Recommendations for eczema creams when hydrocortisone is not helping

[Perpetuallywondering]

Hmm… put this in preteens but not sure if right place!

Anyway, ds11 has been struggling with eczema since New Year. He’s had flare ups before but we’ve always got under control with hydrocortisone and emollient. This time nothing seems to be touching it - we’ve been repeatedly to the GP who just say hydrocortisone and moisturiser. We had one tube of fucidin.

Emollient wise we’ve tried E45, Aveeno, Epaderm and Doublebase. Epaderm seems the best but it’s not actually shifting it. I can’t keep covering the kid in steroids.

I keep seeing adverts on social media for natural creams - Wild Mint particularly makes itself sound like a wonder! I was wondering if people had recommendations as they’re pretty pricey to experiment with.

TIA!

I’m a GP myself, OP. There’s a hierarchy of steroid creams - if the hydrocortisone isn’t working, usually your doctor would prescribe a stronger one and keep going up the ladder until the eczema is under control. This isn't something that should require a Dermatologist, unless the eczema is really severe. Have you told them explicitly that the hydrocortisone isn’t helping?

Thank you all for your suggestions - sorry for not coming back during the day.

Haven’t had a referral to dermatology so I could try requesting that, but also haven’t gone back again to say hydrocortisone isn’t working as I very much felt that we’d been shut down last visit.

I will try the Child’s Farm as that seems quite risk free but also revisit GP.

Epaderm twice a day, and Betnovate on any red or
bad patches. This regime is the only thing that has worked for my son’s eczema. Betnovate is prescription only I believe.

The only things that work for my now adult daughter are betnamethasone and Protopic both prescription only

Dermovate on prescription. It's strong but the only thing that works for me. Only for short term use, but clears up a patch on a few days.

See a doctor for advice-Protopic works for a lot of people but I'm not qualified and can't say if it would be suitable for a child, so it's best to arrange an appointment for her.

Also check out that it isn’t dermatitis herpetiformis (Coeliac disease).
My friend’s daughter had that age 10, nothing would shift the rash; an astute GP tested for CD and the rash finally cleared when she went on a GF diet (don’t do that without a diagnosis as you can’t test unless eating gluten).
Coeliac disease is a whole body autoimmune disorder- you don’t have to have bowel symptoms: my son only had joint pains and anaemia

www.coeliac.org.uk/about-coeliac-disease/related-conditions/dermatitis-herpetiformis/

I’ve used all of those prescribed and a huge range of steroid creams

the only things that work for me are

Sleep and diet under control
allergies under control (with high dose Fexofenadine and sometimes stronger stuff like Hydroxyzine Hydrochloride for night)

and MooGoo was good for not irritating mine and DDs skin (unless you have a dairy allergy as milk protein is used)

Childs farm was awful on us as well as anything else that has even a faint perfume

ProTopic eczema cream was decent especially to stop skin thinning after years of steroid use - took them years to prescribe it to me and only when I asked after a recommendation from a friend with similar skin

This. I’m bemused that your GP is just saying hydrocortisone, presumably meaning the 1% that is available OTC?

I had bad eczema in the inside fold of my elbow for a year but never got round to going to GP. Tried hydrocortisone to no avail. GP prescribed Eumovate without hesitation and it was completely gone within a fortnight.

If finances will stretch, get a private online dermatology appointment. You would have to pay for the prescription but steroid creams are not too pricey and you can probably get it on the NHS for any follow up prescriptions by showing the NHS GP your private consultation note.

Have you asked the GP to explain clearly why they will not prescribe a stronger steroid?

I have excema and use Diprobase as my emollient. Definitely try a few different emollients as they make such a difference. My dermatologist used to say Doublebase but I never got on with it. Diprobase cones as big 500g pump but also a 60g tube so you can try it before committing to a big one. Available on prescription too OTC

I also remember getting Betnovate as a child, worked very well.

www.eczema.org.uk/wp-content/uploads/Topical-steroids-Mar-23.pdf

I would also recommend a dermatology referral. GPs will say it’s not required but I’d battled with my skin for years and the GP really didn’t have a clue, or even understand (or give a shit) about the impact of my skin condition on my overall health. Now I’m almost 2 years in, skin much improved and under control.

What strength steroid have you got? I used to get a strong one prescribed that would deal with flare ups in a few days, the OTC stuff wouldn’t do anything so was pointless. Ive also had differing steroids for face vs hands vs body- they dont necessarily work well on other body parts I’ve found.