AIBU or is the GP

[treelily]

I took DD1 7 to the GP yesterday about her eczema. It has flared up this week and I would say our last 5 visits to the GP (every couple of months) have been about the same problem. I feel we are really struggling to manage it successfully. I have eczema myself so we have tried lots of other things in between GP appointments too.

So I asked the doctor whether we need to consider a referral to a dermatologist and he said he couldn't do that because it was the first time we had seen him with the problem and we needed to try everything first. Our GP practice is also a walk in centre so is staffed 8-8 7 days a week so I have never seen the same GP twice. I explained how many times we had visited and that I felt we had tried everything and that we needed specialist advice, but he was not prepared to refer her and said that a dermatologist would not do anything different to him.

DH has suggested talking to the practice manager, but before that I need to know if I am just cross because I didn't get what I want or if he was unreasonable?

Well is it worth going back to see a different GP? Did you have a better rapport with any of the others?

I waited 2 years for a dematologist and he said 'your father had it so you have it'. I was devastated.

I passed a health food store, walked in and had allergy tests, it said I was allergic to diary, orange juice and smoking so I gave up dairy [didn't smoke and didn't often have orange juice] and was better in 48 hours.

Have you tried a food diary and cutting out different food groups for a week at a time? Also washing powers/soaps/shampoo etc can trigger it.

My DS has eczema, YANBU.

It started when he was four months, the go told us there was nothing we could do! Ever silly we paid for a private appointment with a paediatric dermatologist and it was the best thing we ever did. We then took the letters and prescriptions back to the GP and got an NHS referral.

DS is allergic to dairy so we have cut hat out and we have lots of steroids and creams to work with. 2 years on his skin is beautiful.

We found that the GPs just don't know enough about childhood eczema and tend to prescribe some sort of hydrocortisone without really knowing what they are doing.

I would insist on a referral or see a different GP or go private, but it'll cost about £200.

Apologies for the typos, I'm not sure what my phone is doing.

OP I'd go back and start off, very first thing with, "this is the xth time I'm coming to see you about...." And "we tried what was suggested last time, it hasn't worked, what else can you suggest?"

I'd also try cutting out dairy to see if that makes a difference, and ensuring she is not in an environment where there is dust.

If all that doesn't work, yes, go for a private consultation if you can afford it.

Yes , I think you are cross because you didn't get what you wanted , and cross because your DD is still uncomfortable / itchy / unhappy .
What works to calm your eczema ? Your DD probably has the same triggers . Have you tried wheatgerm based creams , espsom salt baths & vaseline ? All work for some people .
Sorry , but yes I think you are being unreasonable , eczema can easily be treated by a GP , a consultant will only offer the same .
Good luck to you both

You might want to try using 'soap nuts' to wash her clothes in - they gave my little cousin a bit of relief from it on his legs. I would speak to the practice manager but try the soap nuts, try using pure honey to wash her skin and don't rely on the dermatologist. One may be great, but best to look at other things too.

Assuming she's not allergic to honey and lychees for the trying.

If steroids are not clearing it up, even temporarily then something is very wrong.
My grandson had eczema very badly from the age of 3 months. We barely got a nights sleep as he never slept due to scratching all night. We did find that doctors prescribed the cheapest creams possible which were usually useless. He finally got tested for allergies and after cutting these out plus dairy he finally started to get a lot better.
It really helps if you can try and find triggers and try to eliminate these if possible. If you have any pets these could be causing or adding to the problem too.
Coconut oil is really good and it might be worth giving that a go to keep her skin very nourished.
I suggest you contact the national Eczema Society as well as they are the experts on this condition and may have some useful tips.

Thanks for the replies.

His attitude was very much 'she'll just have to live with it' but I live with it and I know it does not have to be like it is at the moment, but I feel like we have tried everything - foods, detergents, loads of creams etc.

I agree pobble I don't think they know enough about it - I don't expect GPs to know everything that's why there are specialists they can refer to, but it feels like he doesn't think she is bad enough to refer.

I should probably just give it a week and take her to see a different GP and see what happens - it definitely won't be this one again - he only works at the weekends and that is 1 weekend in 4. He did say he would document our discussion about the referral....

Next time, go in and begin with - this is our 6th time here in the last 2 months, my daughter's eczema has flared up again, in spite of all the treatment we have received and I think she would benefit from a referral to a dermatologist. Then keep quiet.

Incidentally, my skin's triggers are washing powder (fairy liquitabs are fine), sun cream. If I'm having a bad skin week, a daily antihistamine helps and elcon cream works better than hydrocortisone.

Can you phone dermatology at the hospital and ask to speak to the paediatric nurse? We struggled to get a referral for DD but were able to speak to the nurse quickly and frequently. It made a big difference. She posted out info and samples to try.

Hi, I would keep going back... We were in a similar situation with lots of infections etc. finally we got a referral and it was the best thing ever. Since then we have had an open appointment and when things go wrong we can go back. We are currently using wet bandages and they have worked a miracle. Makes me a bit sad knowing that my DD had to suffer so much before we got the referral.
Sorry for the rather rambling response.

My DD1 had horrible eczema treated by the GP for years.

She was referred to a dermatologist for a different, totally unrelated condition, who took one look at her hands and asked me how it was treated. She told me it was inappropriate treatment and sent us to the eczema nurse the same day. The guy was brilliant!

When we left I had a much greater understanding of eczema, the treatments, how to apply them effectively and how they worked plus a sheet of prescriptions. She never looked back. She still has it but it is much better controlled.

She shouldn't have to live with it, and it's completely unreasonable for the GP to suggest that.

