School questioning child over ezcema

[skinschool]

My DC has eczema. They first got it as a toddler, it went away, then seemed to appear in their scalp. They are now nearly 11 and it reappeared (to start with on face) about 6 weeks ago.

It has spread quickly. It starts as small 'spots', which grow to about a 1-2p coin size. They have several over both arms, over their face (including eyelids now).

I've been in touch several times with the GP over this (not in person, via consult, which allows me to upload several photos).

We've been given hydrocortisone for the face and Eumovate for the body, we found E45 cream worked well, so had that too.

We were told to wean off the steroids on Friday, due to their long use, despite new 'spots' appearing.

I put on steroid cream last night (we are using EOD for the next week), and this morning when I put on the E45 they cried and I noticed the patches were far more red (and new ones on the face).

The school phoned me, concerned about the red patches they have and wanted me to look. I explained they were eczema and we were following medical advice. I went in and they just got me to look at the patches. DC told me they felt uncomfortable as they were asked lots of questions, I don't know what, but DC said they were "interrogated" and feel bad. We couldn't talk as were accompanied.

I don't know what they could be thinking? I suppose they may be thinking cigarette burns? Ringworm (a couple look similar, but they are NOT - I think it may be Discoid Eczema, but the GP has put Atopic on their notes).

I will ask DC when they get home, but I feel judged and a bit worried.

For context I do have severe anxiety and MH problems, which I've always worried could be used against me. I've also got a lot of bereavement with more expected in next few months, along with DC changing schools and wanting their face to look 'normal' before transition day, I'm jumping to conclusions.

You are definitely jumping to conclusions. The school just wants to know that a) it’s being treated, b) it’s not contiguous c) it wasn’t deliberately caused by the child or someone else or due to risk taking behaviour. You’ve done that so there is nothing to worry about.

I’m a secondary teacher and I’ve asked kids about injuries as part of safeguarding, general concerns and sometimes just making conversation and offering sympathy eg child in a cast. Only on a few occasions I’ve raised it as a concern to the safe guarding lead - one was for an obviously untreated infection and knowing the family they wouldn’t have sought medical advice unless told too by the school.

I understand. I've had similar when ds was the same age and had an allergy rash which the school thought were flea bites.

Thanks Fit.

@elliejjtiny I think that is the line they were going down. They asked about pets (and to be fair, the individual spots look like they could be flea bites, but they then grow and get scaly). They looked all over their body.

I checked one of my students’ very sore hands were eczema as I’ve seen self-harm injuries that look similar - it is eczema: no further issue or investigation required, and certainly no judgement on him or home, just would hate to dismiss a self-inflicted injury as a skin complaint and leave a struggling student without support.

I’m really sorry your child felt interrogated.

It’s is bad advice to wean off the steroids if the eczema is still active. The GP is hugely out of date. Steroid fear is a real problem. Active eczema is far more damaging to the skin long term than steroids long term.
If I were you I would pay to see a dermatologist to get on top of it as in the reality is most gps are poorly educated on the topic.

For what it’s worth will tell you what I use but obviously a derm that has looked at your son is better.
My son has dactacourt prescribed for the face ( hydrocortisone plus anti fungal) and he has it in an ointment form not a cream. For long term treatment for the face ( and we are talking if they need it for months not a few weeks) he has had pro topic prescribed in the past. This is not a steroid and needs to be prescribed by a dermatologist.
E45 has lanolin in it which some people are allergic too.
A more basic moisturiser like cetraban is a good idea or possible an ointment like epiderm.

I am sure the school meant well and will not be judging you harshly.

However, from your description, I was wondering if there is any chance this could be pityriasis rosea?

I had this with DS, in fact the (really shouty and unkind!) swimming teacher yelled at him when he was in reception to get out of the pool as he clearly had chickenpox. Luckily my mum was helping with swimming and could explain what it was.

He had eczema that sounded very similar-looks more like spots/disks/boils rather than an ‘in the creases’ type rash. The school are just doing their job and checking all is well. If I were you I’d take in any eczema clinic letter from the dermatologist you have with the diagnosis on (we had so many appointments over the years!) and ask if they want a copy for their files.

