Eczema - any experts?

[florenceuk]

DD and DS both have eczema, which up to this winter has been controlled with a mixture of Diprobase and occasional applications of hydrocortisone. However this winter it seems to have got worse and worse - DD is scaly and red all over her back, her arms and backs of legs, her chin and neck, back of ears and round her eyes. Diprobase alone clearly isn't enough - they scratch all the time, even at night when seemingly asleep. It's clearly not as bad as some in that they do sleep but it is slowly getting worse than say a year ago when it was confined to a few patches on her inner arms and legs.

Now, one of the doctors at my GPs that I consulted a few years ago said to use hydrocortisone on any red and scaly bits and to use betnovate on anything with broken skin. Another one said betnovate was very strong and not to use it at all unless it was clearly inflamed as it would weaken their skin. Another said, ooh that looks infected and to use Fucibet to clear it up. Can anybody give me a definitive answer as to what is the best action/plan as to when to use moisturiser/hydrocortisone/stronger steroid? DH is very reluctant to apply hydrocortisone so he tends to leave it off - do we need to be consistent?

try aqueous cream, it worked on my ds, it is a bit greasy so better putting in on before bed/after bath on a night

Aqueous cream isn't 'strong' enough for DS, he has epaderm. Seriously greasy but does stop his skin from drying out.

When it was bad a while ago the GP prescribed piriton to break the itch/scratch cycle, and now we have balneum cream too which is an anti-itch cream. That seems to be doing the trick.

anyone else (not that you ladies were not helpful, but we abandoned aqueous cream some time back!)

Hi, my ds has had very severe eczema since he was born. He is now 6 and although it is better than as a baby we still struggle to keep it under control. Moisturising is very important as are the greasy ones. Have you tried wet wrapping it really really does help. Don't be afraid to use the steroid creams short term. If it is infected you will need fucibet (or similar) There are other steroid creams of different strengths between hydrocortisone and betnovate. My son now has to always have betnovate as this is the only thing that works. (obviously with moisturising and wet wraps at night) Aqueous cream made my sons eczema worse so always good to keep trying different moisturisers.

betnovate is strong

once it has got to the stage where it is actively irritating them, start with the hydrocortisone

if that doesn't work, then move to the next steroid up

don't use any of the ones with antibiotics in (like fucidin) unless you have confirmation it's infected (so under doctors orders and prescribed) - this is because someone should keep an eye on infected eczema really (as it can get out of control and you may need different antibs cream or oral etc.)

and I wouldn't use betnovate liberally (of course if it's the only one that works then that's a different story). Do try the hydrocortisone properly though - far better to have it clear up so you can go back to just emollients than it is to keep putting tiny amounts on and not have it clear up.

btw, my eczema hideous in this weather - it's too cold and drying. I am going through epaderm like it's going out of fashion and am plastering it on. I found diprobase didn't work as well once my skin had got that dry so you might want to try a different emollient too.

Goodness, I wouldn't use betnovate on broken skin. I'm sure I've been told not to use steroid creams on broken skin because I've never done it. Something like fucidin, yes, if it looks infected. Although it usually had to be oral abs for any skin infections of dd2.

We have had to use steroid creams a lot and have found they do need to be applied regularly for a finite period to have a reasonable effect. I understand why you are reluctant but sometimes that is the only step to take.

Thats what I've found with my son. Better to use it well for a few days than to just put tiny bit on and be using it all the time. He has had infected eczema this winter and is really suffering the last couple of weeks.

relative strength of steroid creams

if you scroll down there's a table which tells you how strong they are and it's quite a good introduction into how you are supposed to use them/how they work

Ds1 had severe eczema as a baby and toddler. Aqueous, diprobase and other prescribed emollients were never moisturising anough and even caused more irritation. I started using pure unrefined shea butter and have never looekd back. I buy it online for about £20 for a kilo and keep it i the firdge and cut blocks off to put in tubs for use and kept in bathroom and smaller tubs in bag so always have some!

When he was tiny and the eczema was inflamed or infected I used fucidin H for short periods as the consultant told me severe eczema was damaging the skin more than short applications of the steroid cream. One the eczema is under sontrol from the use of topical steroids the shea butter keeps another flare up at bay. Ds1 is now 9 and I still use pure unrefined shea butter on dry sreas ie face, elbows, backs of knees to keep flare ups at bay and have not had to use hydrocortizone or fucidin for years (touch wood!)

When I had a severe allergic reaction on my face a few years ago which caused severe itchiness, redness, inflamed, etc I could only use shea butter as it calmed my skin with n irritation.

I also used something called 'mahonia aquifolium' cream when Ds was tiny which is made from a plant extract. IMO it worked as well as hydrocortizone on moderate eczema.

HTH

not an expert in general, only know about my eczema,
have dabbled with lots of things in the last 36 years, but have found that having starflower cream from napier is great as a day to day moisturiser, diprobase if it looks like it is getting over dry and then.....
I have dermovate for my bad patches and anti histamine tablets for night time to help me sleep

I don't try more gentle steroids I have one application of the big stuff then back to diprobase, it clears it really quickly.

My skin was wet wrapped for so much of my childhood that although I know it can work I can't do it - too many memories of having to soak off my bandages because they had stuck to my scabby skin (sorry! tmi!)

Oh just to add, bathing in dead sea salt minerals really helped as well

Thats really intersting foxinsocks. I really wish I'd been on mumsnet to get advice from people when ds was a baby and i was crying trying to cope with constantly applying creams and putting him in wet wraps. His eczema is very severe and has been heartbreaking to cope with.

