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)

@NeverTwerkNaked

Why is there such a contradiction between the extreme caution shown by GPs/pharmacists to use of steroids compared to my son's paediatrician who advised to use a strong dose of steroids to get the eczema under control?

Also I am wondering why there still seems to be a lack of awareness about the link between food allergies in breastfed babies and eczema. I was laughed at by my son's GP for wondering if his severe eczema could be caused by something in my diet ... A few weeks later when I began weaning my son had an anaphylactic reaction. His eczema improved dramatically once we had identified and excluded all his allergens from my diet and his.

And a final question - any thoughts on the different emollients? I always felt overwhelmed by all the different choices

This really depends upon each child on a case by case basis. Tablet steroids are very strong and are not a long term solution, but a short course for a very severe flare requiring a hospital visit can be helpful. This has to be guided by a dermatologist or paediatrician and would only be a very short term solution. It is important to have an approach about what to do once the skin improves and how to manage the eczema as it gradually returns in the longer term.

@PashleyB

I have had eczema on and off all my life ever since I was small. What are the chances of my children inheriting the condition?

Hi PashleyB We know that eczema runs in families, but the inheritance patterns are complex and require other factors such as environmental triggers. The key is if you know what to look out for, if your child does start to develop eczema or dry skin you treat it as early as possible and concentrate on supporting the skin barrier.

@Ratbagratty

Hello, my little one started getting eczema on her bottom when she stopped using nappies about 2 months ago, since then I've noticed it creeping up her legs to the usual behind the knee spots. Is this eczema or something else? What do I do to help her?

Hi Ratbagratty, start with regular moisturisers and avoid irritants and soaps. Its best to see your GP or dermatologist to see whether a treatment cream is needed.

@Mangaroo

What product is best to use near the eyes? DC gets eczema under the eyebrows and I am not sure it is okay to apply moisturiser so close to the eyes.

Hi Mangaroo eyelid and eyebrow eczema is very common. It's important to apply moisturisers to help support the skin barrier. Don't go too close to the lid margin as products can sting if rubbed into the eyes. La Roche-Posay do a super sensitive eye moisturiser in the TOLERIANE range that has no fragrance or preservatives and would be ideal for this sensitive area.

@managedmis

Can eczema be seasonal? DD only has it in the summer months - she doesn't have hay-fever symptoms though, but she actively seems to dislike the heat - and she comes up in an almost instant heat rash from sun exposure.

Hi managedmis, most children have seasonal variation with their eczema- often winter months can be challenging with low humidity due to central heating and temperature changes, however for some children it’s the opposite. Try to avoid sun exposure and keep skin protected with loose natural fibre clothing to keep skin cool.

@ButterflyOfFreedom

Is there evidence that bathing products such as bubble bath, body wash etc can make such skin conditions worse? Or even cause them?

Hello ButterflyOfFreedom, bubble bath and soaps will strip natural oils form the skin which will dry out eczema prone skin, so for all children with eczema we advise avoiding them. Instead use a soap substitute or 'syndet' synthetic detergent like La Roche-Posay's LIPIKAR Syndet AP+.

@Asuwere

DD(10) used to have eczema but seems to have grown out of it. She does still have quite sensitive skin though so can have a reaction when using new products, is there anything we can do to reduce the sensitivity?

Hi Asuwere, Children with eczema have an impaired skin barrier which can mean their skin will be more sensitive to products. Generally avoid irritants or fragranced products.

@Rhinofeet

My boys' eczema flares up at certain times of the year - how common is this? Also, we live in a hard water area. Can you comment on whether water softeners have been showed to make a difference? Apparently they do, but this comes from softening companies and I wasn't sure if it was a selling ploy. Thanks you and what an interesting subject!

Hi Rhinofeet most children with eczema will have seasonal flares- winter time is usually challenging with low humidity due to central heating and extreme temperature variations. Keep skin moisturised and avoid high levels of central heating in bedrooms. To keep the humidity balanced pop a bowl of water near the radiator.

@Snazzygoldfish

What can we do to prevent a flare up in winter?

Hello Snazzygoldfish, winter can be a tricky time for children with eczema! Winter flares need a richer moisturiser or more frequent application of a moisturiser. Also exposed sites such as cheeks, lips and hands may benefit form a colourless barrier cream.

@Nancyjuice7

Perioral dermatitis - My GP said to apply balm/petroleum based cream but online says to use emollient, what is best?

Hi Nancyjuice7, Perioral dermatitis means a rash around the mouth. In children eczema can occur around the mouth and can aggravate a lip-licking eczema which can be a tricky habit to break. Regular moisturiser or ointment or fragrance free lip balms need to be applied. Also look at colourless 'barrier creams' such as CICAPLAST Balm B5 and CICAPLAST lip cream to try to help settle any flares.

