Ask our La Roche-Posay expert your questions about eczema in babies and children - £200 voucher to be won

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Created for La Roche Posay

Baby and childhood eczema can cause distress to both children and parents, especially in winter. Whether you have questions on how often to bathe a child with eczema, or how to deal with the condition during the colder months, Dr Catherine Borysiewicz, Consultant Dermatologist, is on hand to answer all of your questions.

• Everyone who shares a question on the thread below will be entered into a prize draw.
• One lucky Mumsnet user will win a £200 voucher.
• Dr Catherine Borysiewicz will be back online to answer a selection of your questions.

About Dr Catherine Borysiewicz:

“Dr Catherine Borysiewicz studied medicine at Cambridge University and clinical medicine at University College London. She carried out medical and surgical training at a number of prestigious central London teaching hospitals. Today, she consults privately in central London and Surrey where she specialises in inflammatory skin diseases including eczema, acne and psoriasis and sun damage and skin cancers. Dr Catherine has been working with La Roche Posay to support children with eczema - a condition she reflects with personal experience of managing with her two children”

Here’s what La Roche Posay has to say:

“Eczema is quite a common skin condition in the UK, with 1 out of 5 children suffering from it. At La Roche-Posay, we understand how it can impact the quality of life of your little ones and thus, of the whole family. That's why we're delighted to give Mumsnet users the opportunity to ask all their questions about eczema to Consultant Dermatologist Dr Catherine. As the mother of children who suffered from eczema, Dr Catherine will be able to provide you with expert advice as well as practical tips on how to keep your little one’s skin under control, for the whole family to enjoy a happier life.”

Thanks and good luck with the prize draw!

MNHQ

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When does eczema first appear - how young, DS2 has it - age 7, but my 3 month old, who I use La Roche-Posay products on, does not show any signs of redness. My HV has been a couple of times and says just to keep products as natural as possible, use cotton clothing and bedding, and non-bio detergent, and says eczema can start at any age which did not help reassure me.

What washing detergent would you recommend for bedding and babygrows etc - I've tried so many, am not assured that they won't aggravate the eczema

What is more effective - short term use of a more potent steroid against longer usage of a milder steroid.

My DS has eczema on the back of his knees and on parts of her thighs. He also had molluscum in the same areas for the past year. We tried a steroid cream at one point because the eczema was getting bad. It made her eczema better but her molluscum worse. In theory the molluscum spots need to dry up to clear but her skin needs to be moisturised as the eczema makes really itchy and uncomfortable.

What would you advise so that improving one condition doesn’t make the other one worse thank you

What would you recommend for using in the bath ? I pat dry and let DD run around until they are dry before dressing, I find drying with a towel makes eczema flare up somewhat - what are your thoughts on this also ?

My ds is a toddler and has eczema on his face. It started under his eyes and spread to eyelids, around his mouth and under his chin. It's spreading to his chest. The dermatologist has prescribed hydrocortisone but if it's not used daily it comes back. What can we do next? And could it be an allergy? The Dr won't look into allergies but there must be a cause.

Hello everyone,

Thank you for all of the questions so far, I am looking forward to answering them.

Dr Catherine

@Cocoandcleo

My baby (almost 1) gets (fairly mild) eczema on his legs, it's worse in dry weather. His skin feels quite rough. He has been prescribed Zeroderm but it's very greasy. Is there anything else I could apply instead? Thanks!

Hi @Cocoandcleo, the most important thing about choosing a moisturiser is to get the consistency right. With milder eczema a lighter product may be more suitable. Moisturisers range from lighter lotions to more greasy ointments - this is all about the ratio of 'grease' to water contained within them. With mild eczema, a lotion or light cream would be fine as these will absorb more quickly and have a non-sticky finish.

@SnowyMouse

What is the best cream to wash with, and to leave on?

I recommend patients with eczema to wash once a day with a soap substitute or 'syndet' - these are synthetic detergents which will cleanse the skin without stripping natural oils, and often contain additional moisturising agents to support the skin. After cleansing a moisturiser can then be applied to dry skin. This will be more effective than cleansing with a moisturiser.

@AudTheDeepMinded

My two eldest children both had eczema as babies and toddlers and have outgrown it (it was always exacerbated by soap). My youngest child was not afflicted when small but now (aged 6) has incredibly rough arms covered in very small round bumps. Is this also eczema? It does not respond to creams.

