Can anyone recommend top paediatrician gynocologist / dermatologist?

[Bellseybub]

We are at our whits end having waited 5 months for a patch test for my almost 6 yr old who has had sore and itchy flair ups for a long time and have just had our hospital appointment cancelled due to COVID-19.

We have tried doctor cream after cream (and again concerned that they are mainly steroids) and what is worse is that the condition flares in her private regions. Has anyone got a top paediatric dermatologist that we can get to from SW London or ant advice on how to treat it? We’ve done Elecon cream, timodene, and a few others inc emollient cream. The GP is convinced it’s eczema or dermatitis but we are literally banging our heads against a wall and feel v frustrated seeing our little one in discomfort.

Any advice greatly appreciated

No recommendations sorry but was just interested in which foods you've tried eliminating from her diet, if any

Out of interest - and asthma in the family?

We haven’t started that yet but if any foods are recommended we are happy to give it a go. GP suggested this week that black currant juice aggravates but she hardly ever has it

First thing I would try is cutting out all dairy and it has to be all for it to work. So you'll need to read all packets first. It does sound daunting at first but soon it will become second nature. Dairy is a very common allergen with something like 1 in 10 being allergic to it.

I'd be interested to know if there is hay fever/eczema or asthma in the family too?

Generally your be advised to keep a food diary and look at the clothes and detergents.

I had heard about dairy and had wondered about sugar. Her grandfather had asthma and I get hey fever but she doesn’t have any breathing problems. She had topical eczema on her neck as baby but she was exclusively breast fed. So it still flared up and I wasn’t eating much dairy

We also find it gets worse a day or two after school swimming classes which are compulsory so think chlorine is also an aggrivator. We are super sensitive with her washing products and generally try to to without when we can and only use Emolient wash or very gentle shampoo

It does sound like you have allergies in the family and this could be allergy related. I'm the same with washing products, I have to have pure cotton knickers and a very gentle non-bio with no fabric softener or I really suffer.

Agree that really you should be keeping a food diary too.

I think rather than a dermatologist or a gynaecologist, you would be better looking for a referral to the allergy clinic.

Dr Helen Cox runs a private clinic in Harley Street, but is also NhS so I don't know if she's running it right now. Completely sorted our 4yr old's severe eczema with a regime of creams and no need to adjust his diet.

Have they tested her blood sugars?
Increases blood sugars can cause glucosuria which can lead to itchy genitals.

I’d really consider an wheat allergy

Chlorine was an absolute disaster for DS, he missed out in swimming lessons for a few years. Once his skin was under control we were able to take him again with Dr Cox's advice, put emollient on before swimming, rinse of really well with dove soap and flannel, reapply emollient.
You have to find the right emollient and you have to apply it really thickly several times a day. We used Epaderm for body and Diprobase around his eyes which were very dry and sore. Surcare washing powder. Cotton clothes , bedding etc. Dermol 500 as soap and Dermol 600 in the bath.

I was reluctant to jump to cutting out dairy, and Dr Cox agreed that it was worth trying the regime of steroids etc first. I had a very detailed plan which I followed to the letter and it worked. Interestingly, he always had soft/runny poos when his skin was bad, and it got better when his skin improved. There's a theory that bacteria enters through the damaged skin and upsets the gut. Many people immediately down the allergy route but it might not be necessary.

Oh and he had daily antihistamine for a long time (cetirizine hydrochloride in liquid form). He still gets hayfever but is now old enough to take a tablet during the hayfever months,.

I think I go down the allergy route usually because I know that's exactly what worked for me. I've had CMPA as a child, then could tolerate dairy and ate it as an adult but didn't realise how much harm it was causing me. It's only when I cut it out completely that I felt, well it's hard to explain sort of clean from the inside?

Glad you've found something that works for your DS though

Joey Lai Cheong at the Princess Margaret in Windsor is a brilliant dermatologist (does children and adult).

www.harleystreetpaediatricgroup.com/dr-helen-cox/

Honestly can't recommend her highly enough. It says on the website she's open for consultations.

You must apply emollient several times/day and use it so that the skin looks white because of how much you are using. No soaps. Use emollient or Dermol. Stand up in bath/shower to wash hair. Don’t let her sit in the bath afterwards and make sure skin is rinsed completely of the shampoo.

Could she be wetting, even small amounts, which will make her skin sore? Cotton underwear only. No tights/leggings/jeggings/other tight fitting bottoms. Loose trousers/shorts or a skirt.