@MrJollyLivesNextDoor

My son had eczema on his face as a baby for around 6 months - we tried all sorts of creams and the one that finally worked was an anti fungal cream.

I suffer from dyshidrotic eczema on my hands and feet - is he likely to suffer with this when he is older or is it completely random?

Hi MrJollyLivesNextDoor, an eczema rash in very young babies can be seborrheic dermatitis. This occurs where an eczema reaction occurs at sites of the body that have a naturally higher yeast content on the skin. This tends to respond really well to combination anti fungal creams with added hydrocortisone. This doesn't always mean children will go on to have eczema - think how common cradle cap is- this is seborrehic dermatitis on the scalp.

@Woolyheads

My son’s eczema started suddenly at Nursery. All the children in that room had the same symptoms, and all got a different diagnosis- allergy, virus, eczema. For 7 years I have been applying eczema cream to a child that protests and thrashes as he hates it. Could it be something else - or is this a common presentation of eczema?

Hi Woolyheads, eczema is really common, and its not unusual for the first presentations to occur around the time of nursery. This is also a time where children have a great interest in exploring their environment- sand pits, water play, paints. These can irritate eczema. If you are struggling I really recommend you discuss this with your GP or a dermatologist to help put forward some specific suggestions to help solve your sons skin problem.

@Alo2019

I’ve tried so many creams since my son was 4 months old(here’s now 8) nothing has worked with him, I even went to skin clinics where he was given wet wraps likes bandages but leggings and tops, and nothing worked. Until a wonderful lady told me to try this cream called abido they sell it on the African/Caribbean hair stall. And omg it worked wonders he’s not had his eczema come back now for 2-3 years I swear by it just wanted to know if you had heard of this????

Hi Alo2019 - PLEASE DON'T USE THIS CREAM! Abido was investigated by the MHRA (Medicines and Healthcare products Regulatory Agency) and found to contain high doses of a potent steroid which are far too strong to use on a child's skin. This product is illegal to sell in the UK. I strongly advise any parent to be super careful about 'wonder creams' claiming overnight cures as these tend to contain potent steroids. There is an ability to report any product you may have concerns about via the MHRA website- a number of illegal creams are listed on their site but unfortunately many are still available for purchase by unsuspecting parents.

@SayOohLaLa

The spiel you read online when pregnant says that breastfeeding reduces the chance of a child getting eczema. I have 2 x BF babies and 2 x eczema sufferers. What am I doing wrong?

You aren't doing anything wrong! By breastfeeding you have provided the best level of nourishment and immune support for your children. Eczema occurs as a result of problems with the skin barrier and an altered microbiome, however, in addition to inherited aspects of eczema there is also a role of environmental exposure. Basically I'm trying tot say its complicated, not all children of eczema suffering parents will develop eczema.

@sjonlegs

All my children struggle with eczema of varying degrees and not always constant, but there's always creams in the house to treat it. Is there anything you could recommend that I can add to the bath which might help treat/moisturise/hydrate the skin even on good days? Thanks

Hi sjonlegs, all eczema-prone children should use a soap substitute instead of soaps in the bath or shower, La Roche-Posay's LIPIKAR Syndet AP+ is a good option. Some children may also benefit from a bath emollient- but this really depends.

@PiedImperial

My son wears hearing aids, and he has very dry, flaky, red, sore skin behind one ear, where the hearing aid sits. We have been told it is atopic eczema, probably caused by/exacerbated by the hearing aid.

What's the best way to help this? We have tried all sorts of creams. He can't not wear the hearing aid for a while, as one pharmacist "helpfully" suggested, as he's completely deaf without it.

Hi PiedImperial its worth seeing a GP or dermatologist about this as it's clearly a tricky problem. Sometimes eczema can occur in areas that get warm and sticky and have a higher bacterial or yeast growth. Also some conditions such as psoriasis can occur at sites of rubbing. Finally it is possible to develop a contact allergy to components of the hearing aid, if so this can be investigated by a dermatologist using a technique called patch testing.

@Montydoo

What is the best thing to put between the babies 'creases' between bathing and at night to help with the itching ? I use scratch mits at night, is this a good thing to do, if not what do you recommend ?

Hi Montydoo, babies have wonderful skin folds and creases. It's really important to keep these areas washed daily and dried carefully. It is easy for these folds to accumulate moisture and yeast. Once you have dried well apply a barrier cream or a colourless barrier cream such as La Roche-Posay's LIPIKAR Stick AP+ to avoid dampness and irritants such as food, saliva or urine- depending on the body site, sitting next to the skin.

@onemorecakeplease

I eliminated dairy from my daughters diet after visiting an intolerance clinic

Her eczema cleared up within two weeks and never came back. It's been amazing and life changing for her!

Why don't doctors routinely investigate diet / allergies relating to eczema and just prescribe steroids for years on end?