These small rough bumps on the arms sound like keratosis pilaris. This is a variant of normal skin - as 50% of the population have it. It commonly affects the arms and thighs and is caused by a build up of keratin around the follicles. You may find creams containing urea, lactic acid or salicylic acid will help to exfoliate these bumps if they are itchy or creating discomfort on your child's skin.

@TabithaTittlemouse

My youngest had awful eczema (one sibling also has it but not so problematic) and we were advised to cut out dairy. I wondered about the connection between diet and eczema?

Also I get what the doctor calls stress eczema. I take medication for my anxiety but wondered if people are often prescribed medication (anxiety meds or anything else) to help with their eczema?

Hello @TabithaTittlemouse. Eczema, asthma and hayfever all sit under one umbrella called 'atopy'. For the majority of children with mild eczema food allergy may never cause a problem, however for a small number of children with severe eczema food allergy may be relevant. As a specialist we are assessing children for other signs of possible food allergy, as affected children will often struggle to maintain their weight and pass multiple loose stools throughout the day. There can also be flares after exposure to foods and your specialist may ask you to keep a food diary. Remember if you are breast feeding, you will also need to record what you are eating too. If your specialist is worried about a food allergy they may advise avoidance of the food and assessment with an allergy specialist. On your second question about eczema and stress - absolutely for some eczema sufferers stress can play an important role in causing eczema to flare. It is important that this is looked at holistically to see what can be done to help manage anxiety including relaxation techniques, using sport and exercise, CBT techniques and even in severe cases, medication.

@nina26

Hello,

Is there a connection between pollution and eczema? My son has is asthmatic, which is triggered by air quality levels but I have also noticed a correlation with his eczema. Thank you

Eczema and asthma are closely linked. Air pollution is such a terrible trigger for asthma and can be very challenging to manage - as a lot of exposure to pollution will depend on the surrounding environment of where you live and where your child goes to school. Anything that flares asthma can also flare eczema. It is important to follow a careful specialist asthma management plan - with what inhalers are needed regularly and for flares. For the eczema, the same is needed - daily syndet and emollients to support the skin barrier - even on 'good days' and a specialist treatment plan for flares with prescribed anti-inflammatory creams.

@Cotswoldmama

I hoped that my son would have grown out of eczema by now as he's 9 but it seems like it's never going to go. We had previously been prescribed 1% hydrocortisone on an on going prescription and until last year that seemed to just about keep it at bay. Then he had flare up after flare up and we got prescribed Eumovate, which has been amazing. We've been using it for about 3 months now slowly easing off of it using it less often. The aim is to only have to use it at weekends. My question is is it safe to use it long term if we do manage to only use it sparingly and hopefully only weekly? It's worked so well I'm afraid if we stop he's going to be back to having bleeding skin again.

@Cotswoldmama wow it sounds like you are doing really well. As specialists we often say that people will 'grow out' of eczema, which is not strictly true. What will happen is, as your child heads through puberty increased oil production will help support their eczema prone skin barrier. It is important to use regular syndets and emollients even on 'good days'. The treatment plan you have been following with 1% hydrocortisone or eumovate sounds great, and with weekend only treatment you have managed to extend the time between eczema flares as well as getting in plenty of steroid free days. This is an approach we often recommend in clinic. If you have had no flares for 3 months, now may be the time to reduce that a little further, try using the creams every 2 weeks and see how you go. If that is successful try using the treatment creams on an as needed basis. Remember that eczema flares will happen and don't be worried about having to go back to your weekend only regimen if it doesn't seem to work as well, and then try again once the skin settles. Don't forget to keep using the syndets and moisturisers as this will continue to support the skin barrier and reduce eczema flares.

@sharond101

How should I wash excema prone skin?

@sharond101 as a dermatologist I recommend daily short baths or showers for anyone with eczema. It is important to cleanse the skin and remove skin scale and bacteria. It is important that the products used to cleanse the skin are appropriate. I recommend syndets or synthetic detergents - these are often called soap substitutes - they cleanse without stripping 'natural' oils from the skin and have carefully formulated pH to mimic that of your skin. They also often contain moisturising products to provide additional support for the skin barrier. You may have also heard about the 'skin microbiome' this is the normal healthy population of bacteria and organisms on our skin surface which forms an important protective layer on our skin - it is also important that this is respected and not adversely affected.

