Advice please on use of steroid creams on 6 month old with eczema

[rainbowweaver]

My son developed seems at 3 months old. We've applied steroid creams (hydrocortisone 0.5%) twice before, the first twice daily for 5 days then once daily for 5 days; the 2nd once daily for 5 days. The eczema subsides while cream is used but comes back with a vengeance after. Are we doing wrong? How do you apply the cream and for what duration each time? Also, eczema is on his face and neck. Many thanks for any insight!

Developed eczema, not seems....

keep using it!

what other emoilients are you using? whats your daily eczema routine?

Where did the 5 days come from?
We applied steroids for a couple of days after it looked like the flare up had subsided.
And loads of emollient. It may be you need to try a different emollient, and maybe a bath oil.
Its suggested you leave 20 mins between steroid and emollient applications (and the order seems to depend on what you read), however we found this impracticable - but we did put storied on first, and then emollient everywhere, finishing up with the steroid covered area.

Hydrocortisone never touched DS' eczema sadly. We ended up going up and up the steroid scale and now use very strong steroids for flare ups, which now are thankfully few and far between. My GP when DS was a baby was of the opinion that you have to clear it up before you can sort it out. That said, DS never had it on his face and I don't know if I'd be happy with the strong stuff on his face.

Best of luck, it is awful x

Thanks for insights! After much trial and error we've finally settled with Bria Organics eczema balm at least every 3 hours. Basically, wake up (about 7 or 8 am depending), wash his face and neck with water, moisturise, then moisturise again in a couple of hours' time if skin appears dry, then about 4 hours after morning wash we do a midday wash and moisturise, and moisturise a couple of hours later if dry. Bath is normally about 4.30 / 5.30pm depending (with Dead Sea salt) then moisturise again. Then final moisturise before bedtime which 7 / 8pm depending.

We'd tried Oilatum, oilatum bath oil, allergenics ointment, Dr organics manuka honey cream, colloidal oats, coconut oil, safflower oil - all of which seem to irritate him. While Bria at least seems to calm the eczema or some of it.

In the past 2 times of steroid application we didn't moisturise enough I think, so this time will religiously moisturise. This time will apply once a day until flares all gone, and until I think skin has completely healed, so maybe 14 days minimum then start tapering off by applying less each day. Which means might be longer than 14 days limit that NHS seems to recommend.

The 5 days was from the GP instructions.

How long have you applied steroids continuously for, which steroids and were there any side effects?

Forgot to add, steroid application now 30 mins after emollient, but thinking of applying it straight after moisturising as it's complicated waiting 30 mins. He also has some eczema on his back, torso and backs of his knees.

And Dead Sea salt as there's research that says bathing in magnesium rich water will help skin moisture retention. This does seem to help.

Mind you, I also found research papers which say that coconut oil is more effective than mineral oil for eczema but unfortunately coconut oil irritates him too.

Have you ruled out allergies as the cause of the eczema?

Have you ruled out allergies as the cause of the eczema?

Again, just wanted to reiterate, have you ruled out allergies as the cause of eczema?

I know a handful of babies who had eczema. When allergies were removed from diet, it went away.

Not ruled out allergies, but baby is breastfed exclusively. We have started carefully introducing solids and so far does not seem to trigger flare ups.
We've had cow's milk, oranges, wheat (as well as usual baby rice, millet etc)

I suspect it could be dust mites, which is why the washing regime seems to help. Otherwise too much washing would dry the skin.

Have been scouring Internet on safe duration of low potency steroid creams, and there doesn't seem to be a limit? Would really appreciate some insight into how long you've continuously applied steroids, and if there were any dude effects. many thanks!

DS2 had fairly mild eczema as a baby. We used hydrocortisone cream for flare ups and had the same experience - that it came back as soon as we stopped.

Applying cheap old aqueous cream 4 -5 times a day was as helpful as anything else we found.

