Eczema - what else can we do?

[BabaganooToo]

DS is nearly 2 and has horrific eczema in his elbow and knee creases and no matter what I try it just isn't getting better. It has only really developed in the past 3/4 months. It used to come on worse when he was poorly and then clear up - now it's persistent.

We've been using hydrocortisone cream for nearly 3 weeks, morning and night. This used to work but seems to no longer have much of an effect.

On top of the steroid cream we put vaseline-type cream (hydromol) 4 times a day. Both creams prescribed by the doctor.

We do oat baths every 2-3 days, cotton pyjamas, don't use fabric softener, try to keep him cool... it's really bothering him and he scratches loads, particularly at bedtime.

Nursery suggested baby powder but I don't think it's advised, plus the skin is clearly dry and needs moisture. I just don't know what else to try for him! Any suggestions would be appreciated!

Have you considered less baths?

We cut them down to once a week & made a massive difference.

I'm sure you have tried it but Epaderm cream is amazing.

the steroids can make skin thinner apparently which doesn’t always help

good luck

Fewer baths. At his age once a week is fine and just wash his bum, hands, face and neck in between with water only.

Go back to GP and see if he can have a different/stronger steroid cream. Definitely no fungal issues with the eczema?

Antihistamine may help with itching.

@Shouldhavebutdidnt thank you! I haven't cut baths down as he gets filthy at nursery and quite sweaty at the moment, but if it might make his skin better I'll definitely give it a go! I thought the oat bath might be ok, but it's obviously not making much difference.

Thanks for the recommendation- haven't tried that cream yet so will order some.

You can still wash him as needed just with a warm flannel. Stand him in the bath and just wash down where necessary if he needs it but long soaks in the bath regularly are not good for his skin.

My 2 and a half year old only gets maximums 2 baths a week, and washed with a flannel in between. If his hair is dirty in between a warm damp flannel is more than enough to wipe through his hair (the joys of boys!)

@Yourethebeerthief thank you - I've got another GP appointment next week but they keep doing it over the phone rather than actually seeing him which is frustrating. Doesn't look fungal to me but will mention it.

Will ask if they can prescribe or recommend an antihistamine for him too, hadn't thought of that!

I will cut down baths (not a problem cause he absolutely hates them at the moment...)

Have you tried oat baths?

One of our children’s truffled hugely with eczema as a baby. We tried dozens of creams and nothing seemed to work. We then finally got to see an eczema nurse and started using Dermol 500 - absolute game changer for us. We still had to be patient but steady improvement over a few weeks and now he doesn’t suffer at all. I still buy a bottle from Amazon as my teenager uses it for his skin (it’s a great cleanser)

Children suffered - sorry

@Yourethebeerthief he absolutely hates a flannel wash and will flail and scream, but just going to have to get on with it. Feel like all I do at the minute is force him to do things he doesn't like!

I have had eczema since childhood and DS1 also has inherited it. I could list various creams etc but from my experience it's one of those things where each individual person will have something m that works for them and it's such an individual thing, a case of trial and error until you find the best management. There are a variety of hydrocortisone options of different strengths and dilutions. Obviously cautious with young children but if the hydrocortisone you have is not working I would return to GP for an alternative. Bad eczema that's not under control is unpleasant for a child (or adult) and also increases infection risk. I had the wrong creams for over 30 years, never questioned if too much just used what I was given but had to constantly apply it and it was so hard at times. Only by chance when I changed GP's and saw someone new who switched things up and overnight it really changed my life. Now I don't get as bad flare ups, it's much more under control. My advice would be to keep persevering with doctor if what you've been prescribed isn't working. If you can get to see a dermatologist if it gets really bad this can help. Once it's under control it's a case of managing and preventing. Can also look into dietary triggers. Best of luck!

@DirtyMis yes all baths are oat baths, but they do say they need to be in it for at least 15mins and he's only staying in for 5 mins or so because he hates it, so maybe we're not giving it a proper chance to work

I second less baths and epaderm, we applied it three times a day to get it under control and now just at night

You need to get the GP to refer you to a specialist who will see you in person. Keep pushing for this.

A mumsnet thread will not help you as treatment is so individual- e.g I see several posters have mentioned bathing less but did our dd daily baths are what cleared it up.

Our specialist was great and put together a care plan that we've been using for over a year. Persevere until you get the same would be my advice

Yes you need specialist support. Hydrocortisone is a mild steroid, there is so much more that an expert can do to help.