@sophs29

Hello, my DS has quite severe eczema, cetraben makes it worse, the only cream that helps is sudocrem. Does that mean that all the other creams/emollients that you can purchase will have the same result as the cetraben or are they made slightly different and it's just trial and error? Thank you!

Hello @sophs29. Anyone struggling with eczema will notice that some creams and products seem to work better than others - it is important to remember that we are all unique, and what works for one person may not be as helpful in another. There are many products available, each with different textures, so it is important to keep looking until you find one that helps. I will often ask clients what texture they prefer, and assess the skin for dryness and scale when I am making recommendations, You may find that richer, more greasy products are helpful during flares, with lighter lotions and creams being more helpful when the skin is more settled or during warmer weather. Barrier creams such as Sudocrem and colourless Cicaplast Baume can be very helpful on exposed site eczema - hands and face.

@StirredWithATwist

Are there many benefits of having an oat bag in the bath and using it over the skin, or is it woo?

@StirredWithATwist the 'oat bag' in the bath is a very commonly used remedy, and has been recommended for decades. Oats and colloidal oatmeal have many benefits and potential uses in skincare. Colloidal oatmeal is a 'natural' ingredient with a good safety record. It can be helpful in eczema by reducing inflammation whilst gently cleansing and hydrating the skin due to its combination of phenols, saponins and betaglucans.

@Terriblecreature

My little boy is almost 35 months. Never bothered before by eczema. About 2 weeks ago I noticed a rash on his back only. Mostly the top. Round rough patches. About the size of a 5p and there was a few of them. Took him to the doctor they said eczema. Could this be the case considering he hasn't had eczema prior?

@Terriblecreature dry skin patches can be common in children particularly in winter months. As well as eczema, other conditions such as seborrheic dermatitis (cradle cap) and viral infections such as pityriasis rosea need to be considered. In the first instance make sure skin is well moisturised, and if this fails to settle your GP will be able to recommend an anti-inflammatory cream such as daktacort or hydrocortisone which should settle it down.

@Atl2018

My daughter has eczema. Her arms are always rough and her tummy has gotten much worse recently. How often should we give her a bath? We used to use Oilatum in the bath (we got it on prescription) it didn't make difference. Cetraben and Zerobase also don't make much difference. She says it is itchy mainly at bedtime. What else can we try? E45 is the same outcome as the others.

Also does eczema lead to psoriasis later in life?
Thanks

Hi @Atl2018. This is a really common problem, when you are trying lots of different products but nothing seems to be helping. Remember that every child's skin is different, so what we need to do is help you find a product that works. The management of eczema flares often needs a number of steps. Using a soap substitute and regular moisturising will help support and soothe the skin barrier, but often an anti-inflammatory cream is needed in the short term to help settle down the eczema. Your GP or dermatologist will be able to recommend something appropriate. If the creams you are trying are causing discomfort in the skin, stop these and switch to another - remember when choosing a product look for fragrance free products that are safe to use in children. Night time is a great time to get a good anti-inflammatory treatment on the skin as well as a soothing layer of moisturiser under cotton sleepwear. There is no link between eczema and psoriasis, but often the two conditions can look very similar in young children - usually psoriasis will become easier for specialists to diagnose by the teens.

@WaterBottle2

My little boy has just started to get eczema on his cheeks (it seemed to follow getting a cold) is there anything we can do to help with this? We use cream three times a day and try to clean his face with a flannel when he needs his face wiping. Thanks.

Hi @WaterBottle2, it sounds like you are doing a great job. During colds and teething facial eczema can often flare. A running nose and constantly needing to wipe will also irritate the skin (we've all experienced a sore red nose during a cold). Keep the face clean and dry. You can try using a colourless barrier cream on the exposed sites such as Cicaplast Baume or a greasy moisturiser - think of it as a 'nappy cream' for the face - it will reduce contact of the runny nose with the skin and reduce irritation. Also, use the nighttime to apply a layer of moisture on the affected skin to help support the skin barrier.

