the ongoing saga of DDs bum rash continues....

[LackaDAISYcal]

DD has had problems with nasty nappy rash since she was 16 weeks old. It isn't confined to her nappy area either, and she gets huge oval patches at the top of her thighs and more in the small of her back.

We have had about 12 different potions from the GP, inlcuding anti fungals, steroids, emmolients, barrier creams, which work for about a week and then it comes back with a vengeance. I have also tried bepanthen, metanium, kamillosan, sudocrem, E45, canesten, benadryl, calendula crean, arnica cream.......the list is endless and nothing shifts it.

Have been in every brand of disposable nappy, eco and non eco, several types of real nappy and several different nappy/wrap combinations.....all to no avail.

I've also tried several different washing powders, both bio and non bio

Anyway, HV has suggested I see the doc again and ask for a referral to a dermatologist, but I'm worried the GP is going to fob me off with yet another cream that isn't going to work.

She is now 15 months so has been suffering with this for 9 months of her young life, and also gets eczema type falre ups in ger knee and elbow creases and at the nape of her neck.

What realistically should the GP be doing? Should they be taking a skin swab or something to see if it's bacterial? Is there anything diet wise that might help? (HV seemed to think that the link between dairy and eczema had been pretty much discounted )

I'm getting to the end of my tether with it and feeling like I must be doing something wrong that I can't get it cleared up. The longest she has gone without any sort of redness/soreness on her bum is about five days

Oh, sorry that's a bit of a long one ; any advice or shared experience would be greatfully received, ta

I know what the HV was getting at but I dont think that a normally intelligent person would have trouble with restricting dairy while supplimenting with vits etc!

I had steroids for my own legs when a young girl. they do cause the skin to thin so I understand your reluctance to use them all the time.

It is horrible to be so powerless to help the poor little babies when you can see they are in pain with the itch.

hey ronny....I think they assume we are all just silly little girls who know nothing.

Just back from the GP and came away with a reluctantly given referral for dermatology and being made to feel that it's my fault for not lathering her head to foot in emollient cream at least 10 times a day

I basically got a lecture because I only use doublebase on her twice a day (it's what it says on the pharmacists label and what I was told by the GP who prescribed it), and was told off about the steroids and that they should only be used in a flare up (trouble is her skin is always flared up and I don't use them all the time.....she said of course it is because I'm not using the emollient enough). She also suggested that it might be the soap I used in her bath....when I siad she only gets a bath once a week and in water/oilatum, she asked but what do you use when you shower her......erm nothing as she isn't showered either and only cleaned with water or very mild organic baby lotion if she has a poo. She seemed to think this odd, and I could tell that she didn't believe me, but I'm just going on the advice of HV and my own GP.

It's so frustrating, and I feel a lot worse about it now as she was basically suggesting that it's my fault for not keeping on top of it......erm I'm bloody trying

Anyway, she wanted me to up the emollient and if it didn't get better then she would refer me. I stood my ground and said, can you refer me and I'll up the emollients in the meantime and see if it improves and she reluctanlty agreed, but I notice she didn't type anything on the computer .

As if it isnt hard enough without GP giving you grief! I only bath/shower every other day max. They dont ever get dirty enough that they need washing every day. Obviously they get the flannel every morning & night before bed, but that is with just plain water.
I do find that when DD2 has bad skin the more frequent the emollient the less red it appears. Sorry

thanks Ronny

Have been out and bought some eco disposables tonight as we have a few different sorts on the go at the minute and certain brands make it worse than the others. Someone on my PN thread suggested ecos might not be as harsh.

Have been lathering on the doublebase today and it has actually gotten worse, but it could be the boots own brand nappies she has been in.

I'm at the point where I look at all the potions and lotions and really don't know which one to put on. So from tomorrow, we are using daktacort to help the current flare up as it;s the only thing that seems to work, with doublebase as an emollient and as a cleanser on dry paper wipes as well with the eco nappies and see what happens.

Fingers crossed.

