Eczema and 1% hydrocortisone

[homedaddy2020]

My 11-month old is suffering from Eczema.
Doctor prescribed 1% hydrocortisone to be applied on bad affected areas.

I've heard mixed review on using corticosteroids, that it only fixes the problem temporarily and it will come back soon after healing.

Any parents here can share some experience?

I was back and forth to GP 5 times after using steroid cream 'very sparingly' and for no more than weeks as they had instructe, because it got better and then worse after I stopped.
Saw a dermatologist who advised that under-usage is a more common problem, and got it sorted because i used enough, twice a day, for long enough.

Have you also changed to non-bip powder, dropped fabric softener, etc? Avoiding nail varnish can also make a difference.

I agree with Palavah. Long term use of high dose steroids can cause issues. But such a low dose isn’t a problem. Use it as needed.
Agree with making changes to laundry products etc. Avoid MI. It’s in liquids.
Also find an emollient that works. And use it. Lots. Frequently. That should help prevent things getting bad.

www.itsan.org/

low dose steroid creams are what usually works well for eczema.
your little one will feel a lot better for it!

don't forget to moisturise though, you need to do that in addition to using the steroid cream.
good luck.

Use lots and lots of emollient every day whether there is visable eczema or not- this will help prevent the flare ups from returning but when they do you can get them under control with the hydrocortisone. It is very safe if used properly.

It works like magic. I was reluctant but couldn’t get it under control with just emollients but a couple of days of thin coating of steroid cream worked wonders. Dr recommended to use it for a week but after that regular emollients could keep on top of it

Try Sudocrem (nappy cream, the one in the tub).

DS has eczema behind his knees for a period (about 6 months) - we tried loads of different moisturisers and eczema creams, some helped a little bit, others were painful, but Sudocrem sorted it right out! (Didn’t try steroids btw)

Well if you don’t use the steroid cream then the eczema is unlikely to heal. Use it as prescribed (don’t underuse because you’re scared of it), and most importantly use a prescribed emollient regularly throughout the day.
And please don’t get sucked into herbal / homeopathic/ Chinese medicine type nonsense.

It's true that the steroid cream doesn't alter the underlying causes of eczema so it could return. However once you have treated it you then need to do other things to prevent it eg emollients, changes in detergents. It definitely works though.

We found it with some patches we could get rid of them by applying cream twice a day for about ten days. You need to keep doing it for a few days after it seems better.

Also fairly common to have a reaction to some moisturisers so take care to notice what you’re using and how it goes. Ointments which are pure grease have no preservatives in and are most likely to be effective, eg hydromol.

I have suffered from eczema my whole life. Suffered terribly as a child. Hydrocortisone is the only thing that works. The 1% stuff you buy is fine, use it. The relief it gives is not the same as just moisturising. I continue to use it for a day or two after it looks like it has gone and then it stays away until it gets triggered again. Finding out what triggers it is key too. For me stress is a big one along side various allergies including dust. At the first sign of a reaction I put the cream on. Never wait for it to get bad. Mine would crack bleed and get infected if i left it.

I've used steroid creams when required for my whole life due to eczema. There are always news articles about miracle creams and how steroids ruined their lives but it's what I come back to with a flare up because it works.

When my son was was about 3 he got awful eczema on his hands at the same time as I had a flare up that ran all the way up my arm. We used child’s farm moisturiser (the tea tree and grapefruit oil one I think it is) and that cleared it up.
I was very cynical as I usually used steroid cream and my son had been prescribed it but I found loads of stuff online about child’s farm and kids eczema so thought I would give it a go.

Always remember that uncontrolled eczema is also damaging the skin.

Sorry posted too early.

My son had terrible eczema from 4 months. All over arms, legs, torso and later face. Was awful.

No matter how much we moisturised, avoided common trigger foods, it did nothing.

We were referred to a dermatologist and given quite a strong steroid. I was worried at first, but she explained that in many cases kids outgrow the worst of it, and there's growing evidence to suggest that the better eczema is controlled when young, the better the prognosis for the long term. She also made the point that whilst ideally you wouldn't use steroids, the eczema itself was very bad for his skin.

