Eczema flare-ups (2 month old) to treat or not to treat?

[Worrier28]

My 9 week old has eczema and it was confirmed last week, it is all over his back, legs, arms and face. I went to the doctors who said that he needed antibiotics and that they would send the prescription to the pharmacy. There was a mix up and the prescription wasn't there. After a few days of using diprobase on his body (dry/scaly) and aqueous cream on his face (lots of red spots) it went away. Unfortunately it seems to be coming back, so do I need to treat it or let it resolve itself?

Many thanks

carry on with the diprobase. it can be used on his face as well.

Yes carry on using the diprobase, also on his face.

Do you know what caused the eczema? What milk is he drinking?

The flare up came out of nowhere, he had a rash at 6 weeks and then bad cradle cap, then eczema.

I was using SMA and have just recently changed to aptimal. Should I use diprobase as a general moisturizer once the eczema goes or aqueous?

Many thanks

Hi there Worrier - warning as this is a MASSIVE post. My DS (now 16 months) had terrible eczema from 2 weeks which ranged from dry patches to red raw 'wounds' under his arms, in his neck creases and behind his knees and we ended up at Great Ormond St under specialist.
You must definitely treat it - by keeping on top of it even when it is not there you manage it and keep it under control. Whenever I have stopped moisturising DS it has come back and I find the hot weather makes it worse. Once it is under control you'll find that you'll just need to moisturise your baby once after bath and it just becomes part of the routine. I was very worried int he early days that we would become slaves to some sort of 'creaming ritual' four times a day.
Can I list out my favourite creams for you all of which we were prescribed at 12 weeks but you can buy over the counter? We have seen lots of doctors and consultants now and have used lots of different things and it is good to know what works

Diprobase - you know it. Quite a thick white emollient which I use in colder weather. I don't really like the smell of it as it is a bit chemically and prefer....

Cetraban - again, thick white cream like Diprobase but no smell

Doublebase - really light and non greasy. I love it. I use this when the eczema is hardly there.

Epaderm - this is brilliant and people swear by it but it is like a thick vaseline cream and comes in a pot which the dermatologist at GOS said she did not like as your hands can introduce bacteria into the pot which you then transfer onto the baby and eczema can become infected (when you use antibiotics). She does really rate the cream though. When I use this I always wash my hands first and then put DS in an all in one sleep suit as it is very greasy. Excellent though

These are classic eczema creams that the consultants prescribed and you can buy small tubes over the counter (as well as great big dispenders) to find one you like and your baby responds to. I cream DS up just once a day now after bathtime and use one of the four. I just wanted to add that both consultants we have seen have advised not to use Aqeous cream as it can make eczema worse. I hesitate before writing this as you have obviously been prescribed it and the last thing you need is some stranger giving you conflicting advice but it is good to be aware of these things. I always use Doublebase on DS face.

Lots of people like Aveeno or even better Aderma (french equivalent of Aveeno which is actually available on prescription in France for eczema but is sold as a beauty cream over here) both amazing and both based on oats (very very good for eczema - you can put a tied muslin of porridge oats in the bath). GPs will prescribe you Aveeno though I found my tube had to odd bit of grit (a bit of aot husk I think) in it which was awful when rubbing into delicate skin.
If you ever go to the States they sell Aveeno baby product in the pharmacies there - a lovely soap and bubble bath made for children with eczema so worth stocking up on

We also use a bath emollient - Oilatum or current favourite Balneum which is made out of soya oil. It really helps keep DS soft.
A consultant at C&W prescribed Dermol 200/500 lotion to be used as a soap - when they get older and their poo is a bit stickier you want to use a soap to make sure they are nice and clean and we massage this cream into DS before bath then wash it off.
If you baby's eczema is infected you can use the Dermol 500 bath oil as it has an antibacterial agent in it.