Lackadaisical, if using eco nappies, I think the Bambo Nature ones are supposed to be less allergenic than Moltex.
also, if using cloth, have you tried using soap nuts instead of detergent? Here

thanks chipmonkey I had a sample of those back when she was tiny and thought they were really good. I might order some for when the nature babies are finished.

Not tried soapnuts, but we have got some surecare washing liquid to try. I have several loads of nappies to wash and dry over the next few days. To be honest though, I'm losing heart with the real nappies and thingk dispos is maybe the way forward. Mind you, we have nothing to lose by trying the soap nuts.

We thought about geoballs (?) as well, but I'm not sure how effective they will be on everyday stains.

Hi, You can get Aveeno bath sachets on prescription from NHS (or ask your chemist to order them in for you privately). It's ground oatmeal and you put it into the bath. It works better than regular oatmeal ground in a blender, IYKWIM, so worth getting it. It should help keep skin calm until you get to see the dermatologist.

Don't discount a food allergy. I'd ask for a referral to a pediatric allergist and a nutritionist at the same time. It will probably take up to six weeks to get an appointment. I'd suspect dairy and wheat, but best to start an elimination diet only once you've seen a qualified allergist and have a nutritionist to follow your LO.

Good luck.

You MUST get swabs taken, after suffering for the best part of a year it turned out dd had strep A - I am absolutely fuming because they kept insisting it was thrush even though the canestan didn't help but the steroid one did but as soon as we stopped it came back.

She need 2 courses of antibiotics to get rid of it and she is very prone to it coming back - we have since seen the dermatologist as she has also got psorasis. If they have strep A and they get a wound (like through a chicken pox spot) it can be quite serious for them.

sorry my rant over......

I've found with ds (who in no way has bad eczema) that oilatum, aveeno and child e45 all made him worse if anything.
The only thing that seems to help are vitamin e capsules opened and spread on the rash, and avoiding all sodium laureth sulphate shampoos/bath additives and so on.

Sorry, just realised you're also wondering about the disposables/real nappies and how to clean them, etc... I'd try really cheap disposable nappies, because they're less likely to have added gel crystals and the like. I use LIDL pull up nappies for my DS, age two. They are great, and really inexpensive. I also don't mind chaning them frequently, because they are so cheap. Frequent changing might help a lot.

If you are going to go down the real nappy route again, I'd try adding half a cup of vinegar to your rinse cycle. Then rinse again in plain water. The vinegar is a natural fabric softener and also helps remove any last traces of detergent from the nappies. This should work well with both terries and fleece-lined nappies. If you have nappies with a waterproof outer layer, you can still use the vinegar but you might notice they retain some of the smell of the vinegar.

For my other dd that has excema I also found all the creams made it worse and what helped was either jojo oil or organic sunflower with added vit E because it is most like the oil or skin naturally produces. The dermatologist was quite happy for me to use this on psorasis dd too.

ooh, lots of posts (thanks stroppyshopper, cargirl and pooka) and things to consider, but...in no particular order

I asked the GP about taking a swab and she said there was no need

Have tried the LIDL nappies and they seemed to really irritate her. Have just ordered a big pack of the bambo nature ones but they are a bit pricey.....on top of the reusables that were going to save us money .

Have tried vinegar rinses and giving the nappies three rinses after every wash and changing her nappies (real and disposable)every two hours maximum all to no avail.

vitamin E capsules sound like a sensible option. I'll get some tomorrow

I'd heard of the Aveeno stuff and that it's good; didn't realise it was available on prescription though.

food allergy; since this has been going on since she was 16 weeks old and exclusively BF and I am coeliac so wasn't eating anything containing gluten, I doubt it is wheat. Dairy is always an option, but we will wait to see what the dermatologist suggests before starting her on a restrictive diet.

thanks for all the input

as the advert says....together we'll crack it

Hi Lacka, I have a little knowledge of itchy bits I suffer from a god awful auto immune problem that is unfortunatley focused on my vulva!! it must be terribly uncomfortable for her. I can recommend an oilatum product that is a gel for the bath, only used on wet skin. It is absolutely marvelous, really this will help her enormously costs about £8 but you should be able to get a script. I am under a dermatologist and it has been prescribed by him, he has explained it as, although the skin is wet it can lack moisture and this causes the dryness and itch, this gel helps moisturise and lock in the moisture.

