Skin prick tests for eczema problem?

[Jostones]

we are seeing a dermatologist/eczema specialist next week as my 10 month old ds has really bad eczema on his back, chin and chest and has flare ups every few days. I have been trying to do elimination tests with certain foods but he is still flaring up all the time. Do you think it is likely that they will do skin prick tests? Is it possible to determine the cause of eczema flare ups from these types of tests? I'm desperate to find the cause as he is suffering so much and will be so upset if they don't do any tests

They may do skin prick tests but I'm afraid it's a sad fact that childhood eczema often doesn't have a 'cause' that can be clearly identified. As much as us parents wish and hope that by cutting something out of their diet or changing washing powders our child's eczema will be magically cured, all too often this is simply not the case. Eczema is a horrible affliction but it CAN be managed. Going to see the paediatric dermatology nurse changed my son's life. He does have food allergies and these probably made his eczema worse as a baby but cutting out the foods he's allergic too didn't get rid of his eczema, much to my disappointment. However, a rigid skin care regime from the skin nurse worked wonders. Don't be horrified if they tell you to use quite a lot of steriod ointment at first, it's perfectly safe and will be reduced over time (we've all bee conditioned into thinking steriods are really bad but in fact the 'safe' levels are higher than most of us realise). The regime might involve applying emollients 5 times a day which is obviously bloody difficult but it is most definitely worth it. We're now down to 2 or 3 times a day and only have to use the steriod ointment about once a week. As soon as I spot the slightest hint of a flare up I'm on to it with the steriod like a flash, nipping it in the bud before it takes hold. I really hope you get the answers your looking for but don't be too disappointed if you don't, there is still hope and with the right help you will get your little one's eczema under control.

Thanks so much for your reply, the trouble is we have been through nearly all the creams (diprobase, double base, emulsifying lotion, aveeno) and nothing seems to work. I'm putting it on constantly and we must have been through 8 or so tubes of steroid cream. He scratches like crazy every night and is covered in blood every morning, especially since he has worked out how to get the socks off his hands. I have just ordered some scratch sleeves that I am hoping will help. His eczema is constant but he will suddenly get a massive flare up and will be 10 times as red and 10 times as itchy so I thought that something must be triggering it. If it was just ongoing eczema I could probably manage it with the creams but as soon as he has a flare up we are back where we started and we have to go through the days of it calming down and then eventually drying out and all peeling off. I don't want him to be allergic to something but if it means I can avoid certain things and make him better than it would be so much better. I do understand that it could be something that he has to grow out of. My ds had mild eczema and grew out if it by the time she was 2 but this just seems like something else altogether. Do you think it's possible to have flare ups that aren't caused by anything in particular?

Btw, his flare ups are every 4 or 5 days, sometimes more frequent

I totally understand how horrible it is to see your little one suffering so much. I remember numerous mornings finding my son's cot covered in blood from the scratching and having to literally peel his trousers off his legs where the backs of his knees wept so much they'd stuck to him. I think you should wait and see what the dermatologist says. They might prescribe a stronger steroid cream to use twice a day to begin with (hydrocortisone is really low dose, if that's what you've using, and has never really worked for my son, no matter how much I used but Eumovate and Cutivate do the job). Hopefully they will also give you lots of advice like waiting 30 mins between applying steriod and emollient, bathing every night in Dermol (or similar) and NEVER using shampoo/soap, keeping the bedroom really quite cold and never having the radiator on (sounds cruel but you can always add extra blankets), putting a cup of water in the bedroom (on a shelf out of reach) to stop air drying out skin etc. I used to buy the sleep suits with fold over scratch mitts as these were harder to get off. Marks & Spencer, Next, Matalan and sometimes Asda used to sell them but haven't bought any for a long time now! Hopefully, you will find a particular trigger for your son's eczema but the skin nurse told me that almost anything can trigger a flare up, especially a cold or any form of illness and most of the time, we never know what has caused a flare up. My daughter had 'normal' baby eczema that she has mostly outgrown now but she never had anything like my son's flare ups. Children with severe eczema are also very prone to skin infections too so the dermatologist will probably check to make sure your little one's eczema is not infected as this prevents healing. Good luck and let us know how it goes x

