Toddler with severe hand eczema. Help!

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Would love to hear any experiences. My 2yo has such bad eczema on her fingertips and the heels of her palms. They are so cracked and red. Hydrocortisone didn’t touch it so dr prescribed a strong steroid which almost cleared it up but it was too strong to use long term so it has just got worse again.

I don’t know what to do. She only ever washes her hands with moisturiser and water. We apply her moisturiser (zeroderm) throughout the day and try to get her to wear cotton gloves when she will tolerate them. I’m back to using the steroid intermittently.

Any advice would be great. We are in regular touch with the GP and following his advice but I’m hoping any tips from parents who have been through the same.

Oats are a definite help, soothe and prevent itching. Soak a handful in water strain out and let her play with the liquid for five minutes or so until all the itching is covered. Pat dry and apply Aveeno.

My youngest DD has eczema on her elbow crease and my mum suggested Sudocream and it has worked a treat.

Def a dermatologist referral though as others have suggested.

My son had the same OP. He's 4 now and it's under control on his hands.

They looked like the hands of an 80 year old- scaly, cracked and bleeding all the time.

We saw the children's dermatologist who gave us the strong steroids and basically said to use it for a week at a time when you see any flare up until it's completely gone. Don't be scared to use it as short bursts on intense use are fine and the only thing that will clear it once it's there.

We use a heavy ointment (hydromol) twice before bed and also use it as a wash.

We left cream at nursery for his hands and leave one at the school now for his hands and face, they're happy to help him with it.

All eczema is different but we found chocolate caused flare ups despite him not having any allergies.
We stopped chocolate completely and his hands cleared up and have stayed clear for a year but we still slather on the ointment regularly.

Poor little poppet :(

My daughter’s an adult now, but has had eczema since she was 6 weeks old, so I sympathise completely. (She’s was awkward to diagnose, having allergic reactions everything including the control test patch 😆).

Try cutting out stearates (common in most soaps, emollient creams as it helps emulsify oils into products). We used gallons of Cetreben, only for her Professor (after another long stay in hospital) having a flash of inspiration & shouting “Stearate! It’s Stearates!” to his posse one ward round.

It helped. We used petroleum jelly (and she still does) under wraps/gloves/as a general moisturiser.

Elacom is great as a ‘quick burst’ steroid, along with Fucibet or Fucidin, whichever the antibiotic one is (!) along with Tacrolimus if things are really bad & Icthypaste wraps. A little Aveeno cream rubbed on & washed off instead of soap for handwashing (takes longer, especially if they’ve been digging up earthworms, again). And an old tight filled with cheapo oats in the bath is surprisingly good at soaking off Sharpie, mud, paint etc.

A word of warning. A toddler covered in petroleum jelly is more slippery than Cummings in a rose garden press conference. Buy lots of towel as it gets everywhere & is a useful tool to get a grip on them if they’ve escaped giggling from a bath, freshly jellied & are nude streaking around your house...

Also the usual advice of no fabric softener, non bio detergent only.

I really hope you little one finds some relief. And that you do too.

Thank you all so much. We went through all the allergies when she was younger and she doesn’t seem to have any.

I did apply a very strong steroid for 2 weeks straight and it didn’t quite clear it up so im not sure that using it for a week here and there would help at all. Maybe I need a different steroid?

The steroid cream my son has is mometasone and it works really well for him.
Which one do you have?

Yes my daughter had Mometasone too and it worked amazingly.

If you are just using over the counter steroids they are not as strong.

How the derm explained it to me was this - go in hard with stronger steroids that will clear it up more quickly, once cleared moisturise moisturise - I used epaderm too including as soap in the bath. Then you have more chance of preventing flare ups if you get the skin back to normal particularly in the winter. As soon as I saw a small patch developing I would go in with mometasone, clear it up quickly then moisturise well.

I found in the long term despite the steroids being stronger I used less this way overall - no long term effects, at 12 her skin is lovely!

Some great advice on here.

DD has eczema too and the main problem I have is getting her to actually put the damn moisturiser on. She hates it! She will be 4 in January... It was easy to butter her in it when she was 2!

Does anyone have any tips for this?

I use Enstilar (steroid & vit D) and the key to using ANY steroid cream is to reduce use gradually, not to just stop.

It's like a 'weaning off' process. It's crucial. Otherwise you just stop and the eczema/dermatitis quickly flares up again, sometimes more severely than before.

It might not be so helpful if it's just her hands, but for night time I've always Scratchsleeves for both my daughters and found them very good.

I'm currently using Eumovate for my youngests hands and other flare ups, which clears it but only for a day or so.

@JamieLeeCurtains that is a really good tip. Would you decrease use with same steroid on alternate days or step down to hydrocortisone for a few days then stop?

