Eczema... what would you do / have you done?

[luckysocks]

DS is 2.8 and has terrible eczema. We managed to keep it under control with creams for a while but it's getting significantly worse.

He has regular flare-ups, which I now consider to be when it is particularly angry with split, broken skin and infected. Even when not 'flaring up', it's never clear. There's not much of him which isn't affected.

I keep returning to the doctors and keep being told to use medication, most recently a higher dose hydrocortisone (which I hate using as often as we currently need to), the usual emollients and antibiotics.

It seems to me that we need to be identifying the cause at this stage, but we just can't seem to get any further with treatment than the above. We're currently seeing what happens if we eliminate dairy, but a) nursery haven't cut it out completely yet so we're not getting a clear picture (I've spoken to them about this today) and b) I worry that we don't know enough about it to ensure that we are substituting this with sufficient nutrients.

I'm intending to go back again at the end of this week and have been reading the NICE guidelines, which give me something to work with but again recommend treatment rather than prevention. I'm not shy about fighting my corner but at the moment I don't know what to fight for... should I just be insisting that we are referred to a specialist? A dermatologist? A dietician?!

I know eczema's not the end of the world but it's breaking my heart to see him struggle with it :(

Can't write much now as battery almost dead ...but yes, you should see a dermatologist if the eczema is as you describe. We have found bleach baths (yes I know!) very good ....google them....you also need to be aware of what you clean your bath with ....always giving baths a very good rinse. Common sense I know but you would be amazed how many people don't and residue from Ajax etc irritates eczema skin. Also you need special detergent for clothes washing...we use only eucalyptus wool mix and that too has made a huge difference. Dd has been virtually antibiotic free for 2 years.....apart from when she swam in dam and needed antibiotics for 7 weeks...including IV. I really feel for you as it impacts on entire family and is horrid for the child.x

sorry, missed thrust of your question re ivestigating cause...ideally yes this should be done and we have looked at everything but still not really sure what triggers it. We did no dairy from 2 - 4 yrs, she has been wheat free etc but she continued to have eczema. Excluding a food group can be done but it needs dedication.

Get a referral to a derm if you can
You need to use the creams as the GP describes, have they given you clear guidelines about amounts?

Get a referral to a dermatologist and a dermatology nurse. We used wet wraps when ds2 was small. It used to have to be done with tubi-grip bandages but I think you now get special clothing. Ds more or less grew out of it at 7/8.

Thanks for your replies.

tilbatilba I've just googled bleach baths... didn't actually expect it to be a, well, bath with bleach in! Did you try that under specialist advice? Keeping the bath free of residual products is a good point. We used surcare for a long time, although it didn't make a great deal of difference. I've just googled the washing powder you use and will give some of that a go on his clothes - is there any particular brand/source you'd recommend?

EldonAve yep, I'm using creams as described, my only problem currently being that her instructions on using the hydrocortisone, which is currently 5%, would make good sense if the eczema ever actually cleared up. Which it doesn't. So based on her criteria, we would be using it all the time. It's something I need to bring up on Friday.

jubilee thanks - I think that's perhaps what I need to ask for.

Definitely push for referral to a dermatologist. We have seen one and he prescribed Eumovate for the body (which GPs are, IME, reluctant to do), and I know it's quite strong but it works wonders, I am using less cream in the long term. I never use bubble bath or soap, just wash DS (13 months) in oats water (I put oat flakes in a sock and squeeze it under the running tap). For when he needs a good wash, I am using Weleda, which is gentle, and make sure I rinse his skin well before getting him out of the bath.

It's trial and error with many products, I was using Surcare but have now switched to Persil non bio and it's fine.

The dermatologist I've seen said a cause for eczema has not been found, it's just one of those things people seem to have, and the triggers are different for everyone.

I hope you find something that works for your DS, I know how frustrating it is.

Oh, and for cleaning the tub I use the Method cleaner, it's a bit pricey but worth it, IMO, less nasties.

I would go back to your GP and insist on them taking scrapings of the skin to be tested, your DS's skin sounds a lot like mine has been for the last while, red and itchy, cracking and bleeding. I have been using eumovate for weeks and it hasn't cleared up, I saw a different doctor a couple of days ago who actually listened instead of fobbing me off with a repeat prescription for more steroid cream and she said it sounds a lot like a fungal infection, she has taken samples to be sent to the hospital for testing and I will be referred there if the anti fungal cream doesn't help.

Aveeno bath oil is very good. It is oat based. We got samples from the dermatology nurse and then got it on prescription. You can buy it - I think boots have it.

Just checked the packaging - eumovate is the new cream we were given last time - it's hydrocortisone, isn't it?

Oats have come up a couple of times, which makes me wonder if the slight improvement in his skin is down to the oat milk substitute, rather than eliminating dairy. No idea whether that has any relevance.