@bakewellbride yes I know what you mean - appreciate every case is different but thought I would ask in case there was something obvious I was missing!

I have another appointment soon so will push for an in person appt and hopefully referral. It is really quite bad and he's broken the skin scratching it, so I'm worried about infections. It must be so uncomfortable for him.

Re: baths this was our experience too actually. A quick shower daily is what keeps it under control but get the cream on super quickly afterwards. My DS itches more without this routine but lots of people experience the opposite that less baths is the way. Seems it's not a one size fits all

Two of mine had severe eczema and I feel your pain.
We went through everything.
Hydrocortizone won't touch severe eczema. Mine were prescribed stronger steroids (Elecon and Eumovate) by the dermatologist and it was the only thing that worked.
If you use it properly, it works well and no they don't have any patches of light skin /scarring etc (they are mixed race too so have darker skin).

It sounds scary but having watched them on IV antibiotics etc for infected eczema and the pain they went through with it untreated, it really isn't. You just need to wean off it properly which some people don't do and wonder why they get problems.

Epiderm, Hydromol ect did nothing for us alone when it was bad and if anything made it worse especially with 'wet' eczema.
I found calamine lotion a help to dry out wet eczema before putting on emollients.

You really need to be referred to a dermatologist who isn't afraid to try stronger steroids (GPs usually won't).

Oat based creams work well aswell such as aveeno they have one specifically for eczema.

Perhaps with your next appointment speak about alternatives if you haven't already tried. I can imagine it's very difficult. I hope your little one's skin improves. Stay strong mama!

This is going to sound like an ad or something and I should point out that my little one's doesn't sound half as bad as yours but I've been using a daily spray from Salcura and it has been absolutely brilliant. It wasn't expensive so could be worth a go

Back to the GP. Ours has an interest in dermatology and recommended:

Euomovate twice a day until the flare is healed and then on Saturdays and Sundays to keep it at bay (weekend therapy)

Daily baths with dermol - you're putting so many creams on, it needs to be clean so it can breathe, not clogged.

Epaderm cream works brilliantly for my DD, dermol works well with me - IME it can be hit and miss to figure out what works best.

Hydrocortisone won't do much, and I don't know hydromol but if it's thick like vaseline, I wouldn't want it on the creases of my elbows which is where my eczema is worst - too heavy.

We use an antihistamine, wash with Roche posay lipikar and for one son use moogoo, the other epaderm (moogoo stings other son). A lot of people think it may be diet related (wheat/dairy), but we’ve messed with these to absolutely no effect but it might be something to ask your gp about. It’s so hard op, hugs, my 11yo is currently bandaged up as he scratches his wrists and arm in his sleep. We’ve it covered to let it heal for the moment and then we’ll see how it goes. (He can go months being fine then it comes back)

I know you've had a lot of replies but if this helps: my DS is under dermatology for severe eczema. He is down to annual reviews now because it's under control and they all agree what he has is 'top line' so here it is:

Baths EVERYDAY. The idea that baths dry the skin is old - as long as the right creams and emollients are used bathing everyday is the best way. In the bath Dermol 600 oil - a capful. To use instead of soap Dermol 500 lotion. Then after the bath once dry Hydromol Ointment - this also to be used multiple times a day during a flare up. Strong steroid - we use Mometesone which is several 'layers' stronger than hydrocortisone. Used twice a week always, twice a day during a flare up.

Try the Avene water spray for the itching, I've seen it work ready well

Eczema is awful, especially when they're little. DD has had it since she's a baby. Also elbows and knee creases. She's 8 now and I only now feel like we've got it fully under control after discussing with a new GP at the end of last year and he recommended applying liberal amounts of epaderm ointment at bedtime. It's really worked for her and broken the cycle of hydrocortisone cream every fourth week that we'd be doing for ages. The epaderm ointment (different to cream as it's richer) is super greasy though so we've continued to use a lighter emollient in the day (double base gel).

I'd agree with others that the solution is going to be individual. I had severe eczema as a child. So did my brother. Some of the creams and bath soaks he used made mine much worse (I couldn't have a bath after him unless the bath had been fully cleaned of residue). At his age, you might not get stronger steroids, but keep going back to the GP and ideally dermatologist until something works.

Can he scratch it? I had to wear cotton gloves in bed to stop me scratching it raw which resulted in a horrific cycle of infected eczema. Fortunately I eventually grew out of it (in my mid thirties).