Just thought of another important bit of advice. When a flare happens, you need to keep using steriod for at least 3-4 days after it 'disappears' as the lower layers of skin take longer to heal and if you stop, the eczema will flare again withing a few days because it won't have truly gone in the first place. Only thought of it now as my son has had a flare recently and we're now at the 'non-visible' stage but know I have to keep using steroid for a few more days yet. Hope this helps x

Thanks again, it's all really useful advice. I do tend to bit a bit stingey with the steroid cream, even though I've been told loads of times it is fine for him to have it regularly. You are right, he is using hydrocortisone but we do have some eumovate from when he had impetigo, but havent yet been asked to use this or his normal eczema. I have put some on tonight to see if it makes a difference. His eczema has never disappeared since it started so maybe we are never totally clearing it and it is causing more flares, which you suggested. I have just bought quite a lot of organic clothes to see if it makes a difference. The sleep suits that I have bought from frugi have scratch mits built in, I just need to get around to altering them to take the feet off so he can crawl properly. His eczema on his head has been infected before and he had to go on anti biotics. He breaks the skin so much it could get infected at any time. Thanks again or your help, I really appreciate it

Had a really good night last night and ds slept until 5am, which is very rare these days. He still had his socks on so he probably wasn't scratching too much. Guess the stronger steroid cream made a difference. I'd better hold off it a bit as I haven't been told to use it regularly yet. I'll see what they say next week but could be the answer

Yay! What a difference a good night's sleep can make to our general feeling of well-being eh? I think you're right about checking with the dermatologist before you use too much of the Eumovate just in case - I don't want to be responsible for encouraging you to ignore medical advice! But hopefully it might be the answer in the long run.

Hi,
Maybe worth reading my thread .... re preservatives/artificialcolours etc.. worth a read/consideration..

Hope he gets better soon

Thanks mytime777, you have prompted a massive baby food cooking session and the ditching of all the bought baby food that I use when I run out of home cooked stuff from the freezer (which happens a lot recently).

In other news I tried ds with a small mouthful of scrambled egg tonight (he has been off dairy and egg for the last few weeks) and after a few minutes he started rubbing his eyes like crazy and scratching his head. His face went all blotchy and his eyes looked really sore. I was really shocked at his reaction. I wanted to try egg as we are seeing the eczema specialist on Thursday (for the first time) and I wanted to test one of the obvious allergens so she couldn't just send us away and ask us to try it at home. The trouble is I hadn't really thought it through and suddenly remembered that I couldn't give him piriton in case he has tests. I was only expecting his eczema to get worse, I didn't expect such a strong reaction :(

A dose of piriton tonight is unlikely to affect skin prick tests on thursday. It is quite short acting. It is better to dampen down the reaction. I hope he's feeling better now...

I find that the hardest part about skin prick tests, no antihistamine for 7 days beforehand??? - virtually impossible! My DS has to have Piriton almost every time we go anywhere that involves kids and/or food so only option is to stay in the house for a week!!!! Not very practical. I agree that half a spoonful of Piriton is prob not going to make much difference and better than seeing your DS suffering. Good luck for Thurs.

His skin calmed down after half an hour or so, so I decided not to risk it affecting the tests but was a bit worried that he would have a delayed (more serious) reaction so really regretted giving him the egg (and milk that it was made with). I have been checking him in bed regularly and he seems fairly normal. Freefrommum - I can imagine how difficult it must be to keep off piriton if you lo has bad reactions to everything, I think I'd stay in before tests too.

