water, I dress him in natural fabrics, we use non-bio powder and I keep his nails short. The problem is a vicious cycle - I use steroid for two weeks (max time it can be used apparantly) plus other creams and the ezcema disappears. I then stop using steroid cream and it returns. The back of his legs look awful once again, the scratching starts and so it continues, I use steroid cream - you get the picture.
I don't know what to do - i'm worried the steroid cream is not good for him and I also wonder if there are any other causes e.g. food, allergies etc.
Does anyone have any experience of this or just some advice? It is really getting to me
Thanks

PoppyWearer Tue 18-Jun-13 19:32:48

Just sympathy. My two both suffer from it. DC2 is having a bad bout behind knees and elbows at the moment and its waking him at nights. I don't know what to do.

orangeandemons Tue 18-Jun-13 19:37:38

I found this....eventually got a stronger steroid, cleared it up faster and stayed away longer, but still came back.

Fwiw, dd has burnt her leg, and we have not been able to get it wet for 2 weeks. We have no shower, so she has been having a strip wash every other day. Her eczema has GONE

sleepyhead Tue 18-Jun-13 19:43:19

I agree about less frequent baths. Ds's eczema was better when we moved to bath once a week.

We had the same problem with steroids but stronger steroids did fix it for longer. I never found any link with food etc.

Ds thankfully grew out of it around age 4 and now (age 6.5) has the occasional dry patch on the back of his knees in the winter but nothing like as bad, not even 1% as bad.

mamij Tue 18-Jun-13 19:44:44

DD2 had the most awful, infected eczema and was also prescribed steroid creams and various emollients. Dermatologist didn't believe it was food/allergy related, but eczema cleared up almost as soon as we stopped giving her dairy. Try to see if you can get a referral to an allergist if you haven't already.

chickensaladagain Tue 18-Jun-13 19:47:56

Dd has suffered from birth

The only thing that had any longer term benefit was light therapy which lasted 6 months

She's been allergy tested and there is no connection apparently

chickensaladagain Tue 18-Jun-13 19:49:00

Just a thought -what does your dc wear to bed?

tuckingfits Tue 18-Jun-13 19:49:28

Hi. I sympathise entirely. My DS is 28 months now & has similarly had eczema since a few weeks after his birth.

I found my GPs weren't really dealing with it effectively & asked for a referral to the dermatology dept at our nearest hospital.

They were able to prescribe more effective ointments (eumovate,trimovate,fucibet etc) to deal with the active patches of sore skin. We also started using Epaderm ointment as a bath emollient - not sure of it's efficacy personally but it doesn't make thongs worse... He is slathered in Cetraben at least twice a day for it's moisturising benefits. His skin isn't perfect & he still has flare ups but he is so much better than he was. The last time he had infected skin was before he was a year old. That is how well controlled his eczema is now.

After all my waffle,all I can recommend to you is that you ask for/insist on a referral to a dermatologist. It seems that every case of eczema reacts differently to different lotions & potions.

You are definitely right to be bathing without soap & to be using non-bio washing powder. I find I have to give DSs clothes an extra rinse in the machine to ensure there is no residue left at all otherwise his skin reacts. We also used a website called www.itchybaby.co.uk where we bought scratchsleeves from - a marvellous invention that are 100% better than the socks/scratch mits I was taping on every night/
nap time. They sit across the shoulders so babies can't get them off & have several layers of fabric within the hand sections which slip over each other preventing the child getting a good purchase for a decent scratching session,thus reducing the damage to their skin.

One last thing that might be worth trying - plain water in his bath could be a bit drying - try putting some oats into an old pop sock & squeezing it in the water. Oats are very soothing (hence the use of Aveeno lotions) & it might just help a bit.

Good luck. And yes,it will go eventually moat likely,but as the dermatologist agreed with me saying - why not make life more pleasant & less uncomfortable now if we can?! Astonishes me that people think it's ok to leave a small child itchy & scratching in misery when there are ways to deal with it.

tuckingfits Tue 18-Jun-13 19:52:21

DS is dairy free & has been for 7 months now,it hasn't made one iota of difference to his skin. They are very quick to dismiss any link with diet though... I still occasionally think I should try cutting out wheat/gluten from his diet. They are all different!

