severe eczema - 10 month old baby

[fluffydinosaur]

hello, I realise this isn't AIBU but posting here for traffic.
my 10 month old baby has got severe eczema covering his face and arms (also some on legs and torso but not as severe). it started to develop when he was about 5 months old and has got gradually worse. Nothing is helping and we are desperate! we have tried hydrocortisone, euvomate, and fusidic acid for infected patches. he has dermol 600 in the bath and we've also tried oat baths. we moisturise religiously with epaderm ointment and aveeno. we are waiting for him to be allergy tested but none of this is running at the moment so likely to be a while before he can be referred. in the mean time he has never had dairy, eggs, nuts or fish. he is breastfed and I have small amounts of all of these in my diet although I did give up dairy for around 6 weeks to see if that made a difference - it didn't. please, if anyone has any experience of this, what worked?
thanks

with my youngest, it was if I had orange juice or tomatoes...

With eczema this severe it's highly likely to be food allergies. Dairy is the most common, then soya and egg. I'd try eliminating all three completely, checking ALL labels, for several weeks. Then reintroduce one at a time, a week apart. Keep a diary over that time.

In your phone appointment I'd be asking about introducing these foods directly to your child. Our consultant advises giving all major allergens as young as possible to prevent further allergies developing. Also be very careful to wash your hands thoroughly before touching your DC's skin as there's a theory that allergies can be caused by the allergen getting in via broken skin like eczema.

Fairy non bio makes my son's skin awful. The only powder we can use is ecover zero

My first child was like this, he was wet wrapped for two years, tried every prescription cream. He was under dermatologist and was sedated at night so stop him itching. The magic cream for us as a pp said was lush dream cream, honestly it completely cleared him up.

We had the same. LG has dairy, beef, soya and some fruit allergies. She was reacting to allergens in my breast milk. The protein structures of dairy and soya are so similar just cutting out dairy isn't always enough, we needed to cut both.

My son used to scratch his face in bed too. We bought scratch sleeves so he couldn't do it and medical grade eczema bedding as he would rub his face in the sheets. They really really helped.

Boots do an allergy washing powder or liquid. I'm senstive to perfumes in nearly all laundry powders even with a double rinse.

Also piriton and benadryl (cetirizine) dont work well for me as antihistamines. It has to be loratidine (clarytin)

I feel your pain too. We had an absolute nightmare with DD clawing her skin off (shoulders were particularly bad)

After loads of trial and error we are now on a regime of diprobase ointment 4 times a day and then a combination of hydrocortisone for little breakouts (we rarely use this) and clobetasone for any bad break outs. We have to use the clobetasone a fair bit but it’s the only way her shoulders and torso do not get scratched to death

Oh and really randomly we switched to smol non bio washing powder (from fairy) and that’s helped too.

Sorry, and as PP has said Piriton does help a bit at night too when she’s really itchy

I would strongly consider an probiotic. I used Optibac daily and that made a difference. A lot of immunity comes from the gut and IV antibiotics wiped that out and caused many eczema flares in mine.

My son had this and it only went away when I moved him onto the hypoallergenic formula, the one where the milk protein is completely broken down. It was prescription only. He was even allergic to my milk.

My 11 month old has moderate eczema with flare ups. It has required an oral antibiotic for the weepy eczema on his cheeks once before. I find that dribble causes flare ups. At the moment his skin is doing really well for the first time in ages. Our current regime as prescribed by a paediatrician is 2.5% hydrocortisone ointment (not cream) on scaly, red patches, aveeno moisturizing cream and aveeno cleansing oil for baths. I was told not to use aveeno til oats were properly in his diet but now that he has porridge every day without a reaction that it would be safe to use without causing an allergy. Previously we've tried a range of emollients but I don't think any have been as gentle and as healing as aveeno. I would also recommend buying some scratch sleeves if your baby scratches their face in bed. Good luck x

I’ve heard child’s farm is amazing

My son went through this as a tot and we did everything with all the creams bathing steriods. Tbh nothing really worked. They all helped for a few days but then became useless. Hayfever is in our family although my other 2 kids never had any symptoms of hay fever asthma or eczema.

Wasn’t food allergies and doc was reluctant to cut anything out of his diet saying lack of nutrients could cause worse problems. He was a specialist in asthma / eczema and was pretty confident he would just grow out of it.

And he did

There was a period of time when he was around 2 to 3 when we noticed patches clearing and coming back not as bad, until eventually it went completely. I can’t say if it was just him growing out of it or if it can be attributed to one of the following 3 events:

He had a couple of normal bugs followed by a bout of water borne food poisoning after falling in a puddle in the countryside. Cryptosporidium. For the 2 weeks he suffered diarrhoea his skin cleared completely. Doc felt that this was the immune system building and having something else to do. When he got better the eczema started to creep back.

Then shortly after we switched washing powder to Daz. After always sticking to Fairy non bio. I later learned fairy non bio has a reputation for making eczema worse in babies due to its perfumes.

Then a few weeks later we went on a sunny holiday and had some sunshine at home and I noticed his skin improving.

By the next year it had virtually all gone unless he spent too long in a swimming pool.