@Dizzywizz

I read that children should have nothing in the bath as it might cause a flare up. What about essential oils? I use them a lot and wondered if something gentle like lavender could help.

Hello @Dizzywizz. Generally for children with eczema I recommend avoiding fragrances, as aromatic essential oils can be an irritant to the skin. However, fragrance can lift mood and help with relaxation and sleep. I would generally advise not mixing this with bath water or applying directly to the skin, but if you are keen you may wish to put a few drops on a cloth or tissue, or in a bowl of water next to the bath during bath time.

@OogieBoogiePoinsettiaPlant

I have bathed my child in just warm water with no soaps in it and he still scratches his belly. We live in a hard water area, could that be making him itchy? Or could it be the temperature of the water? (I use a baby bath thermometer to check the temperature is ok)

Hi @OogieBoogiePoinsettiaPlant - if you live in a hard water area it can be very challenging to navigate bath time. It is clear that the water is worsening dryness in your child's skin. Studies have looked at whether water softeners or bath emollients can be helpful, but there is currently no evidence that they can help everyone. However, in this situation you may find that in hard water areas bath emollients can be helpful. Also using a syndet that contains additional moisturising products may well be more helpful at hydrating the skin than bathing in water alone.

@SainteCroissante

I've read that eczema/atopic dermatitis sometimes correlates to an imbalance of the skin's microbiome, i.e. colonization of the skin by Staph aureus bacteria. Are antimicrobial washes (like Dermol, or bleach baths) effective against staph bacteria, and recommended for infants with eczema, or would they do more harm than good to a baby's skin?

Hello @SainteCroissante. As our understanding of the microbiome of the skin improves we have become increasingly aware of how important it is in maintaining a healthy skin barrier. If you suffer from eczema there are many things that can adversely affect your skin microbiome, and this can lead to an overgrowth of bacteria such as Staph aureus which can lead to eczema flares and skin infections. Products containing antiseptics such as Dermol 500 which contains chlorhexidine, or dilute bleach baths helps to reduce the overgrowth of staph and all organisms. However, to ideally manage eczema, as dermatologists we would prefer a product that supports healthy microbiome growth, whilst selectively preventing overgrowth of potentially harmful bacteria. Lipikar AP+M works in a different way to prevent staph biofilm formation, whilst being respectful to the microbiome.

@DinkyDaffodil

what do you recommend for night clothes - it's the worst time for us with the creams and dressings. babygrow or vest

@DinkyDaffodil I remember this well with my son! Once you have the creams on, put on a clean cotton babygrow. If scratching is a problem some come with mitts to fold over the hands. Choosing natural fibres will allow the skin to 'breathe'.

@Apple40

My daughters eczema is worse in winter on her inner elbow, it looks red and sore what can I use on it? Most aqueous creams don’t make a difference. Why is it worse in winter ?

Hello @Apple40. Winter can always be a challenging time of year: with temperature changes and the reduced humidity we see with increased central heating use. During these months focus on keeping skin hydrated with a regular moisturiser. Aqueous cream may not be rich or 'greasy' enough so try switching moisturiser. For stubborn patches a barrier cream may also be helpful.

@Sundayschild20

I suffered with eczema in childhood and into adulthood. Now I am expecting a baby and worry about them also developing sensitive skin. Are there any products you could recommend to care for their skin as a newborn which will not aggravate? Many thanks.

@Sundayschild20 now is a really sensible time to think about this, and it is a very common question so thank you for asking it here. Although eczema runs in families there is no certainty that your child will suffer from eczema. Although they may have inherited a skin barrier problem, there are usually additional environmental triggers that are required for eczema to express itself. So, what can you do as a parent with eczema to support your child's skin barrier? There was a fascinating study that looked at mothers with eczema taking probiotic supplements in their third trimester of pregnancy and suggested this may be beneficial their new born infants. Once your child is born it is very important that you use appropriate cleansing and moisturising products on their skin - avoid irritants like fragrances etc - these are simply not needed in children. Keep an eye on your child's skin and if you notice dryness or eczema appearing treat it quickly with increased moisturiser use, and if not sufficient see a GP or dermatologist to manage flares in a timely manner. By protecting the skin barrier, the current thinking is that you can also reduce the risk of the 'allergy march' of related atopic conditions such as food allergy, asthma and hayfever.