I really hope my boy doesn't have bad memories when he is older too Bythepowerofgreyskull. He still hates having wet wraps.

We use shea butter too and seat salt in the bath. Have tried most things really. Shea butter is brilliant. Ds calls betnovate his magic cream which actually makes me cry.

poor you (and ds ) and greyskull and her wetwrap horrors!

yes, I wish I had known about it too mememe30 - nobody really explains it that well I found (when they give you the creams). I certainly didn't really understand the relative strengths of the different creams when I started out with eczema.

This winter has been nasty for skin I think .

elocon is my magic cream

I'm glad you have something that works though mememe30.

If you are only under a GP i would suggest you ask for referral to paediatrician/dermatologist.

We only had vague suggestions from GP about what to about DS's eczema, so presumed it was not too bad - though seemed awful to us (PFB!)

We asked - with some trepidation - for referral.

Had first appointment. Paediatrician took literally one glance at him and admitted him to hospital.

It was shocking but it was the start of getting it sorted - wet wraps and finding out what creams suited him. IME if you ask around you will be informed of a hundred different "miracle cures" but onl one will work for your DC.

Good luck and unmumsnet (((( hug ))))

I was speaking to dermatology nurse at DS's last appt a couple of weeks ago. Aquous (sp) cream is now the subject of research that is pointing towards it being bad news for eczema. She reckons it will stop being used at all soon (although I anticipate GPs will keep prescribing for quite a while).

florence if your DC's eczema is getting worse I would strongly advise getting ref to a dermatologist. Even the best GPs just dont have the right, up to date knowledge about eczema to advise you. They just dont have the time to specialise.

Its been a long and cold winter so it may be the central heating that is aggravating your DC's skin.

My DS has v.severe eczema. I didnt want to use steroids at first either. Got over that now (7 years later!). I will use anything that gets a flare under control. It can be very confusing when you have a whole load of stuff to use. We have learnt to tailor regime to DS's condition. Sometimes we get away with Epaderm on its own, other times we are using a whole heap of sticky stuff.

Hope you find the right treatment for the kids soon.

Definitely not an expert, but had recent experience:

DD has had a recent flare-up which sounds like your dds. Nothing I used made it any better, although the best seemed to be epaderm, esp put on wet skin after a bath. I tried 1% hydrocortisone and it made NO difference whatsoever. Aqueous made it worse.
Went back to GP in frustration and was prescribed Fucidin H(ydrocortisone) and it got rid of the eczema COMPLETELY! This is about 3 weeks ago now, and it is starting to creep back, but is not bad yet, and it has been really wonderful having a break from the eczema.

Good luck.

I agree with balloon slayer - you need a referral to a dermatology paed if possible. GPs just don't know enough about eczema to make appointments worth your time (or their!). My dd1 had awfuk ezcema as a baby - loads of visits to the GP, finally we went private at GOSH and never looked back. A cycle of wet wrapping was very successful; dd is now 8 and has flare ups in the usual spots - backs of knees, elbows, wrists and so on- but we have the know how to handle it which is what counts.

In general we have found it is better to use hydrocortizone when flare ups occur and 'zap' them before they get worse. Then once clear, treat with emollients. We get Propaderm (also known as mometazone I think)on prescription, which is a moderate to potent steroid in emollient for flare ups, plus aveeno for every day use. The aveeno is also on prescption (it costs £7 for a small tube).

I really feel for all parents and children going through this - I have been there and it is so bloody hard.

not sure how this is gonna go down, but have you tried any natural remedies? I have a friend who is a homeopath, and she treated all her 3 children, with dramatic results. That was how she became interested in it. my DS's eczema wasn't that bad, but she cleared that up too. Calendula cream externally and then some natural prescribed remedies, couple of tablets crushed up. I think if it's really bad, then maybe it's worth a try.

Thanks everyone - think I will go back to GP and ask for a referral for both of them (DS better than DD but obviously what works for one....) I am still confused! But I think I need a new emollient and some better guidance as to what steroid to use.

mememe30 please don't worry, there are good ways of wet wrapping, mine were just left on for too long and had dried out.

DD had eczema from 4 months old. Several visits to the GP did nothing...it was only after a referral to see a consultant dermotologist that it improved dramatically. The main things I learned from this are: 1) steriod ointment (hyrdrocortisone) is nowhere near as harmful as GPs suggest; 2) aqueous cream should NEVER be used as a moisturiser & left on skin. The leaflet we got from the dermotologist said that aqueous cream actually made eczema worse rather than better in about 50% of patients. It is designed as a soap substitute so should not be left on the skin, only used in the bath as a cleanser.

DD has 5 different treatments per day - all prescribed by the dermotologist. Although I was at my wits end a year ago, when the eczema was at it's worse, I'm really pleased to say that the she's now a completely different child. I could happily marry the dermotologist for rescuing us from a really unhappy situation!

Good luck with this.

hello
My DD has had eczema from birth and is never completely free from it we have used all kinds of cream and are currently using doublebase but to be honest it doesnt seem any better than any other cream we have used.

I was wondering if anyone has any advice about suncream. She is going on holiday soon and know from past experience that if the pool is salt water she cant go in it, and it ruins her holiday. Has anyone any ideas about a good water resistant sun block which will act as a complete barrier against the salt in the water.

Any help would be gratefully appreciated

cupcakesinthesnow, where abouts online do you buy your shea butter? I've had a look and I'm not sure who sells the unrefined shea butter? Thanks