Eczema back with vengence after 10 day course of steroids!!! What now???

[thebluefoxategreensocks]

My nearly 2yo little boy has had eczema (mainly on feet & behind one knee) for the past 9+ months. Between various ordinary creams & ointments and secure cotton clothing we've managed to keep it from getting too out of hand. Two weeks ago it got seemed to be getting really bad - and on his face (where I can't keep him from scratching, since not covered by clothes). Soooo, finally went to GP for the first time about it and got Hydrocortisone cream as well as Oilatum cream & stuff for bath. The steroid cream was effective immediately and he was no longer scratching - which seemed like a miracle after so many miserable months! However, the 10 day course he was prescribed ended on Thursday last week...and now the eczema is back...and far worse than ever before! His face is getting quite nasty, his feet are horrible, and even starting to appear on one of his eyelids! He was awake at midnight and again at 4am (both times for over 1 hour of misery and scratching through his sleeping bag etc. The lack of sleep is good for neither him nor me (who's nearly 35wk preg with baby #3).

Soooo, what now??? As far as I understood, the idea of steroids was to calm down flare ups - but seems as soon as the steroids are stopped, it's back & terribly too!

The Oilatum was OK as long as he had the steroid cream - but now the Oilatum seems to be making him worse/more red/inflammed. Had similar experience with Diprobase before - so wasn't so keen on Oilatum, as similar ingredients.

Any ideas?

My dd's eczema isn't too bad, backs of knees and only flares up occasionally (when she's worried) but we've found best think is consistent moisturising morning and night, NEVER bubble bath or similar, and best creams for her are aveeno or doublebase, then steroids for tiny doses when we're desperate before it gets out of hand.

sorry did he have steroid cream,steroid tablets or both?
You can get "rebound" eczema after finishing steroid creams when it gets worse as you describe

Take him back to gp say what has happened,If he/she does not seem clear /confident what to do ask for urgent appt for dermatology clinic or general paed clinic

If the skin is wet or broken the oilatums and emollients can irritate the skin i would keep broken skin areas clean and dry[i used to use a bit of sudocrem[not one used for bums obviously!]on more moist areas ]but i would go straight back to gp .

I find there's something not right for me about Oilatum.
Aqueous cream is the only thing I've consisyently been able to use.

Have you thought that he might have dietary intolerances?
There are loads of threads here you can search on.

And you could try just not giving him so many baths - it's very drying, especially if you have hard water.
I'm sure most of us weren't bathed every day as children.

second vote for Aveeno here (both cream and bath oil). My GP would not prescrible them for ages as they are more expensive. Also only bath 2 or 3 times a week as too much bathing makes it worse.

My dd's eczema cleared up as she was allergy tested and was allergic to egg and dustmites. The paed told us eczema is ALWAYS caused by an allergy so it is vital to get tested.

Get you GP to refer you.

Thanks for all the quick & helpful replies!

He only ever has 2 baths a week (since birth), so can't be overbathing! Been using SLS free wash (like Horns & Halos) for over 1.5 years, so bathing has been fairly nasties free.

I wondering if it is actually a rebound sort of eczema after stopping the steroids, since it's rather worse. Though I have to admit (prob done the worst thing! ), but I've just applied a tiny bit of it to Benjamin, because he was crying & so miserable!

Soo, have just phoned GP and they've given me an appointment for 4.30pm today, so we'll see if I can get anywhere. Wish they'd prescribe me some Aveeno! If not, might just have to buy some to try - as I think it would be nicer than the stuff with liquid paraffin and other nasty sounding stuff!

While everyone is diiferent of course...I found that I could only bath my ds once a week and had to have oil it the bath, didn't not use any cleansers, washed his hair of course, but had to make sure the shampoo rinsed off throughly.

My DS had eczema and the paed suggested it was dairy allergy as I was in process of weaning him off formula and onto milk so we removed dairy from his diet for a year and it cleared up. He still says he is allergic to milk but eats chocolate and cheese and most things with no problems. Still gets itchy every so often but Aveeno helps.

DS was also taking an antihistamine medicine every evening.

meant to say my dd is now clear of her egg allergy at 3.5 so they often grow out of these things quickly and this is a reason why NHS often not keen to allergy test as it is deemed 'not economical' if it is a short term allergy.

I once had Aveeno prescribed by my gp - they are quite alternative but it obviously can be done.
Didn't work for me, though; I had to wash it off as it stung.
I know some people hate Vaseline, but it does form a good barrier and it has cleared things up for me in the past.

Hi - my DD1 suffers from eczema and like Buda I took her off diary (and white wheat) and it cleared up. she can now tolerate small amounts of both in her diet without suffering an outbreak.

My view of steroids is that they treat the symptom not the cause - you need to find the cause to stop eczema completely. Steroids also thin the skin so shouldn't be used too often and you should avoid using them on the face (even really mild ones).

A good kinesiologist will tell you what your DS is allergic to and also recommend supplements that can also be helpful.

Agree with the others, a change of milk definitely helped my DD, from normal cow's milk to lactose-free milk (after a million different milk's in between!).

My DD had bad eczema as a baby and we cut baths to once a week and smohtered her in Oilatum twice a day - cleared up eventually - and hasn't come back - my son sounds more like yours - I use Fucibet cream (from GP) when it is bad then step down to HC cream - but we maintain with Vaseline - DS hates oilatum , Aveeno (on px from GP no problem)etc as are 'stingy' !

"A good kinesiologist will tell you what your DS is allergic to and also recommend supplements that can also be helpful."

Sorry but no such thing as a 'good' kinesiologist -- it's pure quackery.

Get a referral to an allergy specialist from your GP -- the only reliable way of testing for allergies is the blood or skin prick test.