Thanks for all your advice.

DC has just told me that the teacher said that it didn't look like eczema, then got someone else to look at them, when they looked at the whole body.

I did think Pityriasis Rosea @thistimelastweek, my DS had this (he's a lot, lot older), I didn't remember his being so widespread though. This DC does have incredibly sensitive skin and also bruises easily (yes we were told of three small bruises on their thigh a few years ago, after they'd questioned DC about it, nothing else was said, which is lucky as when they were a toddler I consulted a GP about the amount of bruises).

They are saying that the spots don't look like eczema but look like bites and are itchy. Yes, they are itchy and I thought they were bites, but they all bubble up and then go flaky and much larger.

I will discuss going private with DH. I've got coconut oil and wondered if that would help, bizarrely I put Vaseline on and they have calmed down (I thought Vaseline was a no, no, but it seems to have calmed down the redness a bit.

Could this be linked to puberty at all? She is starting to develop breasts and hair all over (along with changing from a nice child to a demon teen overnight) - no Aunty Flo yet, thankfully.

We also have stress with a close family member dying last year and another in the last stages, so this has upset her. Also she is going to high school and it's worrying her, especially her skin.

I don't blame the school at all. I'm just worried.

We haven't seen a GP at all. I did the online consult, uploaded several photos and they called me. The time before last I was told she would see her, then she said she didn't need to. I don't know if it's worth talking to them again, seeing as the last contact was Friday?

@Howshouldibehave that swimming teacher sounds awful. It does sound similar, it is identical to the photos of Discoid/Nummular Eczema. She does have it on her eyelids and under her eyes, round her mouth, on her cheek, forehead and tons on her arms.

I've uploaded some photos of her patches. She has some on her eyelids and cheek too, but they show too much of her face.

I think puberty is a key time. I started with eczema at around 13/14 having never experienced it before.

@Carycy did you find it got better as you got older. It does seem to have coincided with the bodily changes.

I would push for dermatology. There is so much they can do for eczema. Also finding the right emollient and applying it V frequently and lots of it is vital.
Also worth checking out how you wash clothes etc. MI is an additive that can really cause eczema to flare up. It’s also in shower gel and shampoo. What do they wash with?
Some people find special eczema clothing (PJs?) a help. I knew one child who used to do a type of wet (eczema cream soaked?) bandaging.
Lots can help.

Those pictures look exactly like mine looked, and it was caused by skin allergies. Might that be something to investigate? Mine cleared up totally when I managed to clear my house of the allergens, though it took over a year, antibiotics, hydrocortisone ointment and pimecrolimos ointment (not together). It can still flare up if I get the wrong things on my skin - weirdly the eczema does not necessarily appear where the allergen touched me - and need hydrocortisone ointment to clear it up.

As for the teachers, they have to ask these questions. My dc all had blue birthmarks on their bums and thighs. One still had them when they started school. I was regularly invited in for a chat on days when they had had PE or swimming with a new member of staff. It's safeguarding, not judgemental. But some do it more sensitively than others.

@Wolfiefan Thank you. I think I will. I started using Non Bio, when that didn't work I bought some Surcare with no fragrance or other things in, it hasn't helped. She washes with Epaderm as I hoped stopping all soap would help, which hasn't at all. I will look into the clothing. The shampoo was sulfate/silicone/paraben free, but that hasn't helped and now she has red patches in part of her scalp, along with giant flakes, we've just started using Nizoral (which was prescribed) and I put some coconut oil on the red patches, which seems to help.

Puberty set mine and Ds 2 eczema off more.
He seems to have grown out of it more, but takes a lot of lot of allergy meds for other things.
Mine looks like your Dd on my arms legs and body at times. Not my face thank goodness, so easy for me to cover. Fexofenadine helps me stop scratching in my sleep and E45 anti itch cream sooths it well. I'm always reluctant to use steroids and use them sparingly in a few places.
I've been known to put vaseline on my hands and cotton gloves overnight, seems to work ok on me. Everyones skin is so different reacting to treaments in different ways.
I'm now Milk free (only 3 weeks in) I was hoping it would help my skin but so far no change.

