Toddler with dry skin / excema advice really appreciated

[NorwichMummy]

Ds is 21 months and has had bad contact dermatitis around his mouth due to excess dribbling. He also suffers from dry skin on his body. I took him to the doctors just after christmas to get some more hydrocortisone as his face had flared up and doc referred him to the health centre excema clinic. When I went they told me to ditch my normal routine of bath every other night and daily application of almond oil in favour of bath every night and using Hydromol emolient in bath, Hydrolmol ointment at night and morningand then the Hydrolmol cream during the day (for his whole body and face). Howver in the five weeks since we first went to the clinic his whole body has flared up and is now really sore and itchy. I questioned this with the nurse at the clinic and was told I'm doing fine and to keep on applying the ointment. However I'm really unhappy about doing this as it seems to be making things worse, rather than better. Can anyone offer me any advice or suggestions about what I should do next?

hi. don't think this is quite the same problem you've had, but for what its worth - my dd1 is 2yrs old now, and had cradle cap for first 6 mths, and then dry patches on back - doc/nurses said it could develop into exzema if not careful, so we have appplied olive oil or calendula oil to her whole body after every bath from very early on, plus rub on some doc-given DiproBase cream on the dry bits. a few months ago though we decided to give her a bath only every other night, instead of every night, and sometimes a couple of nights gap in baths - and really, her skin in much better all round for it. i think there was some research recently, or at least something in the press, to suggest daily baths were not good for kiddie's skin. makes sense intuitively i think.

How about trying an alternative route. Both my nephews had terrible excema and were greatly helped by an allergist(who found their excema was dute to food allergies) As soon as the offending foods were taken out of the diet their skin cleared up very quickly. SIL had to keep them on quite a strict diet for a while but gradually introduced the foods back into their diets over a period of a few years and now they are both fairly ok eating most things.

DD1 has quite nasty dry skin as a toddler and I found chickweed cream really good (from healthfood shops)
Also put porridge oats in a stocking, put it under the bath tap when running the bath'. The gunky stuff that comes out can be used as a soap and really soothes itchy skin.

Hydrocortisone cream can be nasty stuff and not recommended for prol;onged use especially in children unlesws absolutely necessary.

we got on well with chickweed. ds suffered only on his right hand. we also found that Eye Q fish oil greased him up from the inside and made his overall dry skin lovely and silky

my ds1 had the most awful weeping excema on his face, arms and legs when he was a baby. We tried eveything hydrocortisone, diprobase, all the emollients and then someone told be about Aveeno oat cream (you can buy it ove the counter in Boots). I swear to god it vanished over night! I've since recommended it a million times to friends and family and most have told me it works.

two of the DC and I are having big flare-ups just now, is it something to do with the weather??? anyway it is blardy awful.
We are using oilatum bath [junior version for them, they are 2 & 7] and tons of aqueous cream (ds1), E45 (2yo and me) and olive oil (me, raid kitchen pantry). also massaging the DC with Grapeseed oil - yes stuff you cook with, we used it during baby massage course as it is unheard of for it to cause any kind of reaction.
From our experience it is clear that different things work on different people so it is a bit of a hit-and-miss guessing game.

BTW, if you haven't already done so, ditch the fabric conditioner and suss out what soap to wash clothes, towels and bedding in. We end up using very very old-fashioned "soap flakes" at itchiness times like this. Fairy non-bio the rest of the time.

Good luck

If it seems to be making the skin worse, then trust your own judegements and stop using it. I had various creams and emoilients that had a terrible effect on dd1 when she was a baby ! I stopped using them immediately and they should let you try something else. There are MILLIONS of things to try ! She grew out of it before she was 2, but dd2 still has it bad at nearly 4. She has just had blood test for allergy testing - to see if and what makes her skin react, as it is very unpredicatable and reactive.
I don;t bath too regularly, 4 a week usually. The best thing is finding a moisteriuser that suits and plastering it on loads. Actually no, ignore that, in my expericence I have no idea what the best thing for eczema is, it s abloody nightmare ! You have my sympathies !

BTW drinking Goats milk instead of cows has cured my DSes, one is staying totally free atm because he drinks gallons of the stuff, the one who is itching has less of it. Just another thing to consider. or confuse

just been back to OP - almond oil?? what if he has a nut allergy / sensitivity??

I had exactly this problem with DD1 when she was tiny. I took her to the docs as the HV just seemed to shrug it off (I suppose it is common, but I thought it best dealt with early). Doc immediately asked me how often I bathed her. When he realised we bathed her every night he said 'There's your problem then' Once a week at this age is fine. No products in the bath (I wasn't adding any anyway). That advice on it's own was enough to make a huge difference.

She now aged 3.8 has a bath twice a week and DD2 21 months has the same (as her skin is the same). They once styaed with my step mum for a week and she bathed them every night - they were itchy for weeks

That said, if my two have been repeatedly under the weather their skin flares up. Both have dribble dermatitius right now, thinking of putting sa bit of vaseline over it at night to keep it from getting worse - not sure if it will help but I might give it a go and see.

Thanks for all your thoughts, really helpful. Should have mentioned two things sorry, use either grapeseed oil or almond oil, but only almond oil since knew he was fine with nuts, never any flare ups from eating nut butters, ground nuts, etc... Also I am really interested in alternative therapies, etc... but when I mentioned it to the nurse at the eczema clinic she looked at me as if I was mad and started going through dietary advice for first weaning onto solids very slowly and loudly to me. When I explained that what I was actually interested in was dietary control for eczema she looked at me as if I was mad and told me it was a load of nonsense and to use the cream she'd given me.