Also, mild steroid creams will not damage skin when used as instructed. Far better to use them when needed than leave the eczema untreated and risk infection.

As far as emollients and bathing goes, different things work for everyone so it's a matter of trial and error til you find the combination that works best. The current recommendation is actually to bathe at least once a day (although of course for some people it's better to bathe less frequently).

Did you know that recently there has been a link between hard water areas and eczema?
report here

I for one find that when I go abroad or to a place in the UK where the water is soft, all my night time itching stops.

And, looking back, it was when I moved from the NW to the SE that I first started regularly to have skin problems.

Interesting comment on kinesiology; I went to one in desperation for IBS, and it did seem wacky, but I followed her advice and am now clear 4 years later.

I had very similar eczema to what you describe (and psoriasis) as a child. After years of scratching and steroids, Mum saved up (we really did not have a pot to p* in when I was growing up) and took me to see a homeopath. Mum is very lentil weavery, but chose a chap who was also a qualified GP and dermatologist.

Anyway, he prescribed my some homeopathic stuff and set me a loose diet of good/bad foods. I first saw him when I was about 10, and saw him on and off for about 3 years (after 2 visits and a family history he stopped charging us!). After this time, my skin had really cleared up. I had teenage acne, but nothing better or worse than can be expected. The horrid, itchy, red, dry, flarey scalely stuff was gone. It was amazing. It has only ever come back in very stressful times since - exams etc, and then only in a very minor way. I'd had nothing for about ten years until recently -got a very small patch on my foot a few weeks after DS was born.

Homeopathy is very different for different people in terms of treatment and results.
Very well worth the money in my case - may be worth trying. I will certainly take DS to a homeopath the moment he shows any sign of skin trouble. But so far, so good...

Also, my sister always puts bicarb in her bath water to soften it and says it helps her DD's eczema.

Megbusset - 'Sorry but no such thing as a 'good' kinesiologist -- it's pure quackery.'

That is your opinion and (I imagine) backed up by your experience. My experience has been that I took my DD to see a Kinesiologist and her eczema cleared up when we followed her advice. That included: No soap on her body at all, oats in the bath and supplements - some long term some short term. 3.5 years of conventional NHS treatment didn't sort it out, it just gave short term relief of the symptoms. When it spread to her face I decided to try something different - and it worked and continues to work.

Back from GP - and with 5 prescriptions!

BTW, we asked the doctor about allergy testing and he said it's completely useless for children! Surely he can't really mean that, right?? Was he misunderstanding us and thinking we meant testing to see what he might be allergic to in creams? Cause surely everyone knows that plenty of ppl are allergic to things like dairy and get eczema as a result. So I'm a bit confused!

Anyway, he's re-prescribed the Hydrocortisone cream in same strength (1%) for most places on body and 0.5% for using on his face. I just don't see how we're going to get anywhere, if he's only just finished 10 days of the stuff on Thursday - at this rate, I can just see him living on it! And that can't possibly be good, right? He didn't say how long to use it for either - so again, confused!

I did get the GP to give us some Aveeno Bath Oil - so will try that in his bath tomorrow night. As for the moisturising cream, he thought the Aveeno cream had too many possible irritants (had a number of things listed in his book), so he gave us Urea cream instead (Eucerin Intensive 10% Urea Treatment cream) for moisturising him. However, it's still got the liquid paraffin, alcohol and various other things in it - so not too hopeful about it. Besides, the paper inside says not to put on inflamed skin - and my little boy's skin is all scratched, red & irritated! Anyone used Urea cream before? Seems it must be a bit high power, since it says to use sparingly and not to apply to sensitive parts of body.

Also got Chlorphenamine (Piriton) to give him at night to relieve the scratching.

So, not sure where to go from here. I can't really see these things working - just covering over for a while. I just need someone helpful to try and get to the bottom of the problem. But when your GP says allergy testing is completely useless (and that recent research has confirmed this!), I'm not sure I'm getting anywhere.

try giving bifidabacterium infantis probiotic powder and cut out dairy

Allergy testing (done properly) isn't useless at all! DS had blood tests at 9mo and egg showed up 'off the scale'. Now if he has anything with egg in he gets hives and his eczema flares up immediately.

Definitely cut out the dairy - I was where you are Rachel when DD1 was 18 mo's, when eczema got bad enough for doc to prescribe steriod cream (having tried oilatum etc) I wasn't happy as I had eczema as a child and know just how uncomfy it is, I wanted a solution not a sticking plaster. I went to a homeopath who confirmed DD was allergic to milk/dairy. We cut it out altogether tho' were caught out at first with things like ham and oven chips provoking a reaction as they contained milk powder - you have to be absolutely vigilant about looking at ingredients. We used goat's milk (formula then the real stuff) instead which DD liked. After 9 mo's to a year we noticed her tolerance had improved remarkably (had a few false starts before this) to the point where she could have milk morning and night, lots of cheese and yoghurts again, she's always loved dairy (often the way in intolerant people!). Lately however she's found that a cup of milk or a yoghurt makes her tummy feel really uncomfortable - and only gets the faintest trace of ezcema behind her knees (used to be elbows). The homeopath prescribed us some tablets when we saw her which I duly adminstered so no idea if these helped or not. A mutated allergy perhaps!
Good luck - cut out dairy altogether and I hope you will see a vast improvement. Doctors IMHO dont' know as much about allergy/food intolerance as I'd hope given how common it seems to be.

Should say DD1 is now 5.5 so had good run of tolerating milk!

And when I say milk above I mean cows milk - she doesn't like goats milk any more. Pls excuse sloppy posting..!

also give flax oil - a teaspoon a day. it helps heal the gut lining and also has the benefit of efas which will improve the exczema.

doctors no nothing except medecine