Can anyone talk through eczema strategies with me please?

[belindarose]

DD is 3.6. She has had eczema since being a small baby, but it's been relatively easy to keep under control with doublebase, oilatum in the bath, no soap, Surcare laundry liquid. Unfortunately, she's had a really bad flair up and is covered.

GP doesn't think it's infected, so says to continue with moisturising. We're using epaderm now, three times a day. It's not going anywhere and she's conscious of it now - it's really bothering her.

What has worked for others? This is a dry, all over rash, with patches of red, very itchy skin.

Are you using a steroid cream? If not, you need to be. 1% hydrocortisone should get it under control. Make sure you use it for long enough - til the flare-up's gone.

I have used Aveeno Baby on my Dcs. They do a bath powder, a cream and a body wash.
I also put a muslin with porridge oats tied up inside it into the bath in the evening now and again. Seems to really help.

Does nothing for my eczema though!

Yes, we're using 1% hydrocortisone twice a day on the patches. Is that enough?

Do you wet wrap overnight? Lather cream on thick and then flexi bandage or odd socks with toes cut off over top. Good for feet, knees and elbows.

I second sometimes you need to get it back under control with a steroid cream.

I have found that some foods trigger mine. Excessive dairy seams to make things worse.

Does your DDhave it worse in areas where clothes contact because varying style of clothes can help in mine to alleviate rubbing sore bits.

If you have a lottery win a two week spell in the sunshine can help, it did with me when I could afford it pre DC. Alternatively light therapy helps some people an alternative / complementary to steroids but still need creams etc.

Keep her nails very short so she doesn't accidentally scratch and cut at night.

Clothes fabrics are another thing to potentially consider. Soft cottons work best for me. Nylon and wool are absolute no no's.

Epaderm was terrible for DS1's eczema. Would try other emollients - is there a reason you switched from Doublebase?

If 1% hydrocortisone isn't helping you may need to step up to the next strength steroid eg Eumovate for a little while.

Thanks. GP just said to try epaderm because double base was no longer working so well. I didn't think that it might make it worse. She always has cotton next to her skin. Doesn't like being hot.

It makes me feel so guilty! How ridiculous.

Nothing's changed diet wise, or clothes etc. not that I can think of, anyway.

agree with slight step up in strength in steriods, for short term use until flare up controlled.

if new epaderm isnt working, go and try something else frm gp.

we stuck to 50/50 soft mix (gosh cant remember full name of this stuff now, mind gone blank, sorry)

how many times do u do all over moisterising? aim to increase as much as possible.

have u investigated the usual suspects? dustmite is one top enviro allergen that causes eczema, and now that we are creeping in to march, the next big one is tree pollen.

has doc mentioned antihistamine at night?

Aaaaaagh. Much, much worse today. Have stopped the epaderm and have GP appt this pm.

We have a new dehumidifier as we have a condensation problem. It's working great, but I've read this morning that too low humidity can be as bad for eczema as too high, so it could be that.

You need stronger steroids for a short period of time e.g. betnovate ( strong) or betnovate RD (medium strength) twice a day for about a week. Then you can step it down to weaker steroids (e.g. 1% hydrocortisone) twice a day for a week. Do this in combination with loads of moisuring (e.g. 6 times a day). Once eczema is under control, stop steroids and continue to moisurise regularly.

It's much better to give strong steroids for short periods of time, than weak steroids for longer periods of time says my friend who is a paediatric dermatologist.

We've learnt the hard way how to contain major flare ups. For my dd, the trigger was various allergens. In the past she has been literally covered head to toe in pretty horrific eczema and it's taken up to 6 weeks to clear because we didn't use strong enough steroids. Now, as soon as I spot the beginings of a flare, I immediately slap on steroids for short periods of time and it stops the eczema taking hold.

Agree with the use of steroid cream. Betnovat worked for me. Plus when in the house try and put her in minimal clothing, if any, with loads of cream on.

Thanks. Saw an annoying GP who wouldn't listen and said only hydrocortisone for children (!?). Have antibiotics 'in case' there's an infection. Bit pissed off. I'll carry on with lots of double base until after the weekend and try GP again.

Any advice on how to use te hydrocortisone? I can't see how I can get it all over her body? Can I mix it with doublebase or is that a terrible idea? Honestly, GP was useless. I don't usually say that as ours are usually really good.

dh has bad eczema and oilatum makes it worse! doublebase is great as is aveno.

Now I notice GP only prescribed 0.5% hydrocortisone. I've still got some 1% and will try to see someone different in a few days.

Can you be referred to a skin specialist (via your HV)? Only the skin specialist seemed happy to prescribe stronger steroids which was what cleared our DD eczema up at 4mths. We use dermol 600 bath emolient and dermol 500 soap substitute as well as slathering on diprobase after her bath (every other day). She is 8 now and we still use the same routine and it's under control and beautiful although occasionally we ned to use eumovate when it flares up.

Good luck

You should leave at least 30 mins between applying the steroid cream and emollient - otherwise the emollient dilutes the steroid so it's useless. I used to bathe DS1 then put on emollient, then wait half an hour and do steroids. Sometimes it really did mean he had head-to-toe steroid cream. But if it's any consolation, after needing steroid cream every day for years, since about 5yo he hardly ever needs any.

Oh and I wouldn't expect 0.5% HC to touch a bad flare-up. You need 1% as your baseline and step up from there as needed

Btw if you look on the leaflet for the HC it should give a guide to how much to use on each part of the body. Iirc if you squeeze a line from the tip of your forefinger to the first knuckle, that should do one limb.

Thanks, Meg.

I applied the hydrocortisone first and then did doublebase half an hour later. I realised, as you said, that mixing them would dilute it. I might ring GP for a 1% prescription tomorrow.

It's much better to give strong steroids for short periods of time, than weak steroids for longer periods of time says my friend who is a paediatric dermatologist

This is also what our dermatologist told us too.
Do you see one? I wouldn't trust my GP to prescribe steroids for my DS as they have no idea how to treat ezcema.

I'm not GP bashing btw!

Not sure if they will prescribe for children but I found Haelan Tape amazing for really sore areas. It looks and feels like a plaster but has steroid in it, very useful overnight as the plastic film prevents the skin being damaged by scratching.

When my boys have flare ups we do the following
Bath in oilatum
Use aveeno cream all over
steroid cream for really bad areas
plus no synthetic clothing, especially at night.
I only use Organic clothing as normal cotton still irritates the skin, especially with eczema.
Try Frugi, KyNa Boutique, H&M organics - i always use organic pjs at least so the sweat isnt left near their skin