It sounds like I need to push to see a dermatologist with him then, and go from there. I'll also ask about Aveena while I'm there - if there's any chance of getting it on prescription I might as well give it a go...

I'm making a list of all the things we can try, I'm ready to try just about anything! Thanks for the recommendations :)

We had a terrible time with my sons eczema and only really started getting somewhere when we got a referral to the hospital as then we got a proper plan from someone that really knew what they were talking about. I would defo push for a referral as once you are in a clinic you get to keep going back and keep trying different plans until something works.
We got very lucky in that we stumbled upon the cause of my son's worst eczema (cat allergy...we found out my younger son was allergic so had to re-home cats and once cats were gone DS's eczema cleared right up, felt so bad we hadn't realised that was the cause).
Oh one really simple tip that really helped stop repeated infections was to always apply cream in downward motions so it couldn't get caught in hair follicles and cause an infection.
Good luck!

I think eumovate is a steroid cream, but it is different to hydrocortosone. We have also had betnovate - tho I can't check exactly what it is, as its in DS bedroom, and he's asleep.

We have also had success with switching emollients, tho the starting point wasn't as bad as you describe. Aveeno seems to be working at the moment.

The little boy I do know with eczema that sounds like your LO's had wet bandages and ??funcin??? He looks like a different boy now - his face is completly clear.

My ds had it when he was 7 months all over his body. We went to the GP and he gave us epiderm cream and a light hydrocortisone which did nothing, then he gave me a stronger hydrocortisone cream, which again did nothing, then he tried to get me to stop feeding him formula and give him a dairy-free alternative, when I asked him the reasoning for this, he answered that it was difficult to diagnose the cause and that dairy allergy was a common cause of eczema. That was when I asked for the dermatologist referral. Another 3 months later we were referred to the most brilliant dermatologist who explained it all so logically. She said that you need to treat the symptoms first before getting to the cause. Once you clear the skin, and you will need the steroids to do it (just like you wouldn't not give an asthmatic their ventolin), you need to medicate to clear the skin, then its easier to focus on the cause of the problem. Dietary change should be a last resort because it can be so restrictive. She gave us Eumovate, Oilatum for him to bath in. It cleared up most of his body but he did need to go stronger (Betnovate RD) but we only needed to use it for one week before it cleared. After his skin cleared, I was then able to determine that his eczema would come back with certain foods. We did a blood test with the dermatologist and we found what he was allergic to and have cut them out. And finally, though the dermatologist was not fussed about the cream we used, I heard about a cream called Aveeno Baby that is only available in the states that I ship over by the boxful but it worked well for our ds. I wish you all the best, it's tough watching your little ones suffer.

We are all eczema sufferers and have only recently discovered Aveeno. It has been a wonder cream for all of us, having tried most other things.

I second Aveeno and also we use Manuka Honey skin cream when it gets infected. We use infaderm for the bath as oilatum/ epaderm etc just made DS's skin itchy as they are greasy.

YOu can buy Aveeno baby in the Uk
www.soft-skin.co.uk/?OVRAW=aveeno%20baby&OVKEY=aveeno%20baby&OVMTC=standard&OVADID=1921278031&OVKWID=443274211031&OVCAMPGID=122429531&OVADGRPID=1133860919

We had allergy testing done and it turned out DS was allergic to the acids in fruit and veg- tomatoes, berries and cherries being the worst.

Since we regulated the amount of uncooked fruit and veg he eats, DS's eczema has been much better.

We bought Ds's PJ's from here, they contain silver and helped stop the itching, so skin could begin to heal over night.
www.eczemaclothing.com/

WE used dermasilk leggings under his trousers during the day which made his legs less itchy.

Hope some of this helps.

I have suffered from eczema all my life so I do understand. I did grow out of it so your son will hopefully get some relief as he gets older. However, I have a very clear picture of what worked for me and what didn't. There are two separate things I think - preventing eczema arising and then getting rid of it when it does. To stop mine flaring up I really have to focus on keeping my skin moisterised. Interal heating kills my skin as does lots of water, washing up etc. So I would make sure you keep his skin moisterised. I found heavy creams quite bad - so sorbelone (sp?) and aquaeous were always recommended but they made it worse. Aveeno brand is by far and away the best for my skin and I use their baby lotion on my DS who gets eczema. I have about 5 tubes of their hand cream and use it around 10-15 times per day. I also use a bath oil for him now which seems to help.

To actually get rid of flare ups, for me, only cortisone helps I am afraid. I know you are not mean to use it too much but it really is for me, the only thing that actually gets rid of the eczema. An ointment is better than a cream.

I would second those who suggested taking him to a dermatologist, and also second the person who suggested avoiding acidic food. Tomatoes really aggravate my skin, same with strawberries so there could be something in that.

Hope this helps!

Apparently there are eczema nurses out there and they can advise about applying creams eg I didn't know about putting cream on in a downward motion either or that you weren't supposed to rub in. It has to soak in.

