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Webchat: Childhood Eczema |
29 June 2004 |
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My baby has had eczema since he was two months old. I am treating him with 1% hydrocortisone ointment twice a day. The inflammation and redness has now almost entirely disappeared, although he still tends to scratch himself occasionally when his skin is exposed. I am wondering, should I stop using the ointment?
Peggy
Dear Peggy - you should only use the ointment on areas which are red, inflamed and itchy. You may find that now his eczema is under control that you only need to use the hydrocortisone intermittently when it breaks out again but it is very important to continue with the moisturisers.
Dr Susan Lewis-Jones
Is there an official definition for 'dry' or 'wet' eczema. In my experience treating 'wet' bubbly eczema with moisturiser makes the eczema worse.
Carol
Dear Carol - You're quite correct. There is a difference between dry eczema which tends to be the earliest stages of eczema and dryness is often associated with chronic eczema. The most important treatment for this is moisturisers. An acute eczema flare starts with redness and swelling and moisturising creams rather than ointments are better for this type of eczema because they evaporate and cool the skin. Weeping eczema usually starts after the child has scratched off the top layer of skin and often there may be secondary infections if there's a lot of weeping and crusting. This type of eczema may need antibiotic treatment. However, if acute eczema is quickly treated with topical steroids it will settle down and allow healing, thus preventing secondary infection.
Dr Susan Lewis-Jones
Is there a connection between eczema and allergies? We suspect our 3-year-old is getting itchy from pollen - it always returns in the late spring. Is that possible?
Erik
Dear Erik - yes entirely possible. Eczema is considered by most people to be due partly to allergy and it is related to asthma and heyfever. Airborne allergens such as pollens, house dust mite and pet dander are often a cause of eczema, particularly if the eczema is in exposed areas of the face, neck and hands.
Dr Susan Lewis-Jones
Would you recommend not giving childhood innoculations to a child suffering from eczema? We took this route with my daughter, but she insisted on having the TB jab at 14. She has had mild eczema outbreaks ever since (nothing before).
Oli
Dear Oli - No I would never recommend avoiding childhood vaccinations - having eczema is not a contra-indication to them - and it is important to remember that childhood illnesses such as measles and hooping cough can be lethal. My own cousin died from hooping cough at the age of 18 months. If a child has severe egg allergy then you can ask your GP to refer you to a paediatrician so that the child can be vaccinated against measles in hospital. I would stress that even in these cases adverse reactions are extremely rare.
Dr Susan Lewis-Jones
I have eczema, and have had it all my life, I am about to have my second child how can I prevent him/her from developing it?
Hannah
Hannah, I suggest that during pregnancy you eat a healthy diet avoiding nuts. After your child is born, try and use moisturisers regularly on his or her skin. Try and kee the dust levels in the house down to a minimum and if possible avoid exposure to cats and dogs. Once your baby is weaned, avoid eggs for the first year of life and keep to a fairly simple diet - don't experiment with exotic foods and nuts. If your baby is unfortunate and develops eczema, seek early help from your GP. You can also obtain information from the National Eczema Society (NES) which is linked to this website.
Dr Susan Lewis-Jones
Which foods are best for eczema sufferers? I have just begun to wean my son Oscar who's now six months old. (He has been completely breast fed up to now and has a little eczema.) As both my partner and I have histories of eczema, asthma and allergies, I will be very careful to introduce foods one by one. While I'm well aware of the foods he's most likely to be allergic to, I have little idea of which are the most suitable. Also is there a recommended formula milk?
Abigail
Dear Abigail - I agree it's important to introduce foods one by one. It's easier to recommend foods you should avoid such as nut products and raw egg products. I suggest you stick to a fairly simple diet at first and don't experiment too much with lots of exotic foods. There are many different types of formular milk available which probably vary from country to country and I suggest you ask for help from your health visitor or doctor. If a child has true milk allergy then they can recommend suitable alternatives. You can also obtain information from the National Eczema Society (NES) which is linked to this website.
Dr Susan Lewis-Jones
My first son, who died when he was four, had many serious allergies and wet, weeping eczema over most of his body. Fred was wet bandaged and had an exclusion diet, but never steroids. We also spent a fortune and many many hours trying every alternative therapy known to man. His eczema never really cleared up.
Since Fred died, I have been fortunate enough to have another little boy, Ben, and he too has eczema. This time, we have been to a dermatologist and he has been prescribed a "cocktail" of very mild steroids, to be used according to the severity and outbreak of the problem. Ben is not yet one year old and as long as I manage his creams many times a day, he is completely eczema clear and fat and happy.
When collecting Ben's prescription, I was shouted at by a woman who saw that I was getting steroid cream and told me first that I was ignorant, and ultimately that I was cruel and stupid to give my baby this dangerous cream. She had a terror of steroids and lectured me on skin thinning and long term damage, following me down the road and shouting at me like a woman possessed.
Julia
I am so sorry to hear about your first child and it is unfortunate that Ben also has eczema, but I'm glad to hear it is being well controlled with moisturisers and mild steroids. I am sorry to hear about the comments you received when collecting your prescription. Also there is great public ignorance about topical steroids which unfortunately extends to some doctors, nurses and pharmacists. I can reassure you that there is no need to feel anxiety about the treatment that Ben is having. Indeed you will find that if you keep his eczema well controlled, it should eventually clear and you will require less and less topical steroids. If you want further information on topical steroids, the National Eczema Society (NES) have a very helpful information sheet. The NES is linked to the Woman's Hour website
Dr Susan Lewis-Jones
I have suffered from chronic eczema since I was a toddler. I now have an 8 month old daughter, and know that she is genetically pre-disposed to suffering from it too. What can I do to minimise the risk to her? I have been treated with stronger and stronger steroids, and have been left with thin skin as a result, and very little improvement to my eczema. Is eczema only controllable, and not curable?
Tracey
Tracey, I suggest you ask your GP for a referral to a dermatologist. There are many other treatments available that can be used for you, apart from steroids. With regard to your daughter, if she has not yet suffered from eczema, then you may be lucky and she may not develop it. I suggest that you use regular moisturisers at least 2 or 3 times a day and if she starts to develop eczema then ask your GP for some hydrocortisone ointment. I would suggest a relatively bland diet and keep house dust mite levels down to a minimum. Other useful information can be obtained from the National Eczema Society (NES) which has a link on the Woman's Hour website. It is true that present treatments aim to control rather than cure eczema, but with regard to your daughter she has an excellent chance of growing out of her eczema if you keep it under good control at an early age.
Dr Susan Lewis-Jones
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