Itchy eczema allergic toddler - not settling after 6 months. Ideas? (long)

[leckert]

I'm having "fun" with a 2 3/4 yr old whose itching is driving me insane as well. He's scratched raw elbows, behind knees and ankles. We've seen an pediatric allergist (sesame - mid reaction, egg white and dairy - very mild reaction) and that temporarily cleared it up along with a steroid cream. Eczema came back last Oct and hasn't gone so got a referral earlier this year to a dermatologist, several blood tests later and we're about to start a third type of steroid cream and be referred to a dietician, I'm kind of over it all. When we first saw the dermatologist we were told to put ds on a restricted diet without some things being explained why they were on the list but not others (eg ice cream was not allowed but other dairy products were) and to use a stronger steroid cream than we had been. The diet was supposed to last for a month as it was supposed to clear up DS's skin and then we'd be allowed to reintroduce foods back on slowly. Well ds skin didn't clear up totally in the 3 weeks we did it (including at CC) when we went back to see dermatologist but she said we could reintroduce foods again and it's gotten worse even with dropping back foods. DS ends up going around with crepe bandage on both elbows to stop him scratching at night - refreshed daily. Band-Aids are leaving welts on his skin if we try to cover the worst bits. His legs are now starting up as well - came home today from CC with crepe bandage tied around both ankles because he scratched so much that they were bleeding.

I soooo get you on the scratching thing. If ds could just leave it alone for 2-3 days it'd nearly be healed!

I've tried the eczema moo goo cream (nut oil based); tried hemp cream/oil from the body shop; tried sorbelene cream (ds has screamed when putting this on and we've tried different brands); tried other moisturizers.

Currently also trying a natural based moisturizing cream called mums secret - started that last night - friend recommended that - can send link to info on that one if you like in a pm later. That one at least smells nice and feels nice rubbing it in. Can't remember all the ingredients of that one but I know it's not nut based at all as I checked thinking I might send it to CC for them to put on during the day.

I would have tried the third steroid cream (this one also has an anti-fungal cream in it) but I only collected it from the hospital pharmacy this evening while DH was getting DS ready for bed & I was on my way out for tea. We'll start that one in the morning.

Apparently the dermatologist is referring us onto a dietician in a couple of weeks to see if we can work out if it's diet related.
I've ordered a new mattress for DS in case it's dust mites or something in the mattress- he has a second hand mattress on his bed - asked DH to sort that out and I was still waiting 2 weeks later so gave up and sorted that out today. Also need to work on washing his sheets more often as I'm not good at changing his sheets - old bendy mattress doesn't make sheet changing easy in the third trimester of pg and DH doesn't think to do it

[belfie]

Oooh you poor thing! I think your poor DS's skin sounds worse than mine. And don't you love having to cut their nails just insanely short to minimise the damage? I still remember a confident father of 3 (when I was complaining about cutting the nails one day) offering to do it - and saying, oh but these nails don't need cutting. And I'm like "oh yes they do!" - it's enough for him to wake with a face covered in scabs and a blood-spotted sheet.

Interestingly we have a second-hand mattress too.... aaargh maybe I should go shopping. And oooh I remember the nuisance that changing bed linen was in 3rd tri! GL with that!

I also remember trialling moo goo eczema balm on him years ago... pre-diagnosis. Didn't even realise/notice that it had almond oil back then, but I didn't have to worry in those days! I actually did a few weeks trial - that on one side of his face and his "conventional" treatment (can't even remember what it was) on the other side. And the other side won (and was vastly cheaper), so I've not bothered with it since. We typically moisturise with Dermeze (which always has seemed to work the best for him) or Dermaveen and bathe in QV, all of which seems to work. I guess. i say that, but then I'm posting here, so it's not really working is it!

Interesting about the dietitian. I really hope they don't suggest that route to us... but should I say that when it could help? Seriously though it could just be my full time job managing to feed us all if we have to do another diet for him!!

