infant eczema and hydrocortisone on the face

[ratfly]

This has probably been covered, but I can't use the search at the minute without my pc crashing..

Ds is 6mo, and has had eczema since about 3 months. It started out not too bad, and has gradually got worse. At it's peak his face, legs and arms have all been red and scaly and itchy.

Anyway, I saw a dermatologist who said I should only use 0.5% on his face, and then only when absolutely necessary. I did so, daily, and it had NO effect.

When we went back she prescribed canestan with 1% hc in it, to use for 5 days all over. The canestan cleared up his eczema lovely! Then as soon as we stopped, back it came.

So, I used emmolient about 8 times a day, and no improvement. Started on the hc - 1% cleared up his legs, 0.5% did nothing to his face. So, desperate, I used the 1% on his face, and lo and behold it has cleared up. Now I am only using it on the worst areas on his face, and 0.5% where it looks about to flare again. This is pretty much daily, though in some places only once a day.

so what do you guys think? I am completely ignoring the dermatologists advice and his eczema is pretty clear - the best it has been for about 6 weeks.

should I use 1% on his face? can I use it daily?

I was given 0.25% for the face. I think I'd be worried about using 1% for more than two or three days tbh. Are you sure the eczema on his face isn't infected? Perhaps you need an antibiotic cream like Fucidin as well?

thanks twinklemegan

Yes, I don't want to use the 1% for very long - as soon as the redness goes, I go back to the 0.5%. If I stop altogether though, it comes back immediately.
Dont think it's infected - they took a swab, and havent got back to me, so I assume all is ok...

anyone else with experience of hc on the face?

My daughters docter told me to use 1% but to use it sparingly. It was not for eczema though.

But it was on her face.

you need to taper off the use of hydrocortisone, not stop it suddenly.

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I'd use (and have used) it daily on baby's face for a copuple of days. Wouldn't use it on a regular every-day basis. It's hard though, 'cause you have to try to get it under control and often that's all that will work.

I got same advice as Pitchounette. Dermatology consultants will and do prescribe 1% for face if ness. No lasting effects on dd.

Can I swoop in with my story of DS. He had eczema as a baby, bad on his face, medium-bad (if that's a term) on his arms and legs.

After searching on the internet for the triggers and general info I found someone in US who said their child's trigger was banana. I stopped DS eating bananas and within two weeks (honestly) his eczema had cleared up. I couldn't believe, I still can't.

It might not help your child but I just have to tell everyone just in case.

It's also how I found MN!

Ratfly I have had the same dilemma with DS (20 weeks), was originally told by GP only to use HC for a week -- this was about three months ago! I can sometimes get away with not using it for a day or two but then the eczema flares up again and if I don't use HC then it gets worse and worse and ends up infected and weepy. This includes on his face.

My stepmum is a GP so I checked with her and she said that if you imagine a house with a ladder against it, and that ladder is the range of steroids, then the super strong oral steroids are up at the roof but if you're using HC cream then you've barely got your foot on the first rung (hope that makes sense). And that it is basically fine to use every day long-term. So I use 0.5% on red areas every day, and if any gets weepy then I have some Fucidin (1% plus antibiotic) to use for a day or two.

Hope that helps and that your LO gets better soon, it's so hard for them isn't it?

Like KBear I thought I'd just mention DS's eczema. He's 10months old. His eczema kept getting progressively worse until I was rubbing hydrocortisone cream virtually all over him every night.

I saw the doctor numerous times worrying I was not doing something right. Then a friend suggested taking him off dairy.

So now I give him Infasoy (soya) milk and stear clear of Petit Filous and the like and 2 weeks later it's completely cleared up! I am amazed.

I just wish the doctor could have suggested this...

This will be a bit long but HIH - I am 32 and have used 1% since I can remember with no ill effects. And my Mum was slapping all sorts on me as a baby. As long as you give it a break in between it is really quite mild. 5 days on 2 - 3 off etc. If I have infected areas then I notch it up to Synlar or something similar.

I have to point out that you should discuss food intollerence with your GP and look at basic things like soap powder etc before going with steroids long term. Many babies grow out of it or find it improves with age.

The trick is to find a combination of treatments that you can alternate between, emolients and steroids, even natural remidies have worked for me short term such as coal tar treatments.

Each person reacts differently so don't be afraid to experiment a little.

My DD suffers from it too and we mix aqueous cream, 0.5% HQ and Double base type creams. I also use Surcare rather than Fairy and use no wipes or soaps at all.

Good Luck and hope your LO feels better soon. x

No one has mentioned the newer treatments that are now available. These are immunosuppressants and they work by suppresing the allergic reaction by dperessing the skin's immune reaction, locally.

You can get Proptopic and Elidel from a dermatologist- and both can be used on the face- they are non-steroid. I do NOT know if they are suitable for babies, but i THINK they can be used by children over two.

My son has been treated for eczema using these creams for a few years now. You CANNOT get them fro a GP unless he/she has trainng in dermatology, but a referral to a consultant would be needed. If this means a long wait, then you can ask to see one privately and pay around £100. (Just mentioning in case you don't know.)

Plesae take care when using hydrocortisone on the face- I know they say it is safe, but I used it on my eyelids 25 years ago and have the wrinkles there to prove it! It did make my skin sag and change texture, at the time.

Sorry- typo- it should say PROTOPIC.

callmeovercautious - thanks what a comforting post!
I am trying him on non-dairy formula and it is making a huge difference to his eczema- he actually looked clear for the first time in 4 months! It recently flared though, not sure why...

My son, now in his 20s- deveoped eczema at 9 weeks despite being breastfed til 6months. I avoided dairy at that point - and when he was weaned he went onto baby formula soya milk. He has never had dairy at all since then. He is currently having more tests via the dermatologist for food intolerances- blood tests and then skin prick tets- which so far have shown a very high allergic reaction to dust mites- confirming earlier tests when he was a toddler.

Oh yes - dust mites are a big cause of mine too. It's my excuse to make DP do the dusting