3 year old daughter has terrible eczema...

[pleasantlyconfused]

Help! We use hydrous cream, dermol and hydrocortisone yet by mid morning she is still scratching herself silly. She is only three but cries now when she sees her arms (the worst of it) and refuses to wear short sleeves. Can I get allergy testing on the NHS?Can I use anything else? The GP has been dealing with it, am I being too pushy to ask for an actual dermatology referral?

No - definitely ask for a referral. My friend's daughter had terrible eczema and their specialist really tackled it head on. I have no recent experience myself, but I get the distinct impression that GPs dabble too much with eczema.

Yes ask for a referral, sometimes GPs are just not specialist enough or are actually too cautious about prescribing.

Definitely ask for a referal to a paediatric dermatologist There are plenty of other treatments to try to help get it under control

Allergy testing can be done but isn't always very helpful most irritants are impossible to avoid completely ie house dust mite and often it's multiple things that irritate the skin.

Use cotton clothes, cotton bedding, air the room and bedding daily don't have the house too hot and particularly her bedroom all these things can help and just keep applying the moisturiser as often as possible The moisturise not only helps re hydrate the skin but also creates a barrier to prevent the irritants getting to the skin.

Have you looked at the eczema society website really good information and support there.

Hope things improve People often don't think eczema is much of a problem but when you see your child upset or in pain every day it's really hard.

Good luck

Hi. Hydrocortisone is the mildest steroid, so maybe she needs something stronger. The doctor can prescribe that until you see a dermatologist (the wait is a year round here). Or there are alternative treatments such as homeopaths/ naturopaths, but I haven't tried those for my ds.

Also, you can try washing clothes with 'soap nuts'. Don't use any soap on her and avoid strong detergents eg. in the bath, toilet etc. and too much kitchen spraying! Definitely no biological powder or softener, but I'm sure you already avoid. For my ds, the washing powder made a huge difference when it was at its worst.

Thanks everyone! Yes we use surcare and try to avoid all nasties, but it is hard. I think the hardest thing is seeing her crying though. We're in London so I imagine the wait is long,but you've given me a bit more confidence to be pushy, so we are off to the docs today to ask for a referral. Really appreciate the support and great ideas.

Pleasantlyconfused - as others say, British GPs are not very good at treating eczema.

Are you meticulous about hygiene - do you give your DD a daily shower with a soothing body wash, clean clothes all over every day, keep her room ultra clean with anti-allergen bedding and no carpets/curtains?

I hope it goes well for you today PleasentlyConfused. It's hard for a mum to see her child upset. they can do tests to help you figure out what ismaking her skin flair up. it could be washing power, even sometimes the cream you are putting on to help... My DD is three and she is allergic to doublebase cream. we had to switch to another. best of luck,and you are definitely not wrong to demand better care for your baby :)

I feel for you Pleasantly Confused, my ds is finally growing out of his eczema after 4 very hard years. Do ask for a referral and don't be fobbed off. GP's are often not great with eczema.

It's very hard giving advice because what works for one doesn't work for another. I found limiting baths/showers to 2/3 times a week helped and stopping using Surcare seemed to make a difference, I use Filleti now instead. Regular vacuuming and keeping the dust down is good but I know ds definitely has a dustmite allergy, your dd may not but it's worth a try.

Also stronger steroids are sometimes more effective than long term use of milder ones. I hated using them but they are sometimes necessary.

Good luck - I know how awful it is to deal with.

Pleasantlyconfused, you might be pleasantly surprised about the wait. I had a referral to a hospital not that long ago that took only 2 weeks. And I wonder if you could get referred to GOSH. That's where my friend took her DD and she thought the consultant she met was excellent.

I would push for the allergy testing and see a homeopath as well (if money not a problem)
A friend's daughter had bad eczema and nothing worked until they saw a homeopath.Good luck.

I don't know if Oilatum bath oil is recommended for small children these days (its just a soothing oil to go in the bathwater, so I suspect probably ok, tho you'd need to check) - but I found it very soothing when I had bad eczema as a child.

Re. the short sleeves thing, you might want to tactfully make sure that no-one at her nursery/childminders if she goes to one is commenting / making a thing of the eczema.

