baby eczema - dermatologist test for allergies?

[marscapone]

My 8 month old has eczema which he developed at about 4 months. He has patches over his body in all the usual places. Have been recommended a variey of emollient creams etc. Although the eczema is not bad, it has never disappeared either and we do frequently use steroid cream on him to control flare-ups.

What do others think about seeing a dermatologist for a skin prick test or something? The doctor has said the eczema is not too bad and they can't refer all babies with eczema, and so won't refer us. But I feel that we are always treating the symptons and not the cause. I understand that the cause may not be food (could be dust, mould etc). But I'm aware that things like milk, eggs, wheat, fish, soya are common irritants. I would be happy to cut these out of my own diet if I knew that would help, but cutting them all out speculatively would be quite difficult. At the moment I'm holding off giving these foods to the baby, but don't want to cause malnutrition or anything by not introducing things for too long

Has anyone been in a similar situation?

Would you recommend a dermatologist (if so, please can you provide details, cost etc)

Has anyone restricted their own diet - to any avail? how long do you have to cut things out for?

Is it dangerous to restrict baby's diet by not giving these foods for a while longer?

Thanks for any help

[beec]

My little boy had terrible ezcema all over his head and face from 6 weeks old (but strangely did not affect his body much). He used to be a really irritable baby and used to scratch his head and rub his face on my clothes at every opportunity. I had to buy special ezcema pyjamas at 32 pounds a pop with built in mittens to stop him from scratching himself at night. We were given a couple of different types of emollient creams by the doctor plus hydrocortisone which we used EVERY DAY for 2 months to no avail.. Eventually, when he was 6 months old, we were referred to a skin specialist at the surgery (Elm Lodge Surgery on Burbage Road - Herne Hill end) who prescribed Diprobase for around his eyes and Doublebase for the bath and cream for his face and body. This cleared it up after 3 days and he became a totally different baby almost overnight (I can't believe we suffered for nearly 5 months with this). Of course different things works for different babies, but have you tried this??? The other cream they gave me a prescription for was Cetraben but we never ended up needing it because the Doublebase worked for us. They also told us that if the creams did not work, they would recommend the skin allergy test, but thats also because we have allergies that run through the family on both sides. If it were me, I would want to know for sure what the cause was, rather than trying to second guess all the time which would drive me insane with worry. Hope that helps abit...

[melbourne groover]

I also highly recommend seeing a dermatologist, I was back and forth from the docs to absolutely no avail. They just kept saying to moisturise him - by the last appointment I was smothering him in shea butter at least 4 times a day to try and keep it in check but it was still getting worse (although was v impressed with the shea butter). One visit to the dermatologist and he is completely ezcema free. We had insurance so went through a private dermatologist at Gt Ormond st, pm if you would like her details. I have taken both my kids to her and she has sorted out problems really quickly.

[Gubodge]

I'm afraid I have less good news. My daughter developed eczema at a few weeks old. She was eventually referred by the Dulwich Medical Centre to the dermatolgy clinic at Burbage road where they were helpful but there was no great improvement in her skin. It wasn't until they referred us on to Kings that we were prescribed Elocon (a steroid cream) which allowed her to sleep through for the first time ever (at about 2 3/4 years old). She still has eczema, but it is under control now and hugely improved for the majority of the time.

She has also had skin-prick tests as part of the Leap study into peanut allergies, which we guinea pigged her for. Those showed up various food and other allergies, but although we avoid the problem foods and try and minimize her exposure to other allergens it still doesn't cure her eczema, just reduces it.

I would advise pushing for a dermatolgy appointment though; as for us neither GPs nor Burbage road were willing to prescribe strong enough steroids. But don't expect a miracle. Have you tried self-referal?

[Belle]

self-referal sounds good. I think def push for specialist treatment where possible - am only now, at 32, getting allergy tests for myself after a lifetime of eczema. My son's is not as bad so am happy to treat with emollient and the odd steriod for a flare up but if it gets worse I'll also push for allergy tests for him. When I think how much pain mine has caused me - I don't want him to go through that.

[anna75]

NB that eczema, asthma and quite nasty nut allergies tend to be linked... many members of my family have all three...necessitating carrying adrenaline all the time.

We have gone through the usual order of: aqueous cream, diprobase and, as a last resort, a steroid mixed with antibiotic.