Cetirizine every day to get on top of the itch. Steroid as needed.

The other thing to consider if it’s really only her genitals that are affected is lichen sclerosis. Steroid creams are the main treatment for this along side the other measures.

I can't recommend anybody sorry. However your dd sounds just like me. I did have a patch test a few years back after years of issues. I will offer my experience - hopefully it may help. I am allergic to balsam of peru, perfume and propolis. The dermatologist that I saw said that they are common allergens. Unfortunately these are ingredients that are scattered amongst shampoos, soaps, shower gels, medical creams and washes. It's a pain! And recently the toilet roll saga has meant that I have had to buy and use perfumed toilet roll, which has affected my nether regions. The cheaper loo rolls are the best. Once affected, the only cream that truly gets rid of the allergy rash is a steroid cream provided by the doctor. I find that dermol (which you can buy from chemist) is best for handwashing and body washing. I have piriton medicine if very maddeningly itchy. I have had to find shampoo through trial and error - Simple is good. Beware of shampoo as it does hit other areas of the body whilst in bath / shower and affects them. I wouldn't go near E45 has it has lanolin in it, which is awful. So when buying things I would have a quick glance at ingredients to see if any of the common allergens are in - see above. You may have to do an amazon shop as it is tricky to shop at the moment. Hope that helps.

@JiltedJohnsJulie
I just wanted to give an alternate viewpoint as its a big step to cut out a food group and not always necessary. Obviously everyone is different.

I just wanted to give an alternate viewpoint as its a big step to cut out a food group and not always necessary. Obviously everyone is different.

No criticism intended. I'm glad you've found something that works for your DS

For allergies I can recommend Adam Fox and his team. Amazing beyond words.

I realise I'm a bit late, but for what its worth, here's my experience as a Mum of several children with eczema and allergies.There seem to be some very polarised views within the medical profession regarding the role of food allergy in eczema. All my children have been affected, but one in particular had awful eczema as young child and our lives just seemed to be one long round of applying creams and bandages. I was also worried about the amount of steroid cream we were using. To be fair to the dermatologist we saw, the regime of creams he prescribed was a lot more effective than what the GP had given us, especially using short bursts of stronger steroid creams rather than a really weak one almost all the time. But he told me categorically that food allergies dont cause eczema and forbade me to cut out dairy even though I had noticed DS's skin got worse if he ate yoghurt or cheese and there's a strong family history of milk allergy. Not sure why I thought he had the power to tell me how to feed my child, but for some reason I obeyed. However, when DS developed other health problems we were told to eliminate dairy completely and within 4 weeks his skin was dramatically improved. It really was like a miracle. The dermatologist still insisted it was a coincidence but the immunologist said it wasn't!
What have you got to lose by trying a dairy free diet for a bit? If there is no improvement in a few weeks then you can just go back to her previous diet and you are no worse off, and if it does help then you are a lot better off. You do need to be very strict about the elimination initially, and also eliminate all other animal milks and probably soya in the first instance. If you do need to eliminate a lot of things on a long term basis some input from a dietician might be helpful, though to be honest ours just gave me a handout about calcium and a list of dairy free foods which I could have found on the internet myself. You might get a better one though, so worth asking. There is a lot of information on the internet, some of which is of course a load of rubbish, but if you stick to reputable sites its not too hard to find recipes and information about alternatives to cows milk. It isn't really that difficult, especially now there are so many alternatives available.
Away from diet, another thing that we found helpful was hypoallergenic bedding, mattress protectors etc. Both my sons are allergic to house dust mite and various pollens, and minimising contact with those helped their skin a lot. Our immunologist says that lots of people react to both foods and environmental things, but that once one trigger has been identified people often forget there can be others. We also had issues with chlorine and had to stop swimming, but with time they improved and can now go in most pools as long as they shower immediately afterwards. They all react badly to sea water though, and also anything perfumed, like soap, shower gel etc.
Also, I found that every time I tried a different emollient it would really help and we would think we had found the answer, and then after a few weeks it seemed to stop working. So I started swapping between 3 or 4 different ones. I found that after a break, those that had become ineffective seemed to work again. Totally unscientific of course, but I have met several other people with eczema who have also had the same experience, so maybe there is something in it?
Obviously I am not an expert, but that's what our experience has been and what has helped in my family. Thankfully all my children have largely outgrown their eczema now but I remember how awful it is. I hope you get the answers you need and that things improve soon.