It probably doesn't help now, but I believe it is quite common for children to grow out of eczema - mine certainly got much less severe after puberty.

Of course you also get better at identifying triggers over time - mine include all soaps and soap substitutes (I use aqueous cream to get dirt off my hands, but nothing else anywhere), bubble baths, most cosmetics, most non 'eco' washing powders, but everyone's is different. Mine sounds like quite a long list but is in practice extremely easy to deal with.

Ds1 has had to have his hands bandaged for a few months and it helped hugely in reducing the damage done by scratching. Getting them out more now that he is less itchy.

Definitely push for a referral and a paediatric dermatologist makes a huge difference. We had a non-paediatric one for months and his skin improved a bit but still bad. Been to the paeds one for a few weeks and his skin is improving in leaps and bounds.

My DD finds Cicabio amazingly soothing and healing for eczema. I really recommend it. Also use a good body wash, http://www.bioderma.com/en/nc/the-products/what-s-new/product/action/1186.html ABCDerm Ato+.

Hello, was hoping for some advice as my 4yo has been suffering with severe eczema for about 9 months now. She has always had sensative skin and the eczema broke out around 2 or so years ago but got really bad about 9 months ago (scratching until bleeding etc). During the day she is very controlled and will tell me if she is itchy and we will apply her cream (which we do a min of twice a day as routine), and if there are any particularly bad areas we will use her steroid cream.

But the night time is so hard to control, every time I see my GP the just give me more cream and antihistemines to help her sleep!
I have used the antihistemines at times when she has been uncomfortable and sometimes it helps, but like last night it did nothing at all and we were up all night with her scratching.

I am dreading the arrival of summer (still a way off I know) as the heat last year was horrific for her skin.
My GP will not refer us to a dermatologist or send her for allergy tests, as we should have a good idea what she could be allergic to. We did the cutting out of the usual suspects with a slow re-introduction.
She is fine with dairy and citrus now although we did see a huge improvement when we did cut it out. After 4 months or so we bagan re-introducing it without any problems. Her eczema didn't disappear during the absence of the dairy and citrus but has been better since we did the period of absence.

I am 8 weeks pregnant and finding myself exremely tired as you do in pregnancy, and the lack of sleep due to DD's discomfort is really taking its toll. I also have another DD aged 3 who is brilliant at bedtime, but has now begun having nightmares... am so tired!

Any help/advice for bedtime bliss would be very much appreciated. Is she too old to see the Health Visitor for advice?

NatzCNL - can't you see a different GP? why won't your refer?

I have seen another GP, but they have said that the GP I saw origionally is the specialist in dermatology at the surgery and as he decided we didn't need a referral they wont send us either.

TBH during the day the management of her eczema is fine, she will ask for cream if she is itchy but at night time she still scratches away. We have tried mitts and bandaging up her hands but she just gets hysterical or pulls them off. I am almost sure it is more to do with habit, but would she still be scratching if it didn't itch?

@NatzCNL,
NICE published guidance on atopic eczema in children under 12 in 2007 and one of the reasons given for referral is if the parent or child feel the condition is not being controlled satisfactorily. Here, large pdf I'm afraid, referral guidelines in chapter 10

Having disturbed nights such as you describe would suggest that control is not satisfactory. The GP you mention might be a GP with special interest in dermatology, which is not the same thing as a consultant dermatologist. And if you can be referred to a paediatric dermatology dept, there would also be paediatric dermatology nurses, who can show you how to use the medications and techniques to best effect. Given that your DD is having broken nights which are having a toll on the rest of the family, plus that you are pregnant, I would push for a referral.

Thanks Claire08, I will make another appointment with GP as I didn't feel I could keep pushing for a referral. You are right, with her sleep pattern it just isn't fair on anyone. DP and I are constantly tired and snapping at eachother, as well as the toll it takes on DD as her skin is worse after a bad nights sleep, not to mention the fact that she is also very tired!

Thanks for the confidence boost, dont feel like a nurotic mum who is kicking up a fuss over nothing!

