The use of topical steroids in young children with eczema is not at all controversial in the medical community. Markus has given you excellent advice.

I am really hesitent to use a steriod cream as well. We are going to change his diet and be careful with detergents, already use bath soaps and ointments that will not dry him or aggrevate him further.

Thank you all for your advise lots of good tips here that we are going to put to use. Its a really sucky condition for a 3 y/o to have. Its frustrating to watch.

One of the most hard lived misconceptions I have to fight with parents on a daily basis is their fear of steroids in any form. Yes, in the old days, when steroids were only available for systemic administration like tablets and injections, the fear was somewhat adequate. Today there is a very compact scientific consensus in favor of modern applications of steroid derivatives. That is true for treating a few months old babies with asthma with steroid inhalations - as well as equally young patients with topical steroids for eczema.

Not trying to be a hard head or besserwisser. It is just that I meet all these kids every day that really suffer from, for example, a severe eczema because their parents are afraid of steroids - when I know it is perfectly OK to treat them and above all the children will feel so much better without the constant suffering.

Again, sorry, I know every parent want what is best for their child and I do not want to sound like an old school teacher - but I burn for the little ones.

Do not apologize at all. Thank you for your professional opinion and I will relate this to my wife.

Thank you again for your input and setting me straight on my misconception.

If you are ever in Florida visiting the Rat with your kids let me know I would love to meet up with you.

Thanks Jim! I was afraid my passionate feelings on the subject might have come out a bit ... bullish.

What ever questions or troubles you may run into - please let me know (if you feel comfortable with it).

Jim,

Feel for you and the little one. Our little chap suffered when he was two and three.. now five and we followed advice very close to Livi's... and it worked...

Our music minister from our church has suffered from eczema and rheumatoid arthritis most of his life (he's 44) and he went through the "cola tar" therapy last year and got some semi-permanent relief from it. He still has flare-ups, but it's under control. The medication he has to take for his rheumatoid arthritis (don't know the name of the drug) causes him alot of problems, but he's got the eczema under control, but the "coal tar" therapy he described to us was very unpleasant and required him to spend a week in the hospital...

Hey Markus, I've been hearing a lot about food protein allergies and have wondered if maybe something like milk or eggs have been the culprit for my condition. As a youth I consumed plenty of the aforementioned with no adverse affect, but I did lay off milk for a number of years in my adult life until someone convinced me that I needed the calcium benefit. Could it be possible that that my system developed an immune intolerance during my abstinence? I could stop drinking milk of course to see if my condition improves. What is your opinion on that?

Furthermore, as I stated I took Prednesone orally with disastrous consequences. However I still to this day apply Elocon (Prednesone topical cream) to particularly bad areas with no adverse effects and the results have been quite beneficial and so far have outweighed the risks.

It is a very complex and individually unique issue. And I am not certain my pediatric perspective always apply on adults. Generally with these immune related conditions it is never wrong to try and change certain parts of the diet. What works for one person might not work for others. Particularly with a psoriasis component, certain food groups are very often negatively affecting the severity. What food and for whom - difficult to say before hand.

If I were you I would certainly try different strategies. I believe, with adults, milk and meat are among the food groups that apparently make these conditions worse for many patients.

Jim,

My 2 yr. old has it pop up in small patchs here and there. It's usually behind his knees or some area that's warmer. We've found a tiny bit of OTC Hydrocortisone cream each night before bed works wonders.

Coal tar is like being tarred (as in tarred and feathered) then baked under UV lights, not exactly appropriate for 3 year olds...

I worked on the Elidel launch, what a great drug until they ran into some issues, still safe but hysteria set it.

Latest that we have our 2 year old on is "Atopiclair"

http://www.atopiclair.com/

Fairly expensive but its "non-steroidal" and has been good for our little one.

The key is nice warm bath and immediate moisturization, the heavier the better, we like Eucerin. Over the patches we spread teh atopiclair then the eucerin over it...

Peds won't write elidel for kids anymore but that stuff was like miracle cure...too bad.
Adam

Jim,

I will give you a slightly different bent perhaps. I am not a doc, first off. Lots of them in my family, but I actually enjoy time off! (Sorry docs!).