LouBeee Tue 18-Jun-13 19:59:43

I second referral to dermatologist. They are significantly better than GPs at managing severe eczema. My DS saw one at 13 months, now 21 months and eczema well controlled.
I would also add that GPs talk a lot of crap about how often the steroid can be used. Dermatologists (I've seen them as has DH - it's a family thing!) will always tell you to use it as much as you need. The key is to use it for a few days after the redness goes to really ensure the breakout is abated then try to manage a 5-7 day break. We use Eumovate or betnovate dependent on severity on a 5 days on/ 5 days off basis and use Epaderm at night as an emollient
For what it's worth DH has used a strong steroid cream almost daily for 38 years of his severe eczema and he still managed to father a child ... a lot of the side effects are over exaggerated and need to be balanced against dealing with the pain of eczema on a daily basis

PoppyWearer Tue 18-Jun-13 20:02:40

Scratch sleeves ordered, thanks for the tip!

PoppyWearer Tue 18-Jun-13 20:03:45

My DCs definitely have food intolerances going on. Not yet diagnosed but I know there is something going on.

WallaceWindsock Tue 18-Jun-13 20:05:25

I would keep pushing. I have awful eczema. I've had it since I was a baby. The GP tried me on every cream available and it didn't touch it. I can remember having to take a cotton pillowcase into school to put on the plastic chairs as the plastic would stick to the open oozing sores on the backs of my legs. It turned septic several times. It's now under control with undisputed betnovate which I use multiple times a day. I still have cracking, blisters and open sores on my hands, backs of knees and legs but its miles better. If I stop using the cream it's spread over my whole legs and arms within the week.

ATM my GP is reluctant to try anything else as it gets so much worse when I'm off the betnovate. It has side effects though which worry me. Push and push while DC is still young and get referred. Good luck

WallaceWindsock Tue 18-Jun-13 20:09:30

Also I've recently had food allergies emerge and also hay fever develop so am now eczema, asthma and hay fever prone as well as having OAS which is cross pollination related food allergies. Because I didn't suffer with these as a child I wasn't allergy tested re the eczema. I would recommend regular allergy testing - say every 3-5years as a lot of allergies emerge during a persons lifetime and I'm sure mine are all related.

NotSoNervous Tue 18-Jun-13 20:14:33

My DD is almost 8m and has eczema on her back and legs, I've been to the doctors quite a few times and been given a lot of different stuff, at the minute we use diprobase 4-5 times during the day and epoderm (I think I'll double check when I get home) during the night it's thick and waxy and then I use oilatum in the bath each night and touch wood it's getting a lot better and fairly quickly too. I have hydrocortisone for when it gets really angry and use to use centraben but I don't think it worked very well for her.

Hope you manage to get in under control soon

May09Bump Tue 18-Jun-13 20:30:13

This is what helps my son - he had it from birth, now 4 and clear except for a bit behind knees in summer.

washing - we use method liquid free and clear.
bath - was advised nightly bath with oilatum junior (bathing in ordinary water dries skin out) to reduce bacteria loading. If skin is getting infected dermol bath too - start off using half recommended dose as you need to find how much works for your LO.
Emollient - Epiderm (double base caused eczema to flare for my son) and put it on as often as possible. Big coat of it after bath and before bed.
Medicine - eumovate and antibiotics if infected. Piriton if itching stopping sleep.
Temperature - keep as cool as possible.
clothing - cotton clothes and scratch sleeves for night.
Allergies - get referral to allergy consultant for a blood test, which can test for more allergens than the skin prick and also the severity. My son has multiple allergies.

It is horrible dealing with it all and not pleasant for LO - totally feel for you x Fingers crossed you are able to stabilize it and a lot of kids do grow out of it!

chickensaladagain Tue 18-Jun-13 20:33:22

I wish they did scratch sleeves for 9 year olds!

Sommink Tue 18-Jun-13 20:33:36

I've had eczema all my life. I was eventually put on steroid tablets (36 a day to begin with) and it got rid of it almost overnight. I am very lucky now though have a fantastic gp and once I hit a certain level of eczema I get the tablets back straight away (it got to the point that I couldn't turn my head without my neck splitting open in 3 different places and my parents just let my sleep where I fell because it was so difficult to get comfortable). I would also suggest bathing less, it removes the natural oils in the skin. A good wash will do.

SizzleSazz Tue 18-Jun-13 20:39:48

DD1's was awful and got infected to the point her face was literally falling off (she was about 2.5). After about 3 visits to the docs and various rubbish creams, I ended up crying in front of a very young male GP blush. He gave us a referral to a dermatologist who gave us stronger steroids, recommended Epaderm and said we could go back direct to her at any point.

After short steroid applications for flare ups, the Epaderm actually worked to keep it at bay most of the time.

She grew out of it at about 4yrs old I think. Very relieved.

