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To think that emoliants should be prescribed in far smaller amounts initally

(44 Posts)
ReallyTired Sat 06-Dec-14 19:29:59

dd has really bad ezcema and over the last few months she has been prescribed a range of emoliants to see what will help. She has been prescribed aquaous cream, doublebase, diprobase, dermol in 500g containers to try and help her. Dd has had best results with the diprobase and dermol. I can't help feeling that the sheer amounts of the emoliants we have have been prescribed has been a waste. If dd's ezcema does not clear up then we will see a dermalogist and might get prescribed more emoliants and steriods.

I would like the nhs to prescribe 100g pots when trying out an emoilant. If a patient really does not get results with a particular medication then it would be less of a waste of money. Maybe the GP could have a two part prescription. If emoliant A is a sucess then please cash in prescription B for big pot of emoliant A or make another appointment to discuss dratted ezcema.

Another gripe is that I would like better information on how to use the emoliants/ steriods prescribed so that dd's ezcema is beaten. We have no pets and use non bio washing powder. Dd wears cotton and I am not sure what is causing her ezcema.

OhYouBadBadKitten Sat 06-Dec-14 19:32:56

You are right. Those pots are huge and if you don't get on with one it's such a waste.

For my psoriasis my derm says to apply emollient. Leave for 20 mins, wipe off any thing visible then apply the steroids.

GothMummy Sat 06-Dec-14 19:36:08

I feel your annoyance! We have several huge pots of cream that have been prescribed and not worked for DD's skin.

jamaisjedors Sat 06-Dec-14 19:37:00

Emoliants really don't cost very much and you should be using large quantities which is why it's more cost-effective to prescribe and generally provide large pots of them.

You cannot heal (real atopic) eczema with just emolliants which is why none of those will be working alone.

I found the book www.amazon.co.uk/The-Eczema-Solution-Sue-Armstrong-Jones/dp/0091882842 - very useful as a life-long sufferer - it has in particular good advice about using steriods which I had been wrongly using all my life.

It's more geared to adults who are in the habit of scratching on top of atopic eczema but I found it fairly revolutionary in that it gave proper advice about how to use steriods properly so that they actually heal the eczema, instead of just using them for a bit until things are under control, and the skin is not actually healed, whereby it all flares up again at the slightest trigger.

imip Sat 06-Dec-14 19:38:33

Yanbu, I've buckets of the stuff. Only avenno works, and that's a pissy little tube!

JADS Sat 06-Dec-14 19:39:14

YANBU. We had this problem too until ds was referred to the nurse specialist at the hospital. Her entire office was full of different samples and we walked out of the appointment with lots of different 100 ml sized samples. They were brilliant for holiday too.

FatimaLovesBread Sat 06-Dec-14 19:43:49

I work for a company that manufactures some emollients. We don't really do them in smaller than 500g. Occasionally a smaller sample size tube but mainly 500g. It's more cost effective.
Plus I think the frequency you should be applying them, a 500g tube is needed. I know I'm guilty of not applying as frequently as I should

Allstoppedup Sat 06-Dec-14 19:44:58

I think that as it is such a low cost to produce and should initially be used in large amounts for an extended amount of time it's not always a bad thing.

DS had skin issues and I had to go back week on week due to the 250g doublebase dose given. It was needed all over at least twice a day and it ran out very quickly. I guess it should be assessed on a case by case basis but I have to assume it's probably cheaper in a large amount of cases to prescribe a large tub of cheap to produce product first off, than to have repeated appointments and Dr contact just for repeat prescriptions.

18yearstooold Sat 06-Dec-14 19:45:00

Dd gets through 500ml of dermol lotion every month

I don't understand doctors still prescribing E45 or aqueous as neither works for anyone I've ever met but other than that its much less cost effective to be producing different size tubs of emolient which is dirt cheap

Wowthishurtsalot Sat 06-Dec-14 19:46:22

YABU as mentioned above non steroidal emollients are to be applied liberally and are inexpensive to make.