Had a really bad night with ds scratching and unsettled. He was wide awake at 4.45am (which is normal these days) but he was totally inconsolable and refused his breakfast and just cried and cried (which isn't normal). Is this typical of what happens the morning after an allergic reaction or do they normally just bounce back? He struggled to sleep when he went back for his nap but is now spark out in the car

I had skin prick tests myself and didnt have to refrain from anti histamine. I still had a positive reaction to pollen, and other allergens!

Hope he gets o ok at the specialist. Dot let them fob u off or tell u "it's your washing detergent!!" which they love to put a number of allergies down to!!

We have our dermatology appointment today for ds, but his skin has never looked better! We have been using a lot of steroid cream after the recent egg related flare up so it isn't as red and dry as usual. Luckily we have lots of photos of his bad days so we're hoping they will look at those and realise how bad it can get. I also have the food diary that I have been keeping over the last few weeks (and many stories of sleepless nights and lots of scratching and bleeding). I'll let you know what happens

We saw the eczema nurse today and at first she was really concerned about the massive area of red skin on his chest as it was so big and not patchy like normal eczema. She called in the doctor to rule out a skin disease but she said she thought it probably was eczema, just a really bad case of it. I told her about taking him off dairy, gluten and egg and she said to put him back on dairy and eventually gluten as it was unlikely to be that if he was still flaring up. She said he was probably allergic to egg and to avoid it until he is 18 months.

She worked out a combination of creams that she thought would work best (dermol to wash, aveeno as a cream 5 - 8 times a day, hydrocortisone for his chin and head and eumovate for his body). She said we needed to clear the eczema totally then see if he has flare ups and look at the food issue again if we need to. I was hoping for tests but the new cream regime seems to make sense, although I'm surprised she suggested going back to dairy before the skin had cleared up.

He had follow on aptamil this afternoon and this evening and doesn't seem to have had a reaction which is good. It will be amazing if his skin goes back to normal, I have never once managed to clear it since it started 5 months ago. I won't recognise him!

freefrommum - just realised how similar your advice was! It's good to know that the regime has worked for someone else. I'm feeling quite positive about it, even though I thought I'd be disappointed if I was just given more creams

That's good news. Let's hope it works as well as it did for my son. It may take a little while but stick with it x

We have been following the skincare regime from the eczema nurse and she recommended about 5 days for the eumovate but said we needed to carry on for a couple of days after the redness goes. It has taken 2 weeks for this to happen instead of the 5 days that she suggested and we stopped using steroid cream 2 days ago. Today my ds is already starting to go red on his chin and chest and I'm worried that he will be back where he started in a few days. It doesn't seem right that he should go straight back to having eczema as soon as we stop the steriod cream. I got the impression that using stronger steroid cream would mean that we just using it for a short spell then use it again for any flare ups that occur later down the line, rather than 2 days down the line. I'm just worried that something he is eating is causing this and the cream is just keeping it at bay. He is back on dairy and gluten but I'm still not confident that they aren't causing problems. If we have to use eumovate ALL the time to keep it at bay does it mean that there is an underlying problem?

I think you need to give the eczema nurse a ring and maybe arrange another apptointment if it's not clearning up properly. Btw did they swab his skin to test for infection? Children with eczema are more prone to skin infections and until these are treated, the eczema won't heal properly so maybe this could be the problem?

We have a follow up appointment on Thursday luckily so I will be able to chat to her then. They didn't swab his skin for infection. Would the skin need to be broken for there to be an infection? It wasn't looking too bad when we saw the nurse last and the skin wasn't broken. We got it back to perfect (for the first time ever) but it is now looking red again. I seem to remember them saying they weren't worried about infection.

Don't think the skin needs to be broken for infection (not sure tho!) but if they said they weren't worried about infection then I assume they must've been pretty sure it wasn't infected. Good luck on Thursday. It might just be that it's going to take a bit longer to get his eczema under control than they originally thought. And they always have flare ups for no apparent reason, particularly in warm weather so don't lose hope x