May09Bump Tue 18-Jun-13 23:08:33

Chicken - I think this company did large sizes and custom too - they definitely saved my son from a lot of scarring!

www.scratchsleeves.co.uk/

geologygirl Tue 18-Jun-13 23:20:32

Please stop using these steroid creams! I had eczema all through my childhood/teens. My gp gave me the strongest steroid cream available immediately. ..so of course that starts you on a vicious circle. My skin is now highly pigmented and thin in areas. All because of the steroids. My toddler had it but my gp recommended not using steroids because that's not solving the problem. If course if your child is crying and in pain then its a different story, but I used coconut and hemp oils. Brief baths every day or so. I also started him on a more alkaline diet. So no citrus fruits, less meats and plenty more veg, water etc. He still has milk in the evening but I did cut that down. I understand its very frustrating! He is now eczema free but I appreciate that everyone seems to have different triggers. I would definitely try to stop the steroids and try an alternative like hemp seed or coconut oil. You may find it affective.

Wheredidmyyouthgo Tue 18-Jun-13 23:21:31

Just to echo what others have said about not washing so frequently as you would do a non-eczema suffering child.

DD is 3.5, and I bath her maybe twice a week. This has gone up from once a week, but now she's at nursery for three days and does horse riding I've had to up it.

I know that most would bath a child that age every day, but I defy anyone who saw her knees, ankles, wrists and elbows (and sometimes her torso) to insist that she wash more often.

Thank goodness the past six months do appear to have been stable and she has not needed steroids. I never thought we would get to this stage, so hang in there. Really feel for you.

geologygirl Tue 18-Jun-13 23:21:44

Effective!

tootiredtothinkofanickname Wed 19-Jun-13 11:02:42

Geologygirl, no offence but this is pretty irresponsible advice. What works for you and your child might not work for a different child, and advising someone to cut down some food groups from the diet is not the way to go, IMO. Especially for a toddler, who has different nutritional needs. Also the authoritative tone with which you are advising the OP to stop the steroid creams... I completely agree that they should not be abused, but the steroids available now are different to the ones prescribed a while ago. Doctors think twice before prescribing strong steroids, and while I think a long term solution should be found if they are not working, the steroids shouldn't be dismissed like this. IMO it is preferable to use steroid cream for a few days, clear the flare up and then moisturise to keep the eczema at bay. Preferable to scratching and ending up with an infection. As for the hemp oil, this would be a big no no for my DS, who is allergic to nuts and seeds and could end up with a serious allergic reaction.

Referral to a dermatologist is key, IME GPs are not very good at dealing with eczema and very often recommend aqueous cream, which has been proven to make things worse in many cases. Also double rinsing everything and oats in the bath. What also worked for my DS is applying the moisturiser on damp skin, and letting it soak in rather than rub it in.

FALSEdichotomy Wed 19-Jun-13 19:19:50

My DC has eczema which we keep at bay by using eumavate, Aveeno, evaders, ceterazine. I ordered a pot of pure potion which is ok but is amazing on chapped and bleeding lips.

FALSEdichotomy Wed 19-Jun-13 19:20:25

Evaders?????? I mean epaderm

Kasterborous Wed 19-Jun-13 22:11:44

I would push for a referral to a dermatologist as there are other treatments to try. When my eczema gets really bad I use wet wraps which help me a lot.

Might also be worth getting in touch with the national eczema society. They have loads of useful information, you will be able to find them on the Internet.

I hope you get a bit more help soon

WLmum Wed 19-Jun-13 22:18:54

It's awful isn't it. I was at my wits end with dd2 who has suffered dreadfully not so long ago. Her skin has got loads better since I don't use any detergent in the washing machine (do her stuff separately). Also I would say every other day is too often for a bath - twice a week is plenty and get a good oil to go in it. Also find a sympathetic gp and get a hospital referral. I had to ask for the referral but my gp was supportive. Have seen the hospital paeds dr who has referred us on for food allergy testing. Keep badgering them!

Good luck to you both.

ClaireOB Wed 19-Jun-13 23:23:37

NICE guidance for eczema in children, indications for referral. Might be useful if you need to discuss referral for specialist advice with your GP.

A 3rd recommendation for scratchsleeves here!

Theyoniwayisnorthwards Thu 20-Jun-13 13:06:56

I went back and forth between GP and eczema nurse (which is where we were sent when we asked for referral to dermatologist). Eventually we went to see a paediatric dermatologist privately (dr Atherton at Great Ormond Street) and I wish I had done it from the start. We now see him once a year, he prescribes a mild steroid that is generally offered on the NHS and GP now prescribe on repeat prescription.

In terms of care our regime is a daily bath (in the evening) with no soap, then while he is still wet we slather DS in the simplest moisturiser which is 50/50 liquid paraffin in soft paraffin. It's like gloopy Vaseline and creates a barrier locking moisture in and irritants out. Also careful to keep short nails and scratch sleeves when he has a flare up.