My wife is very well studied in the area of nutrition and alternative modalities. We became even more educated about these areas when my 14 year old girl was an infant and started having eczema breakouts if you will. We were not wild about the creams and did not receive many other options form the ped's. The one thing that we have confirmed through our experiences, and perhaps this is NOT true with every case, is that eczema is mostly diet related. Livi gave some great tips as far as things to avoid. What we found to be the biggest agitator was mostly dairy items (milk, ice cream, cheese, etc.). We also see her break out if she starts eating a LOT of bread products or sugar. By sugar, I am not just talking about the white stuff, I am including anything with sugar (fructose, sucrose, syrups, etc) on the label. We eat a pretty healthy diet and eat mostly a raw vegan menu. It has helped tremendously. We avoid just about anything that is a processed food (meal in a box, etc.). If you are interested in more info, I am sure my wife would be willing to discuss it with you. If you will email her at our home address of vanweys@charter.net, you guys could setup talking on the phone or email. Either way would be fine. The bottom line though is that a LOT of good can be had without the use of the steroids, no matter how "safe" they may be.

As a disclaimer, her father is a DC and a Nutritionist. Her mom and sister are surgical nurses. Her brother is a well respected surgeon. My family is also somewhat "mixed" as well. I only mention this to tell you that we are not some sort of vegan, doctor-hater nutjobs (well, my wife might want to say differently about me).

Good luck.

I get very dry and itchy during cold weather. I mean really bad outbreaks that look like poison ivy. The dr. prescribed triamcinolone acetonide cream. It works well, but I don't know much about it.

I wanted to confirm the food allergy connection as well. My mother saved me from agony as a child by an elimination approach to my diet. She literally went to chop meat and rice mixed in a bowl twice a day and rice cereal in the morning. For weeks. (It takes that long for the body to stop reacting to things.) Then she started adding things each week until we landed on the thing that flaired my rashes and dry skin patches. Milk and wheat were the triggers. There is NOTHING harder to do than start preparing meals around a special diet like no milk or wheat/gluten, unless it is watching your child suffer b/c you won't do it. PLEASE try it before the heavy-duty meds.

My eczema dissapeared after I stopped having diary products. And a friend had really bad eczema from an alergy to residual laundry powder - soap based laundry powders are availalble.

Funny this should pop up I was going to update in here.

My sons eczema is all but gone, we did cut diary out of his diet but I noticed something else.

His hair,sounds crazy huh? Well, when we are in North Carolina it gets really straight but when we are in Florida it gets really curly.

His eczema gets really bad when its straight because there is no natural humidity up in the North Carolina mountains, but in Florida where it seems to always be hot and sticky with high humidy his hair is curly and his eczema is nill.

That is good to hear, Jim.

You have noticed something that most children with eczema suffer from: cold, dry air is bad for their skin. Very logical. Eczema is in it self a bad form of real dry skin complicated with inflammation.

Take care with the elimination diet. Ideally you should be monitored regularly by both a pediatrician and a dietitian. Eliminating all dairy food will often need some supplementing. At least with Calcium.

Also, assuming this is a milk protein allergy, most children grows out of it during the pre-school years. Regular (once every 6-12 months - depending on symptom scale) test provocations are called for, not to go on elimination longer than necessary.

Yup, good to hear too, and if you do go down the non dairy route be careful of too much soy products. They taste great but contain a lot of estrogens.

Jim,

As Chris mentioned, our 2yo has eczema - had it since he was born and it got worse as he started eating rice cereal at 6months... it got so severe that a steroid cream was prescribed when he was about 8months old.

Fast forward to now...

I use unscented "no additives" detergent ... no softener ...
unscented dryer sheet - NO DREFT

Bath time: Cetaphil and Dove UNscented white soap
The perfumes and additives of other soaps were agitators...

Cetaphil lotion - lots of lotion on his skin
If it's a really really dry spot, a little chapstick helps too

I've tried lots of other lotions but they contain lanolin
and other products that irritated Wyatt's skin

Now it's manageable with a little Hydrocortisone every now and then.

ALSO - everytime he eats rice, he breaks out with eczema
and also get a wicked diaper rash...
(this I don't understand considering he's 1/2 asian!!) ;)



Glad to hear that your 3yo is better!!! :)