@Dilbertian We do have a cat, but we've had her for years, I guess she could have developed a sensitivity. She is allergic to penicillin (diagnosed after she developed a rash after every dose), so she may be prone to allergies.

@FedUpAtHomeTroels I hope stopping milk works for you soon

If the non bio is liquid it may still have MI in it.
Emollient is different for everyone. My kids use Dermol. I use diprobase (about 10 times a day!) and my mum uses Doublebase.
Don’t panic about the cat. Maybe keep out of DCs room. Damp dusting is better. Groom cat outside. Wash hands after touching. Petal cleanse may help but I’ve not used it.
You have my sympathies. In my 40s mine is now so bad I’m on immunosuppressants.

Non bio makes my child's worse, agree with push for dermatology, gp fear on steroids is misplaced, whilst there are side effects, the side effects from uncontrolled eczema are worse. Have you tried piriotin?

Looks exactly like when I had discoid eczema

Its incredibly itchy and mine was quite sore

Sorry if you have mentioned antihistamines, but I suggest giving OTC piriton to help the itch

Do not wean the steroid- I needed a much stronger topical steroid than hydrocort

That looks my DSs eczema, school asked me about his as well during a flare. I just explained that sometimes the creams we use just stop being effective and we have to change to something else but that we were in contact with the GP about it and that was that.

The only thing that really helps DS skin is an extra rinse on the washing cycle. Sometimes DH puts a load in and forgets and it's really obvious before long.

My ds has suffered eczema since 1 week old, and now under control for several years. There were times his body and face was covered in eczema similar to your dd's, and it was very difficult time for him.
We are under allergy consultant, we were lucky enough to be referred to them since gp wasn't of any help.
I think the key is to find out what she is allergic to. Avoiding allergen makes big difference, though environmental allergen is hard to avoid. My ds never use any soap, and we wash clothes with minimal amount of non bio. Also wash the linen with very hot water to kill dust mites.

Moisturising the skin is key to keep the skin eczema free, so my ds put a lot of cream on everywhere, including clear skin.

How many children do you have, op? when I looked at the title I assumed 1, but reading your first post, I am confused. You keep saying 'they' so I am guessing twins, otherwise you would say 'son' or 'daughter'.

This is a good tip and it really works. Oil of Evening Primrose applied to the affected areas. A good idea to put it on at night after your child or children have bathed and are going to bed. At age 11 it can also be taken orally. Even if it isn't effective, it won't hurt, however it is marvellous.

Eczema is a real pain, discoid eczema can be atopic.

I've asked, after consulting with another member of staff, because I've suspected that the GP was fobbing Mum off (as well as the possible infections, bites, self harm or a worry that they haven't actually taken them to a doctor) and their symptoms needed looking into with more depth; sometimes I've been told that going back to the GP and saying 'The school has queried this' has been enough for a reluctant blood test or referral which has revealed a treatable but not minor condition.

I've also called home about the number of headaches, having checked with other staff about whether they seem able to see the board from where they sit - and children have come back wearing glasses shortly afterwards before now. My own shortsightedness was only picked up in school, as it was the only place where I needed to see things further away, for example. Somebody having particularly painful periods is another; they get told it's a normal part of being a woman, but sometimes you know they're having far more pain than is normal because you see so many of them and a child writhing around, vomiting and panting as though she's in transition is never having a normal, healthy period.

With the things you mention, I'd also hope you asked/insisted upon a dermatology referral to be certain of the cause, as Psoriasis can start off looking and feeling like that as well - mine certainly did. If something isn't properly diagnosed, it can't be properly treated - and using steroids isn't always stopped immediately these days, but GPs haven't necessarily caught up on the most recent protocols; my GP checked with a colleague before prescribing me a hair treatment and three separate types of steroid at differing strengths and ingredients for each part.

In short though, I wouldn't be offended or feel that they are judging her at all; they asked her about it because they care about her welfare and want to make sure that she gets helped.

Oh, and I'd deflea the cat with something that works from the vet, rather than the stuff from the pet shop, just in case it's an allergic reaction to flea saliva on top of a diagnosable skin condition.

No disrespect meant to the cat. Or you.