[quote Fleetwoodmacs]@JamieLeeCurtains that is a really good tip. Would you decrease use with same steroid on alternate days or step down to hydrocortisone for a few days then stop?[/quote]
The best dermatologist I ever had advised that any steroid should be used every day until healing is really noticeable (which could be up to 4 weeks), then switch to every other day for a couple of weeks, then twice a week, then weekly, then fortnightly / switch down to hydrocortisone / stop.

I keep diaries! I have psoriasis as well so I do have to be meticulous about meds and treatments.

I think people are scared of topical steroids because they get the scare stories but don't get decent advice about using them most efficiently.

Aveeno baby, blue and white tube. Widely available Boots, used to buy American import on Amazon

The cream coloured tube version isn’t so good.

Steroid/ antibiotic, if infected

Try to find something with Finger Lime Caviar. It's an Australian botanical and there's a study on it that showed great results for eczema.

My son has had bouts of eczema since 1 year old. We was prescribed Elocon cream, which is a steroid cream and quite strong. It really works well. He’s 24 now and still using it occasionally with each flare up he gets. The GPs have tried over the years to get him to try a cheaper brand, but we find he can control his eczema well with this cream, along with other moisturisers and shower/soaps.

DD had horrific eczema as a baby (allergy related) and the consultant dermatologist at GOSH told us it's better to use a stronger steroid until it's under control than a weaker one for longer. Only once it's healed over do you switch to lots and lots of moisturiser, which acts as a barrier to protect the skin.

I would get a second opinion on stopping the stromger steroid cream. If she needs it she needs it and it sounds like the GP is a bit steroid phobic which goes against current attitudes towards eczema treatment.

Moisturise, moisturise, moisturise.
Put cream on before she goes to sleep.
Put cream on before she goes outside, and gloves when it’s even slightly cold.
Cream after every hand wash.

It may have changed but a few years ago I was given Zeroderm instead of my usual cream as it was no longer available on prescription. I wasn’t thinking and thoughts it was just renamed so used it. Big mistake as it had lanolin in it. It was more than 6 months before I got things under control again.
The problem with eczema (and I have had it since birth) is that what suits one person may be the worst thing in the world for the next. And what you have used for years may suddenly cause reactions. I used Oiletum quite happily as a child but when my daughter was prescribed it I ended up with a rash to my shoulders from bathing her!

And remember with the steroids to taper off of them and not stop suddenly as that can cause a rebound reaction.

This is what we did for my son. We didn't use steroids as he had a negative side effect. We just did a wet wrapping technique but topped it up a notch by using zinc powder. Do this regime at night!

Ingredients (lol)

1. Zinc powder non nano (can get from Amazon)

1. Eczema Ointment

1. Bandages

1. A dry layer over the hands (whether that's using socks or a specialist eczema sleeve which cover the hands.

Instructions:

1.Get zinc powder and mixed it with a reasonable amount of your child's eczema cream.

1. Lather the cream mix on your child's hands, very thickly.

1. Wet some bandages in luke warm water.

1. Use the wet bandages and wrap around them your child's hand.

1. Then use dry socks or a specialist eczema sleeve (which covers the hands) and put this over your child's hand.

Do this 5 days a week, for two weeks. You will see a difference. We had a very bad experience with steroids. So didn't use them

It was the Elocon steroid cream that we had a negative effect from. Since this day we refuse to use any steroid cream.

I've read good things about a Lush product called Dream Cream with regards to eczema-contains oat milk, chamomile and cocoa butter. It could be worth a try.

You could try the Calming Cream from Australian brand ‘Dolly & Friends’. I have friends who swear by it for eczema.

www.dollyandfriends.com.au/collections/skincare/products/moisturising-cream

I would second the advice to ask for dermatology referral, or if there’s a GP at the surgery with a special dermatology interest (often different GPs will have areas of expertise).
I would also second investigating the possibility of an atypical bacterial or a fungal infection.
Also listen to the steroid advice above, we were told that using steroid effectively is much better than lower amounts intermittently. You end up using less of it overall.

Keeping a record book if you have time might help you spot patterns of diet/weather/clothes/creams.

I've had eczema all my life but have kept it under control for the last few years - I use Simple moisturizing liquid soap and Lush Dream Cream (or Child's Farm moisturiser for something a bit lighter.)
As mentioned earlier in the thread, it's very possible that you're making things worse by constant moisturizing, if your child has developed a sensitivity to one of the ingredients - I can no longer use aqueous cream or petroleum jelly, for example. You mention that heat seems to trigger it, so gloves might be a bad idea. (I'm sensitive to my own sweat!)
Hope you manage to get a referral to a dermatologist who can find a solution to the acute flare ups, then going forward prevention is so much easier than curing an outbreak.