Thanks for the info on the cream, I found it with some googling. It looks really good, and I like the combo of plant oils they've used. I did get really over buying lots of different creams when he was younger... but now I've had to shelve most of mine, it might be a good idea!

[Pholi]

If ds could just leave it alone for 2-3 days it'd nearly be healed!

The itch from eczema is so severe, it is virtually impossible to 'just leave it alone', even if you are right that not scratching will improve it. And the nature of eczema is such that even if you get one bout 'healed', it will generally come back anyway.

I was a child who's parents tried everything people are talking about here, with minimal success. I used to wake up in the mornings and the very first thing I would do is check my fingernails, to see how much blood there was under them, how badly I had damaged myself, every single day of my childhood. It wan't until I was in my teens that I became better at managing my eczema, through identifying, and therefore being able to avoid my triggers.

My triggers include woollen clothing and carpets, dust, dust mites, pets, saliva (even my own), grass, all soaps and detergents, the preservatives in many, many creams and lotions, (including hypoallergenic ones, specific eczema ones, and even in topical steroids which were prescribed for my eczema)! Most shampoos and conditioners cause a flare-up - which of course, is all over my body, because the shower rinses them off from the top, all way down. Hot water aggravates me. Anything oily, even olive oil or butter on my skin when I cook, let alone bio-oil and vitamin E capsules, etc, makes my skin inflamed and itchy. I don't use any creams with oils in them. I can eat oranges, lemons, tomatoes, papaya, pineapple, coconut cream, vinegar, but heaven forbid should they touch my skin. Honey, and anything with royal jelly in it. Alcohol swabs. Swimming pool chlorine. Most sunscreens. Sunburn. My own sweat. All the other sunscreens when combined with sweat. Oh, and stress. That's a biggie. As for my current flare-up, I'm hoping I'm not actually allergic to my own pregnancy hormones, but I'm going through a bad patch right now and I can't work out what it is from.

I have noticed that my eczema is worse when others around me complain their hayfever is flaring up, so I presume I'm also triggered by airborne pollens.

There are different elements to managing eczema: 1)Identifying the triggers and avoiding them, 2) treating the inevitable flare-ups (any rashy/ itchy patches at all, even if they are 'normal for your child', and 3) maintaining the skin barrier. All those moisturisers that we keep buying and trying and discarding, even the ones that 'worked a treat' for someone else, they just help to maintain the skin when it's already in good shape. They are not likely to help resolve the rashy patches, and for many of us, they just sting and therefore make us rub and itch, because they're getting into the raw patches and cracks. The patches will almost definitely need treating with steroids and/or other anti-inflammatory/immune-suppressing/anti-bacterial/anti-viral treatments. And they will keep coming back if you don't work out what the allergens and triggers are.

It is definitely worth trying getting bedding with mite-proof covers, and change the sheets regularly, for sibling on who's beds they might play, and for your own bed, if they ever creep in. Vacuum up play areas regularly. Borrow or buy a vacuum with a HEPA filter, and see if that helps. Don't 'dust' because then the allergens just get airborne and settle elsewhere. Use a damp cloth and wipe surfaces, instead, especially in their bedrooms and play areas. Those 'electrostatic dusters' are not as good as you'd like to think - a damp cloth is far more effective. Get rid of, or cover woollen carpets and rugs that they sit and roll around on, and try using a rug for playing on grass. Vacuum the couch regularly. Avoid room sprays, fabric softeners, perfumed washing powders. Try different washing powders, or soapnuts, or ecoballs (my choice). Do do this at low expense, borrow/swap a couple of doses of washing powder from every family you know, and monitor their skin. Watch out for eco-cycles on washing machines, because the low water use often doesn't rinse the soap out enough for us sensitive types. Rinse off well after swimming, and don't sit around in wet bathing suits.

Surely he couldn't be that sensitive that having them in the house would set him of? Could he be?

Possibly, but it's not likely. Playing with egg cartons, however, can be a trigger for some kids - I've heard of that. FDC may well use them for craft projects,even if you don't at home.