Scratchsleeves are good. Aveeno is good tho my GP will not prescribe as too ££. Weleda calendula baby shampoo and wash is also good.

Def get referred to hosp. Made all the difference for us.

Definitely try no dairy, it worked a dream on a friends DS. Good luck.

Sorry for the hijack OP, but for those who did allergy testing for your LOs, how do you go about it and what does it involve? Thanks

With DD1 kept a food diary during weaning and found that a vegetable was causing her to flare up - an intolerance she grew out of. I've had people including GPs insist this could have been but come across research linking food intolerances to similarity to plant pollens proteins - and a common weed where we lived was linked to this vegetable.

Another family found apples and tomatoes were triggers for their DC - apparently both common. A mother at school gate just found her reflux and eczema plague baby was intolerant to diary - she got a referral to dermatologist and detain via her GP and no diary has had a dramatic improvement for her DC. My GP was never that helpful. Apparently citrus fruits and strawberries are also common triggers.

Never used fabric conditions and found a washing powder that causes no issues - one of my parents had issues with washing powders anyway.

For DS finally got a cream that worked for him on prescription - in our case Aveeno. We got that when we changed GPs as first lot and HV kept prescribing cheaper ones or one that wouldn't rub in. Also got a bath emollient - the brand of that seems to matter less. Apparently the ability of certain creams to help can diminish over time - according to HCP but we've not found that. Let cream soak in - read that from eczema charity website.

Used excama clothing to break the itch scratch cycle - DS was difficult to get to ware them during the day but insisted when he was bad and always at night - made a massive difference to him between ages 2 and 3. He refuses to ware them now older.

www.snugglepaws.com/
www.eczemaclothing.com/

Make sure DS always wares cotton - as wearing synthetic fabric flares him up. This is a pain with school uniform and applies to bed sheets as well.

Be very careful with sun creams - found one that doesn't affect him.

He since been diagnosed with asthma. He is also showing signs of having inherited my dyslexia - doing some reading found small scale research showing asthma, dyslexia and eczema having been linked to low zinc levels. Apparently low zinc levels are associated with allergies. I'm not sure about this but have started to include seeds in our diet which are high in zinc and a child vitamin high in it as well. Due to the dyslexia I'm also at moment including EPA and magnesium.

He has shortly after starting been eczema free - the stubborn behind the knee patch has cleared up. No idea if it is the vitamins of not. If he is better I suppose the big test will be in summer month which every year he has a massive flare up.

Sorry it long - world war 3 is breaking out so struggling to think succinctly.

Definitely push to see a dermatologist - and see if you can see a dietitian as well.

Regards milk - has to completely according to mother with baby's dietitian so watch out for processed food as dried milk is in a lot of things as it used as a sweetener.

Wish I pushed harder - as DS was at times bad and I worry if I had maybe he wouldn't have have gone on to have asthma.

Thank you so much for the messages and the links - there is some great advice on here

I had no idea for example that you shouldn't rub the cream in - I always make a point of massaging it in as thought that would be better.

I'm going to order some Aveeno and pyjamas when I've finished typing this :) I'll be asking about a dermatologist tomorrow.

Keep us posted!!

My chum's chum got given a leaflet from her eczema nurse and it tells about how to apply creams, bath emollients to use etc an to apply steroid 10mins after the aveeno or whatever cream has sunk in. If you want I can send it on to you. PM me!

My 19 month old has had terrible eczema from 2 months old. Hydrocortisone did nothing and all the of popular creams were ineffective. We bounced between the GP and an nhs eczema nurse for months and eventually I googled the best paediatric dermatologist I could find and went to see him. It was life changing and I cannot recommend him highly enough. Dr David Atherton. He has a weekly clinic at Great Ormond Street in London and It cost us £180 to see him. He gave us a private prescription which my GP will then prescribe so we get the medication on the nhs. I know it's expensive but you will probably only need to see a dermatologist once. It was worth every penny and DS's skin is now clear as long as I am diligent in our moisturising routine.

The Best advice he gave us was to bath DS morning and night in plain water and then while STILL DAMP cover all over (not just patches) with 50/50 liquid paraffin in soft paraffin, which you can buy in boots @ about £5 for a big tub. Atopic eczema occurs when the skin isn't able to create an effective barrier to stop itself drying out and keep irritants out. This method creates a barrier and locks moisture into the skin. It's like gloopy vaseline.

I am sure that this will not be the case but thought I would mention it as it happened to my daughter. She had eczema all over her body as a tiny baby and we were using the cream from the doctor and the hydrocortisone. It wasn't clearing up but doctors advice was keep using the cream. We ran out one day and had to use ds's cream the next morning we were amazed to see all of the angry red patches had gone. It turned out that she had been allergic to her cream and it had only been making it worse. She still has eczema but it doesn't rule our lives any more.