I have NC'd because I don't think I've handled this right and I know Mumsnet can be rather unkind. I've put my big girl pants on but I ask you to keep in mind that I'm just a parent doing my best. This is super long.
So DS is just-turned 8. He is in Year 3 at school. He is generally fairly well behaved, he isn't an angel but no big issues - often needs to be told to do stuff several times, sometimes whines a bit, can get over excited and silly etc - usual stuff for his age. He is reasonably polite and, this aside, generally trustworthy.
Recently I've 'caught' him lying several times, always about the same, fairly serious issue. I feel upset about both things - upset that he isn't doing what he needs to (explained further on) and upset that he is lying so regularly and so well. I struggle to find the 'right' punishments - natural consequences don't seem to be appropriate here - and clearly what I'm doing isn't working because he lied again yesterday.
The issue: DS has a health condition that include eczema. His eczema is well managed (regime set out by dermatologist consultant) but if we/he doesn't care for it his skin become red, sore, inflamed and ultimately infected. He has had this strong regime for daily skin care since being an infant. Initially I/DH did all of it, then slowly we got him to take responsibility for more and more of it and this is all just about one step in the process - we still do/supervise various other bits. For the last year or so (might be closer to two years actually) he takes himself for a daily bath and uses his prescription cream as soap - this is a vital step in keeping his skin healthy. It's not hard to do and it only takes a couple of mins. So starting (I believe) about 6 months ago he skips this step whenever he thinks he can get away with it. This results in sore skin but not for a few weeks and he struggles to see the connection even though I have tried to explain. I can't just let him skip the cream and get sorer and sorer as a natural consequence - it would take months to get his skin back on track and would likely result in needing antibiotics.
I ask him directly, everyday, whether he has done his cream and he always claims that he has. Sometimes I press further and he always continues to say that he has - it is actually really quite hard to catch him out. Eventually when confronted by the lack of cream used, the red skin, the clean bath etc he admits that he didn't. On questioning he says that he 'just didn't want to'. He knows that he will get into trouble; he genuinely hates being punished but he just says that he 'really didn't want to do the cream' and that's it. He is often upset by the punishments - more on that next - but it doesn't seem to stop him doing it.
Punishments: I'm not sure what to do for the best honestly. I think i probably go to far but I really worry about his skin! As part of his underlying condition he is at high risk for serious skin infections and has narrowly avoided hospital several times. My go to is 'no treats' or 'no screens' for x amount of time. He is really upset by these - last time it was no treats and no screens for a week and he was in tears and saying that he feels 'so sad' on several days so I really thought it would sink in. But yesterday I caught him out again and he admitted that it had been several days. This time I've said the same again combined with sending him for a shower straight from school (rather than tv time first) and insisting he showers rather than baths (he loves baths). But just don't know what to do!
I have spoken to him about it at length, trying to really understand why and trying to get his input to a punishment that will be effective but he doesn't have much to say beyond what I've put above.
I wonder if the answer is that I have to keep supervising but for how long?? He has a sibling with additional needs and I could do without having to supervise this as well - this is one of the reasons that his current 'punishment' includes showering straight after school - his sibling is watching the tv and it's a better time for me to supervise but he definitely won't want to continue this.
Help!