Band-Aids are leaving welts on his skin if we try to cover the worst bits

Adhesives are a common enough trigger, too. You could well make the bits around the bad bit, worse. For me, the adhesive doesn't cause a problem, but when it's removed, a few skin cells come off with it, and I think that tiny bit of damage to my skin barrier makes it likely I'll flare up there within a few hours.

Think carefully about any pets you have. Even if you'd like to think your child is not allergic to the animal (or have had skin ***** testing to show they are not allergic - the animal may still be a trigger), even if you think of your pet as 'part of the family', even if the animal is kept in a cage in another sibling's bedroom, even it it lives 'mostly outside'... You should be really, truly certain that your child has absolutely no reaction to your pet before you decide to keep it (the pet, not the child.) At other people's houses with animals, realise that removing the pet from the room the child is in will not stop the reaction, though it might help a little. To this day I will sit with a clean towel (not from the linen cupboard that their cat likes to sleep in!) on any furniture I sit on, and will change my clothes when I get home. And DP can't pat or cuddle animals, because just sitting in the car with him can make me worse afterwards.

Eczema itching is not just like having an annoying mozzie bite, it's an agony. It's torture. Doing anything that makes it worse is cruelty. If you haven't suffered it yourself, you have no idea.

And the things that come up positive on skin ***** testing or IgE blood tests are not the only allergens for your child, and things that are not allergens can still be triggers. I am not technically allergic to any of the foods I mentioned, and on an elimination diet as a child, my eczema got worse, not better, which confounded the dietician and dermatologist at the time!

Things that are 'all natural' are not necessarily better than synthetic. I can't even rest my palm on the woven natural fibre matting in my yoga class at the moment, but I'm fine on the rubbery mat.

If GP management of your child's problem is not enough to allow them to sleep well and function normally during the day, get referred to a paediatric dermatologist. Get skin***** testing, and/or blood IgE tests. Get referred to a dietician, and ask about elimination diets to help to identify any food triggers AND make sure they're still getting a balanced diet. Ask about skin-supportive supplements, like zinc. Ask about short courses of oral steroids to control flare-ups. Ask about pimecrolimus/tacrolimus instead of steroids (I don't know if they are an option for children.) Ask about wet wraps, and anti-bacterial baths to control staph populations on their skin. Ask about intermittent antifungal treatment. And keep on asking, over time. What's available and what's recommended keeps changing as more and more research is done in this field. And what works for your child now, may reduce in it's effectiveness down the track, and something else becomes more appropriate.

Get a copy of Prof Susan Prescott's recent book, 'The Allergy Epidemic', UWA publishing, 2011. It's very readable, and extremely interesting for any person with allergies or an allergic-type child, and includes the very latest research and theories, and will stand you in good stead when discussing issues with any kind of dr or specialist.

And as far as your children having 'mild eczema' goes, those who have posted here are clearly all trying to do their best to help, to find solutions and causes and treatments, and although no-one feels like they're doing everything, or being completely successful, imagine how much worse your child would be if you were doing nothing at all. Your child is probably only diagnosed with 'mild eczema' because you are doing stuff to stop it from being 'moderate' or 'severe'.

And finally, what works for one, will not always work for another. Everyone is different, with different triggers and treatments. But as hard as it can be to work out what the triggers are, and to find effective treatment, it's worth it to help your child feel normal, not have unattractive skin that makes them a target for bullying and unkindness, avoid the stronger medications where possible, sleep well and therefore have to opportunity to learn and concentrate and think clearly, instead of half their brain constantly being devoted to 'I shouldn't scratch that itch'... ultimately to be healthy.

[Pholi]

Sorry that was so long. Obviously this is a topic that's of great personal interest to me, and I thought maybe an adult's perspective might be useful to the Mums of affected kids. If you get through it all, I hope it's useful.

[Cherished]

Just another thought Belfie, check out GAPS as a means of healing eczema. Goodluck

[Lenny]

Band-Aids are leaving welts on his skin if we try to cover the worst bits.

Latex allergy? Regular band aids cause havoc here.