I agree about Hydrocortisone being nasty, I hate using it and only do if I absolutely have to. I'll have to see if they have chickweed cream in our health food shop.

Also never used fabric softener and use non bio soap flakes always.

I suppose the thing that gets me frustrated is I take ds to docs / hv for advice and I just get perscribed a massive list of things that make his skin far worse, and I hate seeing the poor little thing suffer. I feel much clearer in my head after reading your posts, I really appreciate your advice.

my friend went to see a healer (I know)recently for her dds eczema and he suggested that she cut out baths altogether, she now has about one a week, after which she uses pure talcum powder over he whole body. She doesn't use anything else at all, and her eczema has cleared up completely. My DD doesn't suffer severely, but has a lot of dry patches. I'm considering trying this method, and will feed back if anyone is interested!

It is utter ridiculous for a health care professional to seem so surprised about diet being suggested as a factor in causing excema!

Allergies, especially to cows milk, are on e of the most common causes of it!

Good luck- hope your dc is feeling better soon.

I agree totally with you smartie, the advice I have been doled out time and again by HV's beggers belief. I wish there could be some kind of centralised training for all HV's before they are "let loose" so to speak! Saying that there are some amazing HV's out there and I would hate to think anyone would see me a tarring all HV's with the same brush

eczema is really hit and miss - what works for some doesnt for others. i would recommend trying different emmolients - maybe he is reacting to the one he has.

doublebase is very moisturising, but needs frquent application, but my fave is epaderm. but if your ds is reacting to ointment, perhaps a cream would be better. go to your doctor and ask for a different emmolient - sometimes you have to try several before you find 1 that works.

also, I was advised against daily bathing as it dries the skin - we bath ds twice a week.

if the eczema is an angry red and weeping, it is likely yo be infected - no amount of moisturising and hc will get rid of that, he will need antibiotics

as he is 21 months old, I would doubt it is a food allergy - a lot of kids grow out of them by 18 months, and from what you said it has only got worse recently. my ds has food allergies, and his eczema was bad from introduction of formula (4 months)

hth

My nephew was 3 when his food allergies were diagnosed. He did not have eczema (how do you spell this bloody word- I've used about 3 different spellings today!)from a baby either. started badly when he was about a year old. He still gets flair ups from these if he has too much of a particular food too and he is now 14.

For the discomfort I can really recommend putting some porridge oats in the foot of an old pair of tights, adding a few drops of chamomile oil and tying it up and using it to wash with in the bath. Is very soothing on the skin and dirt cheap.

I'm going to try the porridge oats next time he has a bath, sounds a really good idea.

The HV told me to bath him every day as it makes the ointment more effective, but I'm really not happy with the advice. Ds' skin started to get a lot worse, much drier and itchy about four days after starting the new regime of baths and Hydromol. When I took him back to the clinic they told me that they could see a massive improvement in his skin and to keep going with the regime. When I pointed out that his skin was actually much sorer and drier they totally disregarded my comments. He's due to go again on Weds so I think I'll have to make my point more emphatically this time.

I'm an Epaderm fan too. DS has dreadful weeping ezcema from almost birth. He's 3 now and completely clear (although fresh strawberries make his legs dry with patches of red skin). Has a bath each night in just water. Use a finger-scoop of Epaderm as a soap substitute to clean his "important bits" and that's it.
He was prescribed Hydrocortisone creams when skin problems were particularly bad when younger, but while the solution was quick, the skin got thinner at those points.

My DD had very dry skin which would sometimes lead to her scratching and making it bleed. I bought L'Occitane Mom and Baby Balm here and although it's quite pricy it lasted ages and really worked. You can get it cheaper on ebay but it's all plant based and really moisturised her skin.

i havent read all the replies but you could try some of these that we use:

Aveeno
Oilatum
Unguenten
E45 - sounds silly but has proven quite good at times (espeically Junior E45 if you can find it)
Balneum is very good (prescription only and VERY VERY oily)

I find that what works one day doesnt work the next, so you almost have to rotate your methods. We used Hydromol in the bath along with a mixture of the above.

HTH

sorry that should have read unguentum

Amazing how health pro's can remember individuals' skin, when they see hundreds of kids with similar
Maybe take some photo's each week or whatever to refresh your and their minds of how things are going.
Really hope you get sorted soon.

Try cutting out any biologic al soap powder and fabric softener, go to natural cleaning products (search on the eco parenting threads) and use oats as others have said. My friend used emu oil that she got online from a farm in the west coutnry - sorry no other details other than that. but it was all natural stuff. Also I have seen special skincare (natural) stuff on www.purenuffstuff.com. I ahve bought loads from them, not the special skincare - but can vouch for the stuff being good value for money and really gentle. I am pregnant and have really sensitive skin.

I also agree with you that bathing every night is not necessary. Surely that will try the skin out more?? I have heard that hydrocortisone thins your skin if used long term - I don't have any proof mind you, but a friend of mine has hardly any sensation and reckons that is the cause of it...

Hope you get it sorted

The only reason I can think of for daily bathing is to get rid of any sweatiness, which is unlikely to be a problem right now. ds had bad eczema during the summers which we control with aqueous cream and a special talc (Zeasorb) in the areas which get sweaty. Doesn't sound like we had the same problems as you, though.

I totally agree with you giggle, photos are a good suggestion.

Use all eco cleaning products and washing powder, etc.. already potpouri, was thinking bout going down the soap nuts route, but not sure about them when washing real nappies!

Have decided to go back to infrequent bathing and oil routine and see what happens.

Thanks for everyone's kind words of advice, you cannot know how much I appreciate them x