As a lifelong exzema sufferer the best thing I did was flip side my diet and reintroduce foods slowly. Found out my (and also one of my dc's) triggers is citrus including tomatoes and an excessive amount of dairy also flares it up

Allstoppedup Sat 06-Dec-14 19:47:23

Meant to add, it must be frustrating to have lots of large tubs that don't work though! So I can see your point!grin

Wowthishurtsalot Sat 06-Dec-14 19:49:45

And by liberally I apply it as soon as my skin dries and feels even vaguely like it's going to itch.

ReallyTired Sat 06-Dec-14 19:50:37

dd has molluscum contagium as well as her ezcema. It is the first time in her life she has ever had ezcema and I am convinced that the molluscum virus is causing the ezcema flare up. My GP is not convinced though. At the moment we are using Clobetasol 0.05% cream as a steriod, diprobase as our emoliant and dermol for washing. We use the steriod for 7 days and the ezcema clears up, but returns within 3 days. I am putting diprobase on dd twice a day. I think that the steriod is making the molluscum spots spread.

That looks a really good book. Its a pretty that they don't prescribe the book. I have never had ezcema and ds's ezcema was trival.

I would like a leaflet giving instructions on how best to use all these creams and steriods etc. It feel so confusing! Prehaps the NHS would save a fortune if I was told how to use all the medications properly.

Fluffyears Sat 06-Dec-14 19:54:08

Look into diet as well. I find too much sugar makes me flare up. Things like oily fish, olives and avocado seem to help plus tons of water to keep skin hydrated.

addictedtosugar Sat 06-Dec-14 19:55:22

DH and I used up the emollients as general moisturiser on our legs.

imip we get aveeno cream in 300ml bottles. What are you using? The occasional time we get 100ml tubes ('cause the chemist has run out!), are great for holidays if we can save one.

WaitingForMe Sat 06-Dec-14 19:57:30

Aqueous is the only thing that works for my DS 18yearstooold. Does nothing for my own.

18yearstooold Sat 06-Dec-14 19:59:14

Really

My dd's eczema flares up massively every time she has a virus of any kind

I would want a stronger steroid really

ReallyTired Sat 06-Dec-14 20:02:22

Clobetasol is a medium potency steriod. My GP says that he would not want to prescribe anything more potent for a small child hence he will refer to a dermalogist if dd still has a problem in the new year.

FatimaLovesBread Sat 06-Dec-14 20:05:56

We went to the drs last week and I mentioned how DDs eczema patches didn't seem to be clearing up. He asked how often I was applying. I said once/twice a day, after baths etc. he said it really needs to be more frequent than that. If I change her nappy and her legs look dry then apply more as often as we can.
That was me told :-)

Wowthishurtsalot Sat 06-Dec-14 20:09:53

You really do need to be applying it as soon as the last lot has soaked in and the skin has gone back to normal. It seems excessive but that's the best way to use those creams

LionWings Sat 06-Dec-14 20:13:08

Reallytired our GP told us molloscum contagiosum causes dermatitis and gave us a printout that says the same. It also says that it will be worse and last longer in children with eczema

imip Sat 06-Dec-14 20:22:00

Addicted, our chemist always runs out!!! Still the bottles are not as big as the big emollient pots they they've tried to fob us off with first!

LionWings Sat 06-Dec-14 20:25:43

I found the Eczema Society had useful and practical advice

simbacatlivesagain Sat 06-Dec-14 20:31:47

one of my friends used to get gallons of E45 bath stuff on prescription for her children to handwash her jumpers.

Tinks42 Sat 06-Dec-14 20:46:09

Im with you on this to a certain extent but the thinking behind it i suppose that they are to be applied frequently and liberally as opposed to say hydrocortisone cream.

Son has had eczema since birth (now 17) and doesnt use any of these, there was a big hoohaa a while ago saying that aqueous cream actually has the opposite effect and dries the skin. Son has his very under control these days using oilatum in his bath and hydrocortisone when it starts to appear and annoyingly enough oilatum is given in small amounts confused - at his surgery, may not be the case at others.

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