In terms of medicinal treatment DS's eczema got so bad we had to use pretty heavy duty steroid creams - Sinalar 1 in 4, Eumovate and where it was not so bad just a 1% HC cream
Then when we changed from GOS to C&W the consultant there prescribed a fairly new treatment cream called Protopic which apparently has no skin thinning risk like HC cream and can be used continuously rather than for short bursts. It is brilliant and can be used on the face but DS only saw that doctor at 12 months so I don't know if it is suitable for a tiny baby. Worth asking about.
I slap one of these treatment creams on the minute I see those tell tale red dots on his torso or dry patches on his legs. Once they have calmed down it is back to just moisturising again.

Massive long post but wanted to do a big long list of products we have had experience of. We have found that over time we have become more knowledgeable of the products available than our GPs who are often very loathe to treat babies with eczema because steroid treatment can be controversial but both consultants have said it is more irresponsible not to treat and to let the eczema flare up and cause unnecessary suffering and potential scarring then to deal with it in a short sharp shock of medication then keep under control with emollients

Way more advice/info than you asked for. Sorry!

Worrier - I used Aptamil all the way through. Sometimes is it not allergy based and you can do nothing about it. Having said that after an reaction to egg at 12 months we also ended up having some allergy tests and turns out DS is mildly allergic to cows milk but he scoffs cheese without making the eczema worse so no problems there. I tend to hoover all soft furnishing in the surrounding area too as housemites can be a big allergen.
Stay with the Diprobase rather than the Aqueous as a general moisturiser and def try Cetraban and Doublebase. If you are unsure check with your GP or pharmacist if they can be used on your 9 week old.

Thanks Toppy, your post was incredible helpful. I will stop with the aqueous and use the diprobase. I'm going try doublebase as I don't like the texture of diprobase.

I will discuss the other products with my GP, thanks again I feel very informed.

great post Toppy !

We are ezcema veterans unfortunatly and I cannot stress enough that you should push for allergy testing.

My dd was tested at about 10 months (blood test) and her skin is 90% better since we found out she has an egg allergy (and dustmites so still not 100% clear)

The consultant told us ezcema is ALWAYS an allergy so you need to find out what it is.

most probably dairy as this is the common trigger for exzcema.

you could try soya formula, for a week to see if it clears whilst waiting for allergy clinic.

i would keep away from anti biotics as this can make a baby more sensitive to allergy.

fantastic advice toppy
my DS has eczema too and we e45 him daily

as toppy said at the first sign of any redness/dry patches we use a stronger cream [usually fucidin] and wait for it to calm down

have had probably a dozen different creams from GP and unfortunately it is trial and error to find one that suits your DS
often it was sooooo bad that we have had to wet wrap him with viscopaste bandages - however must say these are fantastic and clear it up well

my DS is 7 now and we have had eczema for years but getting better steadily

it is important to keep a regular creaming regime and treat accordingly

good luck to you both

Not much to add. My DS has severe atopic eczema (from few weeks old) is now 6 so have been at it a while!

Get tested if possible. It does help with management. My DS doesnt have food allergies but my friends baby was v.allergic to milk. It was so bad that if she drank it and then bf he would flare up.

aristocat do you find e45 helpful? I found DS reacted really badly to it. I am a fan of Epederm but do agree with pp about the pot being a breeding ground.

Lots of eczema threads on MN lately. All our poor little itchy babies

chegirl yes we've found its the best for us

DS has been tested too and is allergic to eggs
at the mo eczema is almost gone but have been doing it long enough not to get complacent

Thats interesting aristo. I know its often the first thing GPs prescribe (it was with us) but it actually hurts DS. I think it contains Lanolin so that may be why.

I am glad your DS's eczema is under control. Well done.

Wish my DS's was

Just read that and it looks like I am being all sarky

i.e. Well I am sooooo glad your DS's eczema is under control. Wish ours was!'

Obviously it wasnt meant like that

actually had to ask for e45 as GP kept giving us aqueous cream and diprobase [ugh]

we were often told it would get better when he's 7. and that the skin works in a 7yr cycle - whats that about???????
i thought that perhaps coz we were better at knowing how to treat it

hope yours improves chegirl

7 year cycle? Hmm so only one year to go for us then and DS will be all better.

