Q&A with La Roche Posay - Ask your questions about eczema in babies and children to our expert Dr Catherine - 3x £100 vouchers to be won

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We're going to have Dr Catherine Borysiewicz, Consultant Dermatologist online on Friday 20th September from 1-2pm to answer your questions on eczema in babies and children. Everyone's experience with eczema is different, and it can be especially difficult if your child suffers with eczema to know how best to help them.
This Q&A will work a little like our Live Webchats if any of you have taken part in one before - just ask a question below for our La Roche Posay expert Dr Catherine Borysiewicz to answer.

Here’s some more information on 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, Catherine is an experienced Consultant Dermatologist working within the NHS and consults privately in central London at Imperial and The Cadogan Clinic, where she manages inflammatory skin diseases including eczema, acne and psoriasis and sun damage and skin cancers.”

Here’s what La Roche-Posay has to say: ‘We’re delighted to give MNers the opportunity to ask all their burning questions about eczema to Consultant Dermatologist Dr Catherine during National Eczema Week. As the mother of a little boy who suffers 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.’

Post your question for Dr Catherine and she will be online to answer them on Friday 20th September.
Everyone who posts a question will be entered into a prize draw where 3 MNers will win a £100 voucher each of their choice (from a list).

Thanks and good luck with the prize draw.

MNHQ

Standard Insight T&Cs Apply
Webchat guidelines - one question each (follow-ups allowed if there’s time)

@Caillou

we live in a hard water area, could it be linked to dd's eczema?

Hello Caillou, hard water was always felt to be a driving factor in eczema- both through its drying effects on the skin and the need to use larger quantities of soap products to generate a lather. Interesting studies were carried out to look at whether water softening treatments could be beneficial for children with eczema in hard water areas but no statistically significant improvement was demonstrated. If you are in a hard water area you may find a bath emollient helpful, and as for all areas stick to soap substitutes to minimise oil stripping. La Roche-Posay's LIPIKAR Syndet AP+ contains glycerin and shea butter which helps moisturise the skin from the bath or shower.

@ButterflyBitch

My kids eczema has been pretty well controlled since we got a handle on it but what’s the best course of action if they have a flare up? My daughter recently had a flare up and even though I was moisturising her it took busting out the hydrocortisone to get it under control.

This is really common. There are lots of things that flare eczema- teething, illness, skin infection…the list goes on! Skin will have good days and bad days. Don't worry about needing to reach for steroid creams when things aren't settling. You did the right thing getting it under control and then continuing with your moisturising regimen when things settle.

@Thiswayorthatway

DC aged 4 still has eczema on head, what is the best product which leaves least residue?

Hello Thiswayorthatway, eczema on the scalp is often called seborrheic dermatitis or cradle cap. This eczema happens in areas that have a higher presence of yeast. Soak the scale with olive oil and then shampoo out the olive oil well. The scales should lift away. Any red patches can be treated with a steroid and anti-fungal combination cream from your dermatologist or GP. Avoid applying moisturisers to the scalp as this will cause a build up of yeasts.

@Penhaligon

My baby's eczema started after we started swimming. Is that a coincidence or could it be linked?

Hi Penhaligon, swimming is great fun but the chlorinated water can be drying. Before swimming apply a layer of moisturiser, and after swimming rinse off pool water using a soap substitute and apply a nice layer of moisturiser. This should help combat the drying effects and allow you to continue enjoying trips to the pool. You can try the LIPIKAR Balm AP+ and LIPIKAR Syndet AP+ for this.

@biffyboom

My daughter, 2yrs, has eczema all over her torso, arms and legs. She wears nappies, but never suffers eczema in that area. We've tried various different washing powder brands, bio and non-bio, with and without softener, but nothing seems to make a difference. Is there something we are missing? (my elder child suffered at her age, but grew out of it around 3yrs)

Hi biffyboom, you were right to try avoiding obvious irritants, but it may be that your child's eczema is simply occurring in this pattern. You can try putting clothes through an extra rinse cycle. Keep base layers of clothing in light/white natural fabrics such as cotton to minimise any irritation.

@Gollymissmollypleasesleep

What’s the best course of action for dealing with eczema/ dry skin on the scalp? DD has terrible eczema on her scalp a few months ago (now more controlled due to discovery of an egg allergy!) But she is still frequently itchy, and it’s more difficult to deal with as she’s grown quite a lot of hair now!

Eczema on the scalp is often called seborrheic dermatitis or cradle cap. This eczema happens in areas that have a higher presence of yeast. Soak the scale with olive oil and then shampoo out the olive oil well. The scales should lift away. Any red patches can be treated with a steroid and anti-fungal combination cream from your dermatologist or GP. Avoid applying moisturisers to the scalp as this will cause a build up of yeasts. Longer hair can make these sorts of treatments more challenging, so try to give a good treatment once or twice a week.

@boptanana

Is it better to bathe in water or add emollient?