One thing worth watching out for is that you might well need the ab aspect too. ie pure steroid might not work if it is also mildly infected and not just an inflammation.

[marscapone]

Thanks all for your comments. I now have a couple of recommendations for dermatologists and most people I've talked to think it is a good idea. We also have family history of asthma and hayfever on both sides so not too surprised about the eczema. I really hope it helps - it's not much fun putting baby to bed with socks on his hands every night (with hole cut in so he can suck his thumb), and pretty difficult to encourage him to get to sleep by himself when he lies there scratching

[????]

I think that skin prick tests are less effective the younger the patient, certainly that's what an allergy specialist told us.

[ClareC]

I have asthma and suffer with sensitive skin, never formally diagnosed as eczema but steroid cream often prescribed! I got sick of treating rather than curing and not only had a skin prick test but also saw a dermatologist and had further skin tests on my back. Definitely recommend this, I was prescribed diprobase cream, avoid any perfumed toiletries and soaps etc since then I have rarely needed to use hydrocotisone. The dermatologist was really helpful advising which products to use / not use.

My daughter is 3 months and suffered with dry eyebrows, olive oil did nothing, I couldn't get a dr appointment for her until the following week, having checked with a GP friend first, I put diprobase cream on her, completely cleared it up in two days! Great stuff and not harmful!

[Gubodge]

I think the skin prick tests are less effective in smalls as their sensitivities fluctuate when they are very young. So what shows up as an allergy on week may show no reaction the next and vice versa. But I have no idea when it all starts to settle down.

[James Barber]

I had eczema as a baby. It went until pubity when it came back. At times it felt desperate and debilitating.

As an abult I visit a dermatologist. Best thing I ever did in my life. I have slightly different routines but what a joy to not be scratching.

See a dermatologist. You have nothing to lose except the sleepless nights.

[marscapone]

Can those that saw a dermatologist and recommend it, please let me know what they do and how they are better than the GP.

My GP is prescribing us creams - Oilatum and Aqueous Cream for the bath, and Doublebase for after bath, mornings etc. That hasn't been that successful and now have Dermol prescribed which we've yet to try. Plus cortisone cream for problem patches (face, behind knees...) but it seems that those places flare up if we stop using the steroid cream for a few days. And I really don't want to be putting steroid cream on every day for years! Plus teh itching means constant scratching of face and head - for which the GP suggested antihistines - more drugs! But how does a dermatologist differ from the GP? Is it the Dermatologist who offers the skin prick test or someone else? What else do they do?

Thamks

[civilservant]

I agree with all other posts that recommend a dermatologist. Six years ago, our daughter developed eczema all over at 2 months old and GPs were useless - prescribed a variety of emollients, none of which helped, but were very reluctant to refer her on to a dermatologist.

We finally self-referred when she was 4 months old to a dermatologist at Great Ormond Street, who put us on a regime of Oilatum baths twice daily - yes, twice daily! - Diprobase and steroid cream, also twice daily, just to bring the inflammation down and restore her skin to a reasonably normal state.

Some other things he said - the main reason for using steroids is because the priority is to reduce the inflammation, and food allergies are rarely the primary cause, it's more likely to be genetic. He was furious with the GPs for their neglect and pussy-footing around the need to use steroids.

My daughter's skin is much better now, but we've had to accept that twice-daily Diprobase, daily Oilatum baths and occasional use of steroid creams will be part of our lives for ever...

On the other hand, my niece - whose eczema her parents decided to treat with emollients only - has some scarring on the backs of her knees and crooks of elbows as a result of scratching, impetigo etc. She also has mild asthma - I've seen recent research that claims that untreated eczema can result in an increased asthma risk.

I do hope that your baby gets better - it's very distressing to see them look so itchy and uncomfortable, not to mention the risk of infection and loss of sleep. Good luck!

[buggie]

Treated or untreated eczema doesn't increase/decrease asthma risk.

Asthma, eczema and hayfever often come together (atopic illnesses). The management of these doesn't directly affect any of the other symptoms and it can be that you have one without ever having the other two.

I would theorise though that if a family don't take the preventative measures to try and treat the eczema well (ie ignoring advice to use emolients or not recognising worsening skin) then it could be said they might have a similarly lax attitude to managing asthma symptoms (if the child had them) thus causing potentially worse symptoms than would have with better management.

(hope this makes sense - bit tired!!)