I wont hold me breath.

I'm assuming once the flare-up occurs and is treated it dissapears? I've noticed it has spread - ugh! I cannot wait for my docs appointment on Monday. He also had craddle cap and has red dots on his scalp and hair loss and a big chunk of hair is missing from his crown.

The eczema on his face is red bumps and his body dry flakes.

hi worrier you might have to try a few creams to see what suits best as your little one is so young

if GP doesnt have the answers get referred to dermatologist at hospital, we still see them regularly and they are very helpful

good luck !!!!!!!!!!!!

also look into washing powder, we changed to Surcare and it made an improvement.

we also dont use shampoo/skin cleaners/soap, even now we rarely do.

and only bathed them once a week (apart from top and tail)

hope he improves

dd1 is allergic to e45. it used tomake her scream when we applied it.

We have had 10 years of bad eczema with 3 DCs. Epaderm is a great cream per Toppy above.

I REALLY recommend the sleepwear with built in mittens to stop scratching from "Cotton Comfort www.eczemaclothing.com/" . Much skin damage is done at night and infected eczema can be a nightmare.

regards

Would def. add to look at your wash powder. Only use non-bio and use the extra rinse cycle to ensure it is all rinsed out. Also, avoid the heavily perfumed non-bio's (e.g. the more expensive ones such as Fairy) and go for the shop's own brand. Also don't use fabric softener. I occassionally use Eco Balls for the washing which avoids the use of wash powder altogether. This and allergies accounted for all of both my ds's eczema. (DS1 bottle-fed, no eczema until weaned and then flared up sometimes really badly - found to have egg allergy, ds2 breast-fed ezcema since birth - then found to have cows milk protein allergy. Eczema cleared up when I went dairy free).

I went to the doctors (a locum one) and he wasn't convinced the spots/bumps was eczema. He said it could turn into it, wondering if it is heat rash? On his body, it is clear it is eczema as it is rashy, dry and itchy.

I am going to change to surcare.

I use Oilatum Junior (comes in a tube). Has really helped my own contact dermatitis too unlike anything else.

Sorry have only just joined but found all of the previous messages very useful. My 4 month old has eczema which is quite bad, have tried several creams prescribed by doctor and health visitor. We were given Hydrocostine 1% for use on his arms where it was particularly bad and this worked. Using some of the other moisturisers mentioned but they are not taking the redness/inflammation away, will probably go back to doctors this week as they mentioned referring me to hospital. Just wondered if Worrier had got the eczema under control yet and if so what was used?
Thank you

Hi agreeing with lots of previous posts. DD2 (now 10mo) v bad excema from a tiny baby. Went to GP and was fobbed off lots of times with being told to get E45 or other over the counter baby moisturiser. None worked. Had Diprobase and mild steroid. Didn't work. Saw dermatologist at hospital prescribed stronger steroid creams settled eventually on Eumovate. Also have Bactroban antibiotic cream and starting using Epaderm 4 x daily and OIlatum in bath. All only slight improvement until finally dermatologist pushed through referral to dietician who took one look and said 'cows milk protein allergy' changed onto hypoallergenic formula excema now soooo much better her hands rarely covered during day now and sleeping through most nights. People no longer stare at her I no longer spend every night crying and trying to prise her hands and feet apart. Go to a dietician sooner rather than later I really wish we'd been before she was on solids so her skin had more chance to heal. She now cannot eat dairy, soya, wheat, banana, egg, tomato or plum. Hassle but worth it. All v trial and error re diet and creams. Good luck! sorry to ramble!

Also we have found non bio tablets without fabric softener better. Supermarket own better. Also epaderm then started to make her itch so we have switched back to Diprobase.
Have heard that too about 7 year cycle. Hmm only 6 years and 2 months to go..