Eczema - any advice?

[HouseOfBears]

My DD (5 months) has terrible eczema on her face - it's like an open wound, all raw and weepy, with crusty and flaky patches. It's so sore poor baby. We have had antibiotics, steroid cream, use emollient in the bath and apply Aveeno moisturiser often throughout the day but nothing has helped. We've been referred to a dermatologist, but in the meantime does anyone have any advice or suggestions for how to help?

Both my DSes had it as little babies but not much since.

With DS1 we found a cream which seemed to help - it was a diprobasey texture but it was super-expensive from Health Food shop. Diprobase would have been fine. We applied every half hour for the first day, every hour for the second, every 2 hours, then every 3 hours then morning and night over about a month. It went pretty quickly and only flared(s) up very very occasionally in winter now. I didn't want to use steroid cream because I thought it was the first step of a ladder to skin-thinning etc.

DS2 5% hydrocortisone cream for a week sorted it out. Yes, light steroid cream, but in this case there was only one step on the ladder....

So I would say if you find the right emollient cream, use it absolutely shedloads.

My son has pretty severe eczema and we have tried almost all creams. The best ones for him were dermol 500 and Aripro eczema mousse. Have had to use steriods too but these two treatments minimise the need for it. I agree with try dairy free and possibly gluten free also.

Both my sons had it as babies but they cleared up only for one to suddenly start it again at about 7-8 years old quite severely.

Humphrey that's why I said that every child is different and some will react worse than others.

dd can stand the aqueous cream. We get it prescribed by the GP for dh's psoriasis.
She has it because she has showers instead of baths so needs a moisturiser for her skin.
If you are bathing then a drop of olive oil will cut out the need for a moisturiser. I guess that's the same as these recommendations for rapeseed oil. Just don't use too much of it.

And please DO NOT cut any food out of your baby's diet without speaking to your GP first.
Growing children need calcium, vitamins, minerals and proteins and so removing any of these from their diet will not be beneficial. If your child has an allergy then he/she will need supplements to ensure they are still getting all the nutrients they need.

You need any allergy properly tested for in a clinic and not in a walk-in health food shop. You will then need an appt with a nutritionist.

It may or may not be down to diet. It could just be environment. It could be something your baby will grow out of. There's no harm in trying various creams and potions, changing your washing powder and even your cleaning habits but when it comes down to food, you need the advice of a qualified doctor.

Sorry, THERhubarb, I didn't mean to offend and of course everyone is different. It is just that aqueous cream is no longer recommended by the Eczema Society, but is still prescribed by many doctors despite having an irritant in it

see here

there are lots of things less likely to irritate so it is worth trying those first

Fwiw THERhubarb both my DCs have a milk protein allergy and I have never had to give them supplements.

S'ok Humph.

GirlOutNumbered - brilliant for your kids. But just because it worked for yours.... you know the mantra. Not everyone is clued up on food and I admit that if my kids had a dairy allergy I wouldn't know what other foods contained calcium, I would have to research it. A good doctor can tell you this and regular check-ups will ensure that your child is getting all the nutrients they need.

DS started to get eczema flare ups around the 5month mark. After a few trips to the GP and multiple chemist creams, we decided to go and see a dermatologist. She recommended dermol for everyday use (morning/ night/ whenever else on dry patches) and then two other creams for flare ups/ more irritated skin. One was synalar (I think) and there was another one w steroids. Anyway, we used these and his skin cleared up in two weeks. We've been managing it say to day using dermol and have had to use the stronger stuff a handful of times when it's gotten more irritated to nip it in the bus. Think the important thing is to try and find something to stop the itch so the skin can heal. And then it's about managing it to avoid flare ups so less itching and skin breaking and getting infected. Best thing was seem the dermatologist who knew what they were looking at. The Different GPs were frustrating. Good luck... It's so hard watching them scratch and be so uncomfortable...

Yes and I completely agree with seeing doctor, but then pushing to see a paediatric dietician. My dr didn't think babies could have allergies when breastfed. It was only when DS1 had blood in his nappy and I went to A&E that I actually got anywhere with him.

I haven't read the whole thread but the carrier bag full of products that I got from the gp made the excema much worse. A wise old woman in the village suggested that baby dd was allergic to lanolin. I stopped putting anything on her apart from oilatum in the bath and it cleared up. I was on the point of wrapping her in brown paper it was so awful and uncomfortable.

(Almost all of the products from the gp contained lanolin.)