[civilservant]

buggie, you may be right, but see also http://news.bbc.co.uk/1/hi/health/8055038.stm

[buggie]

.... that does back up my point regarding atopy:

They did more experiments and found that even mice with normal skin but bred to overproduce TSLP also developed asthma-like symptoms, suggesting TSLP is indeed the culprit.

Roughly, it's never been clear what has caused the atopy that links eczema/asthma/hayfever - this protien looks like it could be the link which could lead to better understanding/treatment of all the conditions.

[sb]

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[sb]

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[Belle]

sb - what do you use in the bath now? We currently use oilatum for our little boy but no soap or anything.

[civilservant]

sb - on our GP's advice, we tried not bathing the baby - outcome: the baby's skin worsened; when she finally saw the dermatologist, she was 95% covered with eczematous rash (dermatologist's estimate). Clearly, it varies according to the individual case. We too use Oilatum, nothing else. For what it's worth, I find the whole 'pampering' industry with is smelly lotions and potions rather distasteful.

buggie -

Early treatment of the skin rash and blocking TSLP production might stop asthma developing in young patients with eczema, they hope.

[Gubodge]

I'm allergic to oilatum, so bear that in mind. Oilatum never helped my small much but she now has emulsiderm in her bath, which is a great improvement.

GPs can be quite nervous of prescribing strong enough steroids, and don't have the experience of the range of different emollients and bath oils that you may need to go through before you find one that is effective for you. Even now our GP doesn't like to do repeat prescriptions of the high strength steroids that my daughter needs, even though they are what the 'experts' at Kings have said are needed, and are the only things that work. Our GP is great, but he is a generalist and can't be expected to have the same level of knowledge as a specialist dermatologist.

[GinaG3]

Diprobase is to me THE cream to use. After suffering with eczema all my life until I hit puberty this was the option my parents took. With a very strong family history of allergies and skin conditions, I have recommended this to many people who have come back with positive results. My daughter has just started to develop eczema at 15 months, it has started to flare up every now and again, so I use diprobase and I do highly recommend it! Im starting to experiment by cutting out wheat and diary from her diet, to see if this makes a difference to her flare up's. Also be careful of using scented bath products and washing powders. After giving birth to my brother my mother found herself having to take serious measure's to control his terrible eczema, his whole face and body head to toe was scaly, dry and red, and extremely painful, she found gluten & dairy products caused him a lot of flare up's so cut them out totally for my brother and herself as she was breasfeeding and saw significant results, come the age of 4 my brother had no eczema in sight. Food groups such as these are definitely common irritants. I hope you find a solution soon, maybe before seeing a dermatologist you should experiment with cutting out gluten products and diary to see if this makes any difference over a week or two. Good luck.

[sb]

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[matlow]

Our 3 year old daughter has had eczema since she was a few weeks old, sometimes really very bad and sometimes much better but she has always had it. We have tried everything and now have a routine that keeps things under control.

She has oilatum in her bath, we use diprobase on her whole body after bath at night and before getting dressed in the morning. We get this on precription as we get through loads of it and it's quite expensive to buy.With really nasty flare ups we use eumovate steroid cream and if scratching is really bad we give her baby Piriton syrup. This really calms her down and helps her get a good nights sleep.

As she is getting older it is getting better and we are hopeful that she will grow out of it. I know it seems like a never ending nightmare at the time but hopefully it will get better and you will find a a routine that makes your little one a bit more comfortable in the meantime.

[Ole]

My son is now 5 months and from 2 months started developing eczema, sometimes so bad he would scratch himself raw. The routine we follow now and which has done wonders (his skin is completely clear most of the time now) is slather on Citroben (sorry not sure of spelling and do not have pot to hand) at least 3 times a day everywhere including the scalp but except the nappy area (it is a chore but the point is to keep his skin as moisturised as possible). I have noticed he hardly ever gets flare ups now, but if he does then I put a little 1% hydrocortisone cream in the affected area before it gets really bad. In the bath I use doublebase and nothing else. This routine has really worked and now I only need to use the hydrocortisone cream very very sporadically (last time was over 2 weeks ago and I only applied a tiny bit to a very small area once!). I used Oilatum before, even the junior one, and I found it made his skin worse but Doublebase agrees with him. I also found that Diprobase irritated his skin as did aqueous cream. I think it is a case of trial and error until you find what works for you, we must have gone through a whole chemist worth of creams!