eczema crisis point

[topmum1]

Help! I'm new to mumsnet but need some advice. I have a 16 month old toddler who has had ezcema pretty much since he was born. I have been to the doctors several times about this but feel i'm just getting fobbed off with 'it will go eventually'. That's not good enough!
I have tried several creams (aveeno, double base, really thick stuff at bed time) and steroids (two types). I give him a bath every other night with just water, I dress him in natural fabrics, we use non-bio powder and I keep his nails short. The problem is a vicious cycle - I use steroid for two weeks (max time it can be used apparantly) plus other creams and the ezcema disappears. I then stop using steroid cream and it returns. The back of his legs look awful once again, the scratching starts and so it continues, I use steroid cream - you get the picture.
I don't know what to do - i'm worried the steroid cream is not good for him and I also wonder if there are any other causes e.g. food, allergies etc.
Does anyone have any experience of this or just some advice? It is really getting to me
Thanks

I would push for a referral to a dermatologist as there are other treatments to try. When my eczema gets really bad I use wet wraps which help me a lot.

Might also be worth getting in touch with the national eczema society. They have loads of useful information, you will be able to find them on the Internet.

I hope you get a bit more help soon

It's awful isn't it. I was at my wits end with dd2 who has suffered dreadfully not so long ago. Her skin has got loads better since I don't use any detergent in the washing machine (do her stuff separately). Also I would say every other day is too often for a bath - twice a week is plenty and get a good oil to go in it. Also find a sympathetic gp and get a hospital referral. I had to ask for the referral but my gp was supportive. Have seen the hospital paeds dr who has referred us on for food allergy testing. Keep badgering them!

Good luck to you both.

NICE guidance for eczema in children, indications for referral. Might be useful if you need to discuss referral for specialist advice with your GP.

A 3rd recommendation for scratchsleeves here!

I went back and forth between GP and eczema nurse (which is where we were sent when we asked for referral to dermatologist). Eventually we went to see a paediatric dermatologist privately (dr Atherton at Great Ormond Street) and I wish I had done it from the start. We now see him once a year, he prescribes a mild steroid that is generally offered on the NHS and GP now prescribe on repeat prescription.

In terms of care our regime is a daily bath (in the evening) with no soap, then while he is still wet we slather DS in the simplest moisturiser which is 50/50 liquid paraffin in soft paraffin. It's like gloopy Vaseline and creates a barrier locking moisture in and irritants out. Also careful to keep short nails and scratch sleeves when he has a flare up.

That should be NOT usually offered on the NHS!

Thanks for all the advice. Will have a go at a few of them and think I will try and see a dermatolgist too.

the things that really helped DS2, who had severe eczema, was

1. Having the GP actually watch me applying the creams. It turns out that I was applying far too little steroid cream and also applying it after his other creams and that this was affecting its effectiveness. We had a wonderful GP at the time, and booked a double appointment for this.

1. Not stopping the steroid cream abruptly, but tapering off gradually over several days.

1. Treating his eczema very aggressively. When DS2 was your DC's age, I completely smothered him in moisturizer at least 6 times a day, so that we got through a large tub of aveeno every week! At the first sign of a flare up, I got going on the steroid cream.

1. Bathing only once a week and potty training as soon as I dared (DS2 had repeated infections in his nappy area ).

The wonderful news is that severity of eczema in under 5s does not correlate with severity in older children. Although most children who have bad eczema when then are little will remain susceptible, it might be very mild. This is what has happened with DS2. When he was 16mo, I couldn't imagine him ever having clear skin, but his skin is beautiful now.

I will 'fourth' the use of scratchsleeves. And the itchybaby site that tuckingfits mentioned. www.itchybaby.co.uk

I think you need to find what works for you - epaderm was the best gloopy cream for us. We also used oats in a muslin when we bathed DS. And I swapped my fairy non bio for those washballs things you get - natural soapstones I think, in plastic spheres. They were fine - every bit as good as non-bio powder.

We also think that a cream sold on itchybaby called 'Hope's Relief' did wonders for DS's skin. It may have been a complete coincidence, but I don't think so. It was amazing for us, but it's really expensive. It may be worth trying and just seeing if it works for you.

Also, if you need suncream, the Badgers one on that site was fine for my DS. (He was one of the few who got worse in the summer, not the winter.) I promise I don't work for Itchybaby btw!

There have been threads on here too about putting Milton in the bath water. I know it seems completely counterintuitive, but I remember reading a research paper online about putting bleach in the bath of babies with eczema. Apparently it was so successful, they halted the trial so the placebo babies could have the bleach too . But when I mentioned this to our gp, he looked absolutely horrified, and obviously hadn't heard of it. I reckon it must tie in with the Milton thing though - do a search and see if it comes up.

Just quickly, both waitrose's baby botty butter (think some solidified veg oil and camomile) and their baby salve (solidified coconut oil) are good maintenance creams now my ds is no longer acute, but just needs to keep moisturised. They are not expensive - £2 or £3 I think.

regarding the bleach baths, there's a 2010 blog post by a respected US based allergy specialist here about the concept, giving links to the research.

Hit the eczema hard with a stronger steroid, we used betnovate and eumovate and it cleared what hydrocortisone had failed to touch.
It means we don't often use steroid often now, only in response to a flare. We also use Balneum cream every day morning and night and balneum bath oil in every bath. I bath my 18 month old DD every other day sometimes less although my South African dermatologist does not agree with the reduced number of baths theory (she is very confused by 'the British and their reluctance to bathe!?')
I am using goats milk with my DD but have not seen a real improvement following the switch (mind you she still eats a lot of cheese so if it is a dairy issue this wont be helping).
I bought scratch sleeves but never used them as discovered the eumovate at the same time.
However we were prescribed tubifast long sleeved vests and leggings which my DD used to wear/sleep in and little mitts which I taped on with surgical tape, this stopped scratching at night to a great extent.
She now has eczema behind her knees and in her elbow creases, back of neck and occasionally flares on her arms Andy legs but she is so much improved from this time last year.
Good luck it does get better, you're not alone, it is awful so I truly empathise.

I have had eczema since I was baby (now 36) and still use steroid creams.

I use Vagisil(!)when it gets so bad I want to Brillo pad my skin.
It has lidocaine in which gives me enough of a numbing to break the itch scratch cycle enough for me to at least sleep.
I get awful patches on my nipples (not Pagets I have been checked), eye lids and round mouth where I need to not scratch at all.

I have asked my GP about it and we considered that as long as I wasn't slapping it on all the time, it's meant for you nether regions so can"'t be too bad.
Maybe something to try in an emergency? Obviously I am not a dermatologist or remotely medically trained but I do find it really helps me