Please go back to your GP, and insist on seeing a dermo, no ifs or buts, tell them you have taken their advice listened to their suggestions but at this point it is only a dermo who can help.

I saw countless gyno's, who told me I was imagining it, my GP's told me it was everything under the sun but what it actually is, I had one visit with the dermo and he knew straight away.

It really was the best thing I have ever done to argue my way there. Please dont take no for an answer, and try the oilatum gel, it has been so helpful to me, and believe me I know how it can itch down there.

thanks colacubes; we already use the liquid stuff that you put a few capfuls in the bath. I'm getting a referral so we'll see what they have to say. I actually should've got a private referral as DH has bupa cover through work. Will call tomorrow and get them to do that.

Thanks for all the helpful posts; it's given me lots to think about and lots of other options to pursue

and ouch, poor you . I used to get dermatitis herpetiformis as a side effect of my coeliac disease before I was diagnosed so I'm all too aware of misdiagnosed nasty skin conditions. This doesn't look like DH though, thankfully.

Oh I know, I have a clever little jig that I do, If Im in public and its to much to bare, lol.

Glad you have arrangements for your dd, she must be very uncomfortable, the bath liqiuid I have tried and it didnt work for me either, but the gel, honestly that is one of the best things I have ever done for myself, brilliant stuff, the difference can only be felt to be believed, my No 1 tip for anyone with itchy bits,she will reap the benefits. Hope all gos well, and your dd is better soon.

Daisy - so shocked at how unhelpful your GP is being! With the number of creams etc your DD has been prescribed, surely the Effing doctor should realise that she needs to see a specialist. Well done on fighting for that referral. Someone has to figure this out - and it's not you, they're the ones who are qualified to do it.

Your HV knows nothing wrt eczema and dairy. Ignore her as far as that bit goes.

Have you tried the herbalist I suggested on the other thread? She might be able to suggest something (she is a pukka biochemistry-trained medical herbalist, not some witchdoctor) link here again if you want it.

The GP I saw wasn't my usual one; she is one of the newly qualified ones they sometimes have in and who get to use the old store cupboard as a consulting room . I think I'll try and see my own, experienced, knowledgeable and lovely GP soon (he usually does the baby clinics). He suggested ages ago looking into dietary reasons if it didn't improve over time.

HV said "she might just be one of those babies" and that it would "improve once she is out of nappies"......even though the worst of it is on her thighs.

Thanks again thumbwitch . Would she need to see her though? It's a bit far away, lol. I might look into a local herbalist here in Leeds.

Lacks
I used Oilatum for DS- it could actually be quite stingy for them, so not sure it's the best thing.
My Brother is a prof who works in skin, he always says go see a consultant dermatologist if anyone asks him about skin problems. It might not be finding the right cream but finding the right way to use the cream, IYSWIM, and it can vary greatly from patient to patient. I would get a referral ASAP before you try putting anything new on the skin.HTH

Thanks pinky. I'm going to call the GP this morning and see if we can get a private referral through DHs BUPA scheme to try and hurry things up. It's looking a bit better this morning thanksfully.

Message withdrawn

How did the call go Daisy?

Not being funny but have you tried olive oil? I have used it for scaly, irritated skin with good effect, i rubbed it on/in several times a day, great in the nappy area as it moisturises and protects.

Drapolene is a good old fashioned cream.

you've given me an idea MNP; we have some cradle cap oil that is basically the same ingredients that are in all the natural, homeopathic nappy creams. I might try a bit of that and see how it goes.

After a few days in eco dispos with a little daktacort morning and night, and using double base as a cleanser/moisturiser at each nappy change, things are looking much better. She is still scratching though.

Didn't get through to the docs on Friday; I left it too late apparently. They only do telephone consultations until 11:30. Will try again on Monday.

hope you managed to get a swab done.