Initially we had to apply to bad areas (most his body) daily. The regime moved down to every other day and eventually just the weekends.

We now only have to apply the smallest amount of steroid cream to a couple of small areas in Friday and Saturday. His body has been totally clear for about 5 months now, and it was originally horrific.

We use a vaseline based cream during the week, and his skin is generally lovely now. We get the odd flair if he's ill, but very minor.

That's not to say he's cured, but we feel it is under control. He is happier, doesn't spend his whole day scratching and it's changed his life.

Yes it's important to use steroid creams carefully, particularly the stronger ones. But provided they are used appropriately, they are very safe. As others have said, people tend to not use them properly. Applying too little and for not enough time. The skin has no chance to heal and they just go round in circles.

Also, whilst some people do have a food intolerance, most eczema is seemingly genetic and sadly requires treatment long term. But there is a light at the end of the tunnel, or at least pit stops on the journey.

Thanks for all the messages and suggestions.

We are applying moisturiser 3-4 times a day already, I guess maybe they are not the right one for him.

So far we have tried, calendula cream, Mustela's Stelatopia, various brands of cream with ceramide, own blend of sweet almond + avocado oil.

Today, we tried ovelle aqueous cream to bath him as per doctor's suggestion.

I don't think my 11month old case is severe (yet? fingers crossed), I will try some of your other cream/lotion suggestions first. namely, Sudocrem, Child's Farm, etc.

It would buy us sometime before our visit to the dermatologist, as so far we've only consulted a pediatrician.

Any other suggestions, please keep them coming! :) Thanks

caution on 'natural' creams. some are commin allergens.
especially lanolin, calendula, nut oils, citronella.
that's why the prescribed ones are usually medical grade petroleum based.

No no no to child’s farm and sudocream!! Sudocream is a barrier not a moisturiser. Get a Doctor prescribed emollient. Try zeroderm or epaderm.

It might not be that the moisturisers you are using do not work- but that you are not getting it under control using the steroids first.

Also just seen your comment about aqueous cream- this is no longer recommended for eczema. Your doctor clearly isn’t aware of current guidelines so please try to find one who is.

Mini maxi- that wasn’t eczema your son had if sudocream cleared it up.

For my dc that suffer with eczema I use Aveeno skin relief (dark blue band on bottle) daily. If there is a flare up I apply the Aveeno first then the hydrocortisone. Otherwise it can sting. But it works like magic.

Aqueous cream is ok as a soap substitute.
When my daughter was bad I would apply emollient more like 10-15 times a day!

Epaderm is a good emollient and we also use it as a soap substitute.
I convinced myself once that coconut oil worked well but had to go back to epaderm (and a steroid prescription) as I couldn’t keep it under control.
He’s 8 now and still has the occasional flare up-usually when he’s worn something new without washing it first but much better than when he was a toddler

@homedadddy2020 why are you going against medical advice? You've been told what to use, please use it. If your child's eczema is sufficiently severe as to warrant a paediatrician, he must be in some distress. Please use medically recognised and sanctioned treatment for this rather than buying woo woo stuff off the internet. All the time that his skin is inflamed, he's in pain. Your job as a parent is to sort it out, otherwise you are neglecting him. You've got a prescription, please cash it in and use it.

First thing is to control the flare. As everyone has said use the HC as prescribed for as long as required. Much, much more damage will be done if it is not properly treated. There are a tonne of creams & oils and yet more home remedies for eczema, and I understand the wish to avoid steroids, but they will not give you control of the problem.

We couldn't use any cosmetic moisturisers or even the lotions on prescription as a base, only the ointments (not cream or lotion but ointment). Don't bathe them every day. Don't use soap, get emollients on prescription for shower and bath oil too but like I say on prescription - Dermol 200/500 worked for us. I swear by Clinifast clothes, socks, gloves, leggings, long-sleeve tops and balaclavas, they made a huge difference (Skinnies made it worse), this also on prescription in the UK.

I found GPs very variable but our local paediatric dermatology department really, really good.