Hi onemorecakeplease, for some children there is clearly a need to investigate for food allergies. If your child is failing to thrive, poor weight gain, loose very frequent bowel motions it is important to discuss with your GP or paediatrician.

@PeacefulInTheDeep

Is it best to keep the affected areas covered or give them exposure to the air? My son is 14 months and his worst patches are on his ankles. I tend to put socks on him to keep him from scratching but wondering if this is the best approach?

Hi PeacefulInTheDeep eczema is very itchy and it's completely understandable that children scratch. This scratching however causes problems in the skin- skin thickening called lichenification and breaks in the skin that increase the chance of infection. By keeping areas covered with natural cotton sock you are providing protection to the skin. Consider applying moisturiser under the sock to the ankle area, as the sock will help absorbtion of this and help maintain the skin barrier.

@Serin

Are GPs aware of the implications of formally diagnosing eczema in children? Our eldest DS has failed an army medical because of childhood eczema and asthma. He may have had a rash and a chest infection at some time but it was in no way severe enough to warrant ref to a consultant. He will appeal but had the GP not written this in his notes he wouldn't have to.

Hi Serin , this is very tricky. Childhood eczema is very common however most children will outgrow their eczema by teenage years so it is important the army medical takes into account how your child's skin is now rather than historically. I wish him luck!

@emphasisofmatter

If my child has eczema now (age 5) will it likely continue into adulthood? My husband still has very bad eczema which is easily irritated. Is she more likely to have it in adulthood considered my husband still has it?

Every child is different, most children will settle by the time they reach their teens as there is a boost in oil production which helps support he skin barrier. This reduces again in your 20's. It is very difficult to predict how thing will develop at this age- it may be that there will be one or two troublesome ares, or things may be more widespread. Concentrate on optimising her skin barrier and supporting a healthy balanced skin microbiome as these will help improve the resilience of the skin.

@Thistly

Also, is Lipikar going to be available on prescription by the nhs? If not, is it because the formula is not evidence - based?

Hi Thistly, LIPIKAR is not available on prescription. Your GP can advise you about products that would be available. One of the reasons why 9/10 dermatologists recommend La Roche-Posay products is because a huge amount of research goes into the products to ensure they are safe for your skin and helpful for people with challenging skin conditions. Further information about how products work and ingredients can be found on their website. As a company they are also committed to skincare research and education. On a personal level I would never feel happy working with a company unless I agreed with their ethos, science, safety and had good feedback from patients who have found the products helpful.

@Thistly

Gosh, plenty of people on here commenting on diet and eczema. My experience is that dermatologist laughed at me for suggesting it, but once I looked at NICE guidelines, it confirmed that if there are no digestive problems then dietary sensitivities are unlikely. Do you agree with this? My child has eczema on her face and exposed areas, which is said to be exacerbated by environmental allergens. Is it still worth investigating dietary allergens?

What are the side effects of Tacrolimus versus steroids?

You are absolutely right, the NICE guidance points out that children with food allergies will tend to have other features such as failure to thrive- poor growth and low weights and digestive problems. In these cases it is advisable to seek advice about whether a dietary allergy exists. As I have mentioned in earlier posts the key issue in eczema is felt to be a skin barrier problem, and unfortunately because of these barrier problems environmental allergens can gain access through the skin, resulting in an inappropriate activation of your child's immune system. This can commonly lead to allergies to things in their environment such as house dust mite or pollens.

@Sooverthemill

Eczema in tricky places: eyelids ( 'don't use on eyes' is common), genital area ( ditto) and on scalp. Any ideas?

Hi Sooverthemill, I have made a couple of posts on scalp- so I'll concentrate on the eye/genital skin questions if that’s ok. The skin around the eyes is very thin and delicate and for this reason you must avoid using anything more than a very mild steroid. Moisturisers can also get rubbed into eyes and get sore. Avoid putting products too close to the lid margin. If sensitivity and irritation are an issue look for products suitable for super sensitive skin such as La Roche-Posay's TOLERIANE range- these have special packaging which has allows the products to be preservative free they are also completely fragrance free. A quick note about genital skin- as a site steroid creams only need to be applied once a day, as in warm sticky sites such as under a nappy the steroid will be more readily taken up by the skin.

@LaDilettante

My daughter has eczema on the back of her knees and on parts of her thighs. She’s also had molluscum in the same areas for the past year. We tried a steroids 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....

Molluscum is caused by a viral infection of the skin, it will settle with time and rarely requires active treatment. In children with eczema it can be very challenging as with the impaired skin barrier and scratching the lesions can become multiple. If you apply a steroid cream it will also spread the molluscum. Continue with moisturising to avoid scratching and further spread of the molluscum. If lesions become infected see your GP or dermatologist for advice about how best to treat.