Eczema - 2 yo covered head to toe. What should I do?

[neolara]

I've already posted this over in health but thought I might get more responses over here.

My 2 yo dd had an allergic reaction to nuts about 2 weeks ago. Rash, swelling and hives that disappeared with piraton. About 48 hours later she was covered head to toe in eczema. Normally she has some eczema but this is clearly different as it is all over her body as opposed to isolated patches. (About 6 months ago she had a similar allergic reaction to raw tomatoes.)

As soon as the eczema started to develop (12 hours or so after the initial reaction) I applied betnavate. When I saw the GP, 36 hours after the reaction, she said to stop steroids and apply epaderm. Twelve hours after that the eczema had gone beserk so I ignored the GP's advice and started to reapply betnavate. I applied the betnavate in total for 6 days, as well as giving epaderm 2 or 3 times a day. DD has now been "off" steroids for about 4 days and she is covered, head to toe, in eczema. It looks pretty bad to me. Normally at this point I'd be giving steroids but I've just completed a run of nearly a week.

So, what do you think I should do? Obviously I need to go back to see the GP (appointment booked for thursday) but in the meantime should I carry on with epaderm and / or steroids. DD is scratching a lot and saying it hurts. She also has big bags under her eyes which makes me wonder if I should be giving her anti-histermine still. Any ideas would be great.

Hope your GP and the good old NHS will clear this up for dd. If not, and you can stomach the idea of private health care, try something like Nutritional Therapy. I've found it good for MS which has limited NHS treatment.

I would keep giving the anti histamine. She needs something to help with the itching - poor little thing.

My dd1 who is 5 now has eczema, allergies etc and has had flare ups like this on top of her regular patchy eczema.

I would be wary of applying the epaderm directly to the skin. We used it in the bath for dd but found it was too heavy to put directly on her.

What are you using in the bath? We are now using Hydrolmol and finding it very good.

We have never had much luck with emollients, everything seems to irritate her more so now we stick with warm baths with the Hydromol several times a week and steroid cream on the worst parts.

DD has used Benovate RD and it did work really well the first few times. However the last time I used it she seemed to get a reaction to it. We are waiting for an appointment to see an allergy specialist.

A cup of oatmeal/oats in a tepid bath can help, the pharmacy will have various short term, anti-itch creams and health food shops have an array of lotions which can work. Also use Surcare to wash her clothes.
I'm a bit wary of steroids on one so young for more than a few days.
Sory not to be more help. I feel for you.

I think I'd try the anti-histamine, because then if it calms down, you will know its an allergy. Also are you sure its eczema? yeast rash can be very widespread & will worsen with steroids.

Hope she is better soon, must be very uncomfortable.

I think some of the anti itch creams can't be used on younger children. There is a Eurax lotion which says check with doctor before using on child under 3. I've tried that on dd but it didn't help at all.

I think E45 have one too but not sure from what age it can be used.

Hi - have loads of experience with this. both my kids had similar reactions. It is probably a dairy / milk allergy. Cut out all dairy and switch to soya or rice milk. No cheese, yoghurt, chocolate, etc. Stop using all creams provided by doctor and get some natural creams, eg cocoa butter, calendula, hemp. Visit a homeopath who will talk you through it. In about a week your child's eczema will be on the decline. Sounds drastic but really works.

My ds2 also suffered terribly at about aged 2. Probably not practical, but just in case you are in the south of England, the only thing that gave him real lasting relief was a dip in the sea. Emmolients, steroid creams etc, keeping him cool all helped a bit, but a dip in the sea would take down the redness immediately and after a day or two he would be 1000 times better.

HTH - sending loads of sympathy. It's horrid for them when they are so tiny.

My dd when little had really bad eczema and using epaderm made it worse. We only used it as a soap substitute. We then changed it to aquaous cream and now only put oilatum junior bath oil with a few drops of olive oil in the bath. I'm afraid a good cream that works for one may not work for your lo. It's a case of trial and error. We used so many creams and lotions it was unbelievable! I think majority of the petroleum based creams exacerbated her eczema.
Eventually after we found out about her allergies (egg, dairy, fish and now peanuts), we changed her diet and the eczema seemed to disappear overnight! We do still get the occasional patches on her hands but that's only because we constantly wash hands but a def improvement! She's now a completely different child, sleeps better and happy!

It's common for eczema to flare up badly after an allergic reaction, especially if the hives were widespread. I would give 2.5ml Piriton once a day to help with the itching and demand ask the GP for a referral to a dermatologist/skin nurse. I also agree that Epaderm is good as a soap substitute but not so good as a moisturiser/emollient. We use Hydrous or 50/50 but it's trial and error as every child's different. I also use Eumovate steroid ointment on bad flare ups and whilst it is true that we should be careful with steriods on children, we have generally become too scared of them and in fact the recommended safe limits are a lot higher than we think (according to our dermatologist). I would love to say that when we cut out DS's allergens from his diet his eczema disappeared but sadly this was not the case although it did help a bit.

cross posted from children's health. Sorry - don't have time to read all the posts, so I may be replicating or contradicting others

Go back to the GP - (preferably a different GP!). She needs steroid creams to bring it under control, and possibly antibiotics if there are any areas of infection. You should keep on with the steroids twice a day until her skin is completely clear and then tail off their use (i.e. go from twice a day to once a day then every other day). You should also be moisturizing her skin all over her body several times a day, and if she wakes up at night, at different times to the steroids. You may need to experiment to find the best moisturizer - we found Aveeno worked best. When DS2 was this bad, we were getting through 3 big tubs of Aveeno a week!

Even after she has finished the steroids, you should carry on with the moisturising - aiming for her to be the slimiest toddler anywhere.

Treat any recurrences with more steroids (prob hydrocorisone rather than betnovate, which is very strong).

I would avoid all baths for a few days to let her skin rest.

If these things don't work, she should be referred to a hospital dermatologist as an emergency to be treated with a short course oral steroids, and probably antibiotics as well.

Thank you all for your posts. Some very helpful ideas here, particularly about finding the right moisturiser.

I was lucky enough to have a chat with a paediatric dermatologist at the school gate! She recommended going back onto steroids to clear it up as well as continuing with moisturing. She was very helpful. It really is a mindfield knowing what to do for the best, but I'm now confident that we've got really good advice. Her advice is, I'm absolutely certain, different from what I would have got told at the GP.

Lucky you finding a paediatric dermatologist at the school gate! Really glad you have a way forward now.

From when he was 6 months or so until he was 2, DS2 was totally covered in terrible eczema. Only the palms of his hands were spared . Once we got him on the right treatment regime (which took a while because, like you, I initially had bad advice from the GP), it cleared up within days.