Quick update, saw the GP again today, spent a good half an hour telling how unhappy I was with the way things are. I asked if we could be referred to Dermatologist, BUT he said he wanted to put her on a course of antibiotics for a week with stronger steroids, to continue with the antihistemines and Dermol cream then go back in a week to see how things are, and he also took a skin swab. He did however agree to refer her to a paedeatrician (spelling?) because she is very small for her age and he is concerned about her weight....
She has always been small, the same as I was as a child and my mum before me (she weighed 6 1/2st when she got married aged 20, and when I was 20 I weighed under 8st, just small people) All changed since Ive had kids, but I have no concerns about her weight. Although I do believe her eczema is related to her diet (loves fruit, all fruit and eats loads of it). So Im happy to see a peadeatrician as they may be able to help with the eczema.... DP is coming with me next week to the GP as I feel like my concerns are never taken seriously unless he is with me

Well, one cheer in that you are at least getting a referral to a paediatrician. I hope it's helpful. I'm aware that some parts of the country have long waiting lists for paediatric dermatology referrals, maybe that is an issue. I know it certainly can be for parents asking for paediatric allergy referrals. Taking DP along is a good idea, also write down a list of your concerns so that you cover everything during the appointment.

The National Eczema Society has a helpline here - you can either phone or email,phoneline is an 0800 number, open 8am-8pm Mon-Fri. It might be helpful to contact them before your next appointment.

Good luck,
Claire

Something else which occurs to me: if your GP is worried about your daughter's growth, surey having a lot of broken nights due to troublesome eczema won't be helping, if indeed there is an issue here. Sleep is important for children's growth and development. So you could argue that getting her itchy skin sorted out more effectively should help on that front.

Thank you so much for the help you have given Claire, I will ring them tomorrow when the girls are at pre-school (3 hours of no distraction!).
I told him I was concerned about the effect of broken sleep and some time very little sleep was having on her daily life and appetite. Looking back on her growth chart, she weighs pretty much the same as this time 9 months ago, which incidentally is when the eczema really came out in force and the sleep got disrupted! So I will go armed with that to the paediatrician and the GP.
Thank you again for your support, I will let you know how we get on

I'm not saying this could solve your problems, but when my DD had really bad eczema and the doctors were just prescribing steriods and cream after cream and bandaging her up. I heard from another mum that cutting dairy out might help. It had cured her daughter.

So for 2 weeks I had to COMPLETELY cut out everything dairy - not easy.

Then I was gradually reintroducing it to see the effect.

After 2 weeks the difference was amazing. It turned out that she could eat cows cheese, but cows milk would bring her up within 24 hours scratching again.

So goats milk it was for about 6 months, but she could eat yogurt, cheese, butter. Don't ask why, but there is something in the milk that isn't in the other products, even though they are made from cows milk.

Then one day tried her on cows milk again and no reaction this time. 2 years later and she only has very mild eczema now, no creams or anything.

We're putting it down to a build up of cows milk nasties in her diet, and her body just needed a break.

Talked to my HV about it afterwards and she swears by cutting out dairy for 2 weeks, she has adult friends it has made a difference to as well.

Just a thought, I know everyone is different.
Good luck.

Thanks for the advice ILJD, it's something that was suggested to us back in the earlier days of eczema. I cut out all dairy for about a month and substituted with soya, but after DD begging and pleading to have the 'nice milk again' we began re-introducing it. There wasn't a huge difference in her eczema to be honest from cutting it out, although we did see some improvement.

We also did the same with citrus fruit and drinks, we saw a greater improvement in that. She had no citrus at all for 4 months I think? Then we began allowing her a glass of orange juice a week, the occassional orange segment, and there was no reaction to it. The reason we cut it out in the first place is because she would go into manic scratching episodes about half an hour after digesting any citrus. Not an allergic reaction but definately a sensativity to it.

The other GP we saw said she is hypersenstive which is just a recepie for skin problems. Although all of these 'diagnosis' have been made by observation alone, no testing or anything like that. I am hoping the skin swab will show something. That way I will have some idea of how to treat it.

Have begun the food diary (bad day to start it as not the best meal plan for today, plus biscuits for snack instead of usual grapes and strawberries, Tesco needs a visit!). It's been a long raod to getting a referral and I have no doubt it will still be a long road ahead of us once the Paediatrician is on board. here is to parenthood and all its challenges