Hello boptanana, as a dermatologist I was always trained to recommend using a bath emollient, but a recent study was published to day that not all children benefit from this. I think it’s a personal choice and it may be worth seeing whether you find them helpful- particularly in harder water areas. La Roche-Posay's LIPIKAR Oil AP+ could be worth trying.

@Dangermouse80

Is it best to always shower / bathe after using suncream? I always find sunlight helps clear up the eczema but all kinds of suncreams tend to have a drying after effect.

Hi Dangermouse80, for children with eczema its best to use mineral sunscreens- which reflect sunlight off the skin using reflective minerals rather than chemicals. These often leave a white sheen and can get a little caked by the end of the day with regular re-applications. Its best to bathe or shower every night to remove this residue using a soap substitute.

@Shaz00

Can eating nuts trigger a flare up in breastfed baby? What moisture would you recommend for an infant that has eczema on his scalp and its extremely ITCHY?what are the long term side effects of using steriod on a child?

Hi Shaz00, good question! There is a lot of understandable anxiety about steroid use in children. The key message is not to be frightened of them but to know how to use them in a safe way. Your dermatologist will be able to let you know what appropriate strengths of steroid creams are and also appropriate quantities. The aim of steroid treatment is to use the weakest strength steroid that is needed to clear the rash for a short period of time- usually no more than 2 weeks. The main skin side effects of steroids occur when too strong treatments are used or treatments are applied for too long without a break. If you are concerned about the amount of steroid cream you are requiring make sure you discuss this with your GP or dermatologist. There are other treatment creams available that may be helpful in this situation called topical immunomodulators such as elidel and protopic.

@ohdannyboy

What food types should I avoid - and encourage to help my DS who has eczema on the backs of their legs and arms.

Hi ohdannyboy, there are no food types that we routinely recommend parents avoid for children with eczema. This would need to be discussed with your GP or dermatologist or allergist. Most eczema is not triggered by food allergy. We now recognise the main problem to be a skin barrier problem, so concentrate on supporting the skin barrier as your main focus.

@jacqui5366

Both myself and my OH had eczema in our childhood, by DS1 and 2 have not developed this yet - what are the chances the will in the future (they are 8 and 11) - I had eczema which mainly flared up when I was stressed and run down, and is now very slight.

Hi Jacqui5366, most eczema presents by the age of 4 years, but it can vary. If things have been fine up to this point in time it's unlikely it will occur. As kids move into their teenage years skin will naturally produce more oils that really helps children with dry skin tendencies.

@Evilmorty

Please could you recommend a cream for targeting inflamed eczema on hands and body which works in winter, as well as something lighter and everyday for all over after the bath for the children.

There are lots of different moisturising products available. For lighter products look for lotions or creams that contain more water, these tend to leave a lighter residue on the skin. For winter months you may need to use a richer cream or ointment. I would recommend La Roche-Posay's LIPIKAR Balm AP+ everyday and if you need a richer cream try CICAPLAST which can really helped with chapped skin.

@ConorMcGregorsChin

DD has mild excema and dry skin. We swim 3 times a week. I was her hair weekly. She's 7. I don't feel the need for her to have a bath every day at this age as it seems unnecessary and dries her skin out more. However, as she gets older and she needs to bathe and wash her hair more often, how do I keep her skin from drying out?

Using a soap substitute will be the first step, as with each wash you won't be stripping natural oils from the skin and you will leave the skin feeling moisturised. You can then apply a moisturiser to dry areas. During teenage years the skin becomes more oily which will help with the dryness.

@lovemyflipflops

Is eczema an allergic reaction or allergy, and what are the differences ?

Eczema is primarily a skin barrier problem. Unfortunately this defective barrier can lead to inappropriate allergen exposure through the skin and over time trigger the development of allergies. The main focus of eczema treatment is the early support of the skin barrier and microbiome to minimise later problems with allergies.

@blackleggingsandatshirt

My son has atopic eczema and is 4, at what age would they begin to 'grow out of it', and the symptoms lessen - or is this just a myth ?

Most children will see an improvement in their eczema certainly by the age of 10, and this will continue to improve during teenage years due to a boost in oil production. Some adults can continue to have dry or sensitive skin and its important to continue good habits with use of soap substitutes and moisturisers.

@pushchairprincess

I don’t want to use topical steroids on my child age 8 as I am worried about long term skin damage? What are your views on steroid creams ?

Hi pushchairprincess, there is a lot of understandable anxiety about steroid use in children. The key message is not to be frightened of them and they are a really important tool during eczema flares. However it is important to know how to use them in a safe way. Your dermatologist will be able to let you know what appropriate strengths of steroid creams are and also appropriate quantities. The aim of steroid treatment is to use the weakest strength steroid that is needed to clear the rash for a short period of time- usually no more than 2 weeks. The main skin side effects of steroids occur when too strong treatments are used or treatments are applied for too long without a break. If you are concerned about the amount of steroid cream you are requiring make sure you discuss this with your GP or dermatologist. There are other treatment creams available that may be helpful in this situation called topical immunomodulators such as elidel and protopic.