I don't have a baby with eczema, but I've had it most if my life. The best advice is moisturise constantly. I use diptobase which is quite good but really greasy. I would be careful about using things like E45 it actually made mine worse (iam allergic to one if the ingredients). Don't forget to use the prescribed medication either, if it works keep on and on until it goes. If you leave it for even one day it will get worse. Avoid at all costs anything scented or fragranced no matter now good they claim to be, they inflame it. Things like heating and really cold weather do not help, but make it worse.
Use a pair of cotton scratch mitts in the night to help prevent scratching (not scratching eczema is the key, open weeping wounds from excessive scratching can cause infection).
If it gets worse go back to your doctor and demand to see a dermatologist. I was referred to one, they do a little patch test to check if you are allergic to anything and prescribe you the appropriate medication. I am surprised that a doctor has given you steroid cream for the face! I was always told you could not use them on the face. I found them pretty useless after using them for years, they ruined my skin.
I hope this helps, but please don't take no for an answer from the doctor if you know all if the above is not working. But most babies grow out of having it which is a blessing. X good luck xx

I've just read one of the other messages, I am allergic to lanolin too which is why I can't use E45. Your baby might not be but worth considering.

Just want to reiterate @TheRhubarb's point about not elimating foods without the advice of a doctor. if you think it is a food allergy causing the problem ask to be reffered for tests. The side effects from elimating food groups can be bad if not managed properly.

She's not eliminating food from the babies diet though, is she? The baby is 5 months old, nad presumably not eating 'food' yet! She's talking about an elimination diet for herself, not the child.

Tempnameswap - should have added that blood tests are usually done after the scratch tests, yes, absolutely.

Cutting things from the diet - one should never do it with a child except under medical supervision, as has been said above; however, even a bf mother might need extra guidance about her diet. It's so easy to become deficient in calcium.

she shouldn't be eliminating anything from her diet.

I'm glad you've got confidence in docs. ethelb None i've ever been to have known what the hell to do with eczema or asthma apart from throw steroids and or ABs at it. Both of which are no help in the long term and are being over used. I cured my DS's eczema (and asthma BTW) with alternatives.

Er... just to reiterate - it is perfectly safe for the OP herself to eliminate dairy and egg from her own diet for 2 weeks to see if it makes a difference to her bf baby.

It may well hold the key.

It sounds as if her GP is not up to date with current thinking over allergens in breast milk so she is unlikely to get medical advice to eliminate these foods whilst breast feeding.

Whilst waiting for the dermatology appt (which may be ages) it is perfectly ok to do a 2 week elimination diet herself. For 2 weeks you wouldn't need to take any supplements. I say this as a medic and someone who has been advised exactly this (by allergy specialists) having waited 100 years for referrals.

Will dig out the NICE guidelines...

No Shady, in this age group (5 months) blood tests are done instead of skin prick tests which are not considered reliable (too many false positives and negatives).

Calcium deficiency is not a risk for the mother over the period of a 2 week trial......

I feel a bit exasperated tbh. This is an area where there is a lot of misinformation, not least from GPs, and families are struggling on with the worng advice. Please don't let MN perpetuate it too!

How on earth do you think vegan or vegetarian mothers manage, or those with an allergy of their own that means they have to eliminate a food group? Of course it requires some common sense. If you are not going to be getting essential nutrients from one source then you need to get them from another - if you don't know what these are it is not exactly difficult to find out.

No opinion on here is a substitute for proper medical advice, but this thread has shown, if anything, how variable the advice you get from the gp can be. It is not always easy to get a referal, and the simple truth is that with eczema there are no simple 'right' answers, and any hcp worth their salt will tell you this. You keep going until you find something that works for your child, while consulting, of course, medical professionals.

See here for a flow chart from the NICE guidelines.

Eczema (atopic dermatitis) is considered a possible sign of a problem with cow's milk protein allergy. And a trial of a diet excluding cow's milk and egg in the bfing mother (for 4 weeks actually for eczema) the correct course of action. (They do recommend a calcium supplement though, although I would suggest that would be more important longer term than just for a short trial).

adc.bmj.com/content/92/10/902/F1.large.jpg

@mostly they will probably already have a lifetimes worth of info on how to maintain an health diet. They will also know what certin products are 'contaminated' with the product you are trying to avoid.

How many 'lactose intolerance' threads have we seen with people who still eat dairy milk? Its not as simple as just stopping eating a few things.

@ppeatfruit silly me for believing evidence based medicine. Drs have always been frank with me about the diversity of possible causes, complications and treatments for eczema/asthma actually.

ethelb - but lactose intolerance is completely different and would be most likely to cause gastrointestinal symptoms, not eczema. Actually in this age group cow's milk protein intolerance/allergy (to some degree) is not an unusual cause of eczema.