Now at age 8 there is no signs at all.

Was it one of those three things or did he just grow out of it? We’ll never know but I hope your child does too

My hubby has been like that from birth, it has got better but the 2 things that has worked for him have now disappeared. One of them was coal tar, just wondering if the soap might help. You could try it on a patch.

I highly recommend Kokoso baby organic coconut oil. Also double check that all the baby's clothes, blankets etc are not causing irritation. Sometimes the washing powder can make it worse.

Forgot to mention Diprobase ointment is good as well.

My son had eczema on arms and legs and face, but not on torso, it turned out to be mostly caused by a contact allergy with wool.

There are so many repeated misconceptions about eczema on MN. The most important one is fear of steroids. Steroids are massively underused, are safe and effective and cause minimal side effects in the majority of children. When skin is hugely inflamed you need an anti-inflammatory. That’s steroids. Please use them and don’t be afraid to use them. You can’t moisturise very red, angry, inflamed skin and expect it to improve. Here is a very good article from numerous dermatologists explaining this:

medicinetoday.com.au/system/files/pdf/medicine_today/article/MT2015-12-040-MOONEY.pdf

It’s also worth making sure there is no coexisting infection and treating with oral antibiotics.

The second misconception is food allergy. The vast majority of eczema is not caused by food allergy. Posters who say their child’s skin improved by removing foods are over representing that possibility on MN, and usually too much time is spent eliminating food with the hope of small improvements when a good course of strong steroids will improve skin within 2 weeks. Food allergy is more likely to be caused by eczema; poorly controlled skin with broken barrier provides an unnatural exposure to the immune system by foods that get on the skin.

Think of the eczema like asthma. Steroid ointments are the reliever, like Ventolin. No one would expect to manage an asthma attack without Ventolin. The preventers are the moisturisers, trying to keep the barrier in place.

So, good strong steroid, antibiotics if needed, and moisturise when able, then look to see what might be triggering it when it’s better and clear changes can be delineated more easily.

Good luck.

It really is just a matter of trying different things. For my son it's washing powder and bath wash - he can only tolerate persil non bio powder and clothes have to be washed on a long wash. Anything other than child's farm will bring him out in a rash. Oilatum junior cream clears it right up if I slip up and he does break out.

My eldest little girl had severe eczema all over her body, hands, face and scalp (she pulled all her baby hair out with the scratching and used to have blood on the moses basket sheets in the morning). Ultimately it was trial and error with the prescription moisturisers (we found doublebase gel good), but ultimately what cleared it up was a short period of using a high dose of steroids (betnovate which did shift it, and hydrocortizone on her face - both under GP guidance). Once it was cleared we were able to maintain with moisturisers and short stints of hydrocortizone, and bath emolliants were good too.

We tried various things with diet, but it didn't have any impact, and I would urge caution with this at this young age (see this leaflet by the Eczema Society: eczema.org/information-and-advice/triggers-for-eczema/diet-and-eczema-in-children/). It's not actually that common a trigger (it's much more common as a contact allergy), and you can do more harm than good in restricting their diet when they're so little, so maybe one to discuss with your GP for guidance? My little girl had a reaction to milk if it touched her skin (she got hives), but ingesting it had no impact on her general eczema (we did try excluding it for a while but made no difference).

I'd echo what other users said in terms of looking at washing with detergent free washing liquid/powder. We found that even non-bio stuff caused clear outbreaks/reactions where the clothing had been in contact. We use Violets which is expensive, but really good stuff, and also moved to more natural cleaning products where they might come in contact with it (like on the high chair). We also used scratch sleeves which really helped at night when they can't help but scratch and make things worse. If you want to DM me, I've got a few pairs I could post to you (free of charge) to try if you think they might be useful. The mitts are made of silk and they go round the back so they can't wiggle out of them at night.

I hope it eases up for him soon - I remember how heartbreaking it was seeing her so covered in it. She really turned a corner around 2 and is 4 now and only gets the odd flare up from time to time.

thanks everyone for all the advice - it is horrible that so many of our children have had this, but also reassuring to know we aren't alone. we have just finished a 1 week course of euvomate(moderate steroid ointment). it really didn't work though - seemed to help for a few days and then it was all downhill again so by the end of the week we are back where we started! the gp is supposed to be getting back to me once he speaks to the dermatologist. in terms of the food, it is difficult to know what to do. I think we will try an elimination diet and food diary assome of you have suggested. my husband had eczema as a baby and he also has food allergies - mostly nuts but was allergic to egg as a child, so that makes me think there might be a connection. I'm also quite reluctant to give DS any foods that might provoke an allergic reaction while we are in the midst of a pandemic and may be harder to get medical attention...although I realise leaving it too long to introduce foods can also increase likelihood of allergies - it's all so frustrating!

Eumovate isn’t strong enough. Need something like Elocon ointment. If there was partial response to a moderate steroid you’ll get good response to a potent steroid. It really does work well. Babies sleep better, aren’t miserable and skin can be much better managed and any triggers can be more easily found. Push for a stronger steroid and keep a diary. The article I’ve linked explains steroids very well.

Good luck OP.