@lillypopdaisyduke

Have tests been carried out on children who have/have not been breast fed - and are there proven results for lower rates of eczema for breast fed babies. DS1 and 2 have mild eczema, and I breastfed for 6 weeks, number 3 is due in 3 months and I would love to know what the 'proven' results are.

Hello lillypopdaisyduke, breast feeding will be important for nourishing and protecting your babies immune system. Also you're just in time to put the latest research into practice! Recent studies looked at the use of probiotics in the third trimester of pregnancy and post delivery to help reduce eczema prevalence in babies. We are increasingly aware of the importance of the skin microbiome in eczema- this is the happy healthy population of bacteria and yeasts on your skin. Have a chat with your doctor and midwife and let us know what you think.

@kateandme

are there any creams/wipes you should avoid when they have it. what is the best thing to put on it when it flares up to the sore red stage. what is the best way to help a baby/then toddler stop itching.as they dont understand it amkes it worse and simply need to scratch! does it usually clear up on its own.or is their a point you should be concerned/worried.

Hi Kateandme, during an eczema flare continue to apply regular moisturisers and increase how regularly you are applying them. Once the skin is very sore they may need a treatment cream from your dermatologist or GP. Learn how to spot skin infections early so you can treat them quickly. Unfortunately eczema is really itchy- keep nails short and try to soothe itching with moisturisers and keep itchy areas covered and protected with clothing. I would recommend avoiding wipes altogether and prefer cotton wool and water.

@Lighteninginabottle27

My son has persistent eczema behind his ears. Steroid cream helps when it it gets bad and it cracks but what could I do in the mean time to reduce the occasions when it gets like this. We have been prescribed Aveeno and a couple of other big tubs of cream to no effect. We use a mild shampoo. Hard water area and we have a filtered shower to reduce that.

Hi Lighteninginabottle27 the key is trying to find a moisturising product that your son likes and feels soothes his skin. LIPIKAR Balm AP+ has many ingredients that soothe and support the skin barrier and also promotes a healthy skin microbiome. On that persistent patch behind the ears, you can try using the LIPIKAR Stick AP+ which comes in a handy format for when you're out and about.

@homertonb

What is more effective - short term use of a more potent steroid vs longer usage of a milder steroid?

Hi homertonb, as a dermatologist I always promote short term use of the lowest strength steroid needed to clear the eczema- in some children this will mean reaching for a 'stronger' steroid, but this should be done under guidance by your dermatologist who would be able to advise what would be appropriate for your child. I don't advocate using daily steroids that are ineffective as this approach can lead to longer term consequences in the skin.

@TellMeItsNotTrue

Why is it that a miracle cure for one person does nothing for another? Are there different types of eczema?

I'm forever buying products that are supposed to work miracles and I'm always left disappointed

Hello TellMeItsNotTrue, in my practice its really common to see one approach working brilliantly for one child and not doing anything for another. Its important to remember that sometimes it can take a few attempts to find the right treatment for your child, and a lot of the clues will come from your observations and experiences as a parent.

@Duchessofealing

What can I use for eczema on the arches of feet and is going barefoot best (stress related in a seven year old)?

Hi Duchessofealing, foot and hand eczema can be very stubborn to treat. In the summer it can be easier to wear open shoes and sandles, but in winter its more tricky. Make sure the footwear is breathable- avoid trainers as these get super sweaty, and wear cotton socks.

@Theimpossiblegirl

DD has a very small patch of eczema behind her ears, DH has a recurring patch on his cheek. Which products would be best for them?

Hi Theimpossiblegirl, for small areas always start with a good moisturiser twice a day. In some facial areas a colourless barrier cream can also be helpful. Sometimes scratching can become a habit. Try to offer alternative suggestions to scratching- such as La Roche-Posay's LIPIKAR Stick AP+

@ShePersisted

Any advice for a pre-schooler who refuses her cream? I don't persist with it because it doesn't seem to help much. But she does have consistent red marks of irritation on the backs of her legs and in the creases of her arms. She scratches it which makes it worse and I wish there would be a way to get this sorted!

Hi ShePersisted ahhh we call my pre-schooler the 'threenager' so I understand how tricky this can be! Try involving them in the decision making about their 'special cream' and try to encourage your child to apply the cream- to start with this may mean they rub cream on you whilst you apply it. They may not be keen if they feel a cream is making their skin sore, so try to understand if this is the case and look for an alternative product. Also all the usual tricks such as star charts etc. Every child is different but its really worth persevering with regular use of a moisturiser to prevent flares.

@fergusthefrog

Is discoid eczema common in children? If so how would you recommend we manage a very mild but irritating bout? Thank you

Hi fergusthefrog discoid eczema is a very stubborn form of eczema that presents with raised circular patches of eczema. Daily soap substitutes and moisturiser application is really important and will help with mild flares, but for more stubborn flares a steroid cream is often required.