You wouldn't say the same thing about asthma or epilepsy and refuse to treat. Why is eczema any different?

You need to be firm OP. Have you looked up any NICE guidelines that may help? I know there's one about not using aqueous as a moisturiser. The eczema society website may be some help, you can phone them for advice.

Yanbu to want to see a specialist. I object to the comment upthread that GPs can easily treat eczema! It's is very difficult to treat and can take time to find the right treatment. My dermatologist (got referred again recently but have had eczema for years) has given me a new cream routine and discussed options of further treatment that my GP can't offer.

If a specialist won't do anything different to the GP then why the hell is he called a specialist???

YANBU.

I'd go in again, go with a different attitude to before. Go in knowing you will get the answer you want. be firm as you can and if you still get the same then call practice manager...

Have you tried a clean diet for 6 weeks? Then introduce dairy, wheat and soy 1 at a time to see if these affect her?

My quite bad excema has disappeared since I gave up wheat, I know others who've had the same result from giving up egg and soy. Also I am allergic to lanolin and can't use any creams containing it (fun when I was breastfeeding, no lansinoh doesn't work on me!!) Could be worth checking these.

But definitely go back and ask for a referral, if they say no keep going back until they do refer you. No one should just have to live with excema, it is a horrible condition which can cause almost constant pain and discomfort.

Thanks for all the suggestions - there are a few things I haven't tried!

Exactly Raskova!!

The problem is I feel I was quite firm. I said pretty much what Karoleann suggests, but he just said no and didn't really seem to listen to what we have tried already.

I might speak to the practice manager about whether it is the policy of the practice to ignore what has happened in previous appointments because they were with different doctors.

And then if she is still suffering next week, like I suspect she will be, I will take her back and ask again.

Have also just been wondering whether the school nurse would be any help?

Oh do please keep on at them. Def speak to the manager and if possible, go back to any of the same doctors you've already seen.

I had childhood eczema and my mum was always constantly fighting my corner. Then luckily in my teens it died down a bit apart from on my scalp. Since being a 'grown up' and doing my own doc appts when I have flare ups they palm me off with the same thing, no referrals allowed because I have to keep seeing so many different doctors (like you, 8-10 staff and never able to see the the same one regularly).

By the time I finally did get a referral I was pregnant, so the dermatologist said there weren't many options that were clinically proven to be safe in pregnancy (as they don't test the creams on pregnant women) but I should have been moved up the ladder years ago and offered light therapy etc. and they wished people would keep nagging the GPs as too often people suffer needlessly! So good luck with it, I hope they can help her.

YANBU - I had eczema as a child and it was utterly miserable. I also had adult acne that I struggled with for two years before a referral that sorted me out within six months. I now pay privately to see a specialist if I have an issue and see it as a necessary occasional living expense. If that isn't an option absolutely keep pushing for your DD through the NHS.

YANBU.
We were back and forth to the GP for 2 years with DS and his severe eczema. It was really bad on his face, arms and legs. We were finally referred to dermatology by a paediatric Dr after DS was admitted to hospital with a "viral wheeze"( - now known to have been asthma).
The first dermatologist was rubbish and kept insisting on stronger Hydrocortisones. Then when he retired we saw an amazing dermatologist just over a year ago who said we needed to try something different, and put DS on Elidel.
Within 3 days his skin had cleared up completely. He was like a different child.

Unfortunately DS has had a few flare ups lately, mostly to his legs, but our current Dermatologist is good, and always has new things to try (such as creams which are not steroid based, Skinnies leggings and tops, different moisturises etc) which to date have all improved his skin.

I would keep going back and push for that referral. Had we not been referred we would still be plodding along with the rubbish hydrocortisones the GP favoured - which never helped at all. Good Luck.

Check to see if you can self refer to a specialist at your nearest hospital!

Ive had 2 chronic problems which GPs have said they can do nothing for and won't refer me for. Discovered i can self refer and have already seen one specialist who diagnosed the exact problem and gave me something to help as well as great advice and a follow up appointment.

We have eczema in reaction to a wide range of washing powders, lanolin/wool, skin left damp, polyester worn next to the skin, silver (now added to lots of clothes, horrible!)

I don't think we can self refer here but will look into it.

Thanks for all the encouragement to keep asking.

my dd has eczema and my GP's have been fantastic! The lastest thing is an oil based lotion that i can melt down to use in the bath as soap as well as applying direct to her skin. i have used it for a week and all her really sore patches have cleared up! i can't think of the name off the top of my head and it is in her room so will find it in the morning and pm you with it as it really has been like a miracle cure

I do find that dd's flares up when she is poorly (she is only 10 months old) or teething. Could your dd be a bit run down maybe or coming down with a cold maybe?

Hope you get it sorted but ime you do sometimes have to go in with the attitude of 'i am not leaving without an action plan or a referral' I have an ongoing issue with pain in my shoulder that i have had endless battles with my GP over - including them refusing to re-prescribe pain medication that i was put on by the pain specialist consultant at the hospital because the GP felt it was "knocking down the wall to swot a fly"

Eczema is horrible Seems like a lot of GPs just don't know how to treat it. A friend and I both had trouble a couple of years ago with treatments. Do you know what kind of eczema it is?
I'd recommend researching as much as you can yourself because the GPs are just generally rubbish and don't have a clue (in my experience).
The last bad patch I had I managed to clear up eventually using sunbeds, avoiding swimming, avoiding dust, gardens/grass/pollen, only using non-bio detergent etc. etc.
Have you tried cetaphil cream? That stuff can be fantastic for certain kinds of eczema.