Theyoniwayisnorthwards Thu 20-Jun-13 13:08:08

That should be NOT usually offered on the NHS!

topmum1 Thu 20-Jun-13 15:35:11

Thanks for all the advice. Will have a go at a few of them and think I will try and see a dermatolgist too.

acebaby Thu 20-Jun-13 17:02:40

the things that really helped DS2, who had severe eczema, was

1. Having the GP actually watch me applying the creams. It turns out that I was applying far too little steroid cream and also applying it after his other creams and that this was affecting its effectiveness. We had a wonderful GP at the time, and booked a double appointment for this.

2. Not stopping the steroid cream abruptly, but tapering off gradually over several days.

3. Treating his eczema very aggressively. When DS2 was your DC's age, I completely smothered him in moisturizer at least 6 times a day, so that we got through a large tub of aveeno every week! At the first sign of a flare up, I got going on the steroid cream.

4. Bathing only once a week and potty training as soon as I dared (DS2 had repeated infections in his nappy area sad).

The wonderful news is that severity of eczema in under 5s does not correlate with severity in older children. Although most children who have bad eczema when then are little will remain susceptible, it might be very mild. This is what has happened with DS2. When he was 16mo, I couldn't imagine him ever having clear skin, but his skin is beautiful now.

LatinForTelly Thu 20-Jun-13 23:49:02

I will 'fourth' hmm the use of scratchsleeves. And the itchybaby site that tuckingfits mentioned. www.itchybaby.co.uk

I think you need to find what works for you - epaderm was the best gloopy cream for us. We also used oats in a muslin when we bathed DS. And I swapped my fairy non bio for those washballs things you get - natural soapstones I think, in plastic spheres. They were fine - every bit as good as non-bio powder.

We also think that a cream sold on itchybaby called 'Hope's Relief' did wonders for DS's skin. It may have been a complete coincidence, but I don't think so. It was amazing for us, but it's really expensive. It may be worth trying and just seeing if it works for you.

Also, if you need suncream, the Badgers one on that site was fine for my DS. (He was one of the few who got worse in the summer, not the winter.) I promise I don't work for Itchybaby btw!

There have been threads on here too about putting Milton in the bath water. I know it seems completely counterintuitive, but I remember reading a research paper online about putting bleach in the bath of babies with eczema. Apparently it was so successful, they halted the trial so the placebo babies could have the bleach too confused. But when I mentioned this to our gp, he looked absolutely horrified, and obviously hadn't heard of it. I reckon it must tie in with the Milton thing though - do a search and see if it comes up.

Just quickly, both waitrose's baby botty butter (think some solidified veg oil and camomile) and their baby salve (solidified coconut oil) are good maintenance creams now my ds is no longer acute, but just needs to keep moisturised. They are not expensive - £2 or £3 I think.

ClaireOB Fri 21-Jun-13 14:17:57

regarding the bleach baths, there's a 2010 blog post by a respected US based allergy specialist here about the concept, giving links to the research.

salvadory Fri 21-Jun-13 14:36:49

Hit the eczema hard with a stronger steroid, we used betnovate and eumovate and it cleared what hydrocortisone had failed to touch.
It means we don't often use steroid often now, only in response to a flare. We also use Balneum cream every day morning and night and balneum bath oil in every bath. I bath my 18 month old DD every other day sometimes less although my South African dermatologist does not agree with the reduced number of baths theory (she is very confused by 'the British and their reluctance to bathe!?')
I am using goats milk with my DD but have not seen a real improvement following the switch (mind you she still eats a lot of cheese so if it is a dairy issue this wont be helping).
I bought scratch sleeves but never used them as discovered the eumovate at the same time.
However we were prescribed tubifast long sleeved vests and leggings which my DD used to wear/sleep in and little mitts which I taped on with surgical tape, this stopped scratching at night to a great extent.
She now has eczema behind her knees and in her elbow creases, back of neck and occasionally flares on her arms Andy legs but she is so much improved from this time last year.
Good luck it does get better, you're not alone, it is awful so I truly empathise.

ChocolateCremeEggBag Fri 21-Jun-13 22:58:29

I have had eczema since I was baby (now 36) and still use steroid creams.

I use Vagisil(!)when it gets so bad I want to Brillo pad my skin.
It has lidocaine in which gives me enough of a numbing to break the itch scratch cycle enough for me to at least sleep.
I get awful patches on my nipples (not Pagets I have been checked), eye lids and round mouth where I need to not scratch at all.

I have asked my GP about it and we considered that as long as I wasn't slapping it on all the time, it's meant for you nether regions so can"'t be too bad.
Maybe something to try in an emergency? Obviously I am not a dermatologist or remotely medically trained but I do find it really helps me

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