Might be worth thinking about eggs as they are the main culprits in eczema and the proteins can travel through breast milk.

you can have a blood test for dust mite and other environmental allergies. there are lots you can do to lower the amount of exposure to dust mite, but not remove totally.

first step is dust mite covers for bed good quality ones make a difference and remove soft toys. bedding needs to be boil washed to kill the mites!

When you say that the eczema "subsides" with the steroid, what exactly do you mean? How long does 14 days use keep the eczema at bay? DS got eczema at around the same age as yours and we did the "firefighting" steroid treatment (Twice a day for 2 weeks), prolongued, occasional use(we only did this for a month) but it never really cleared up and would return within a couple of days of stopping the steroids. I now see a gp with a special interest in dermatology (last step before a dermatology referral) and he's been fantastic. He prescribed Protopic Ointment (Tacrolimus Monohydrate) and it has almost completely cleared up. If I see a little patch developing I apply some and it's gone the next day. I still use Cetraben, E45 bath oil and limit baths to every other night but his skin is just soooo much better.
With regard to long term steroid use, it will be fine. I was very worried about skin thinning as ds's eczema was on his face too but I was told by the gp that the side effects are massively over inflated (even by other gps) they just didn't work very well for us and if you're having to use it just all of the time it might be worth looking into something that works better??
I'd get the dust mite theory checked too otherwise I'd say too much washing would dry the skin out. Try the health visitor, some can get you in touch with an eczema nurse or get a dermatology referral to see a specialist. Until we saw the gp with the dermatology specialism I constantly felt fobbed off by other gps who just told me to moisturise more. Even when I was applying it 20 times a day!! Best of luck

We were told (and it sounded sensible) that while steroid creams are not great for skin, it is much less damaging than infected, long term eczema. So we used cream til flare up over, and for a day or two afterwards to ensure it was cleared, and then stopped.

I would ask to see a dermatologist to find an emollient that works. Diprobase is great for my skin but Dermol works better for my kids.

Epaderm is horribly greasy but is a good barrier over the steroid. In fact ointments in general worked way better on DS than creams. His steroid is also in ointment (grease!) form. White creams in general pretty useless on him.

YY to that addicted.

If the eczema is not very bad anymore, would suggest Calendula Cream, ideally the brand 'Nelsons' rather 'Boots' because the concentration of extract is higher... it's totally herbal and it works for me and my two little nieces. It does take bit longer to work but that's better than steroid creams.
Also ensure that washing powder for kids are non bio. Moisturise with Aqueous Cream. Hope that helps.

NEVER USE AQUEOUS CREAM AS ANYTHING OTHER THAN A SOAP!!
It is not designed as a moisturiser.

Oh and one more thing! Cutting out fabric softener and setting the washing machine to an extra rinse really helped.

I will book a gp appointment to get a dermatologist referral. My internet scouring this afternoon has unearthed some good research papers on eczema management, thought I would share.... Tacrolimus was also mentioned as a good 2nd line treatment in the article, will ask the dermatologist for a prescription.

[[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3809588/ ]]

So far the eczema seems to be persisting in his face (day 3 of steroid) but almost cleared on his neck. I have a suspicion that the eczema is also triggered by sweat as it seems to be worse where he's slept on us. Will stop washing his face so frequently from tomorrow - or just cut it down to just the 7am wash for now as skin has improved slightly.

It's really helped just posting and talking about it here, I've been quite stressed about it and this has helped immensely.

My experience with the steroid is that is almost clears it away, then when we stop it comes back again. Once it just went completely red and itched terribly - he was trying to scratch all night and was very irritable. The next morning we found his neck weeping and red, so applied the balm only which seemed to calm it.

We don't use conditioner, and there doesn't seem to be a correlation with my eating eggs and his flare ups, so I think could be ok that side.

I've also come across Apple cider vinegar as a possible treatment. Has anyone tried adding a cup of it in the bath to increase skin moisture retention?

@addictedtosugar have you ever used the steroid cream for longer than a month?