All this scratching is making me itch - baby eczema

February 15, 2007 1:54 AM

What can stop my 5 month old scratching his skin off?

I know there have been questions asked before about eczema in babies/children - but I'm going to pull back from looking for a cure, to ask simply: is there a cream/lotion that would really reduce the itch of eczema?

He's tearing himself apart, and despite covering his hands and feet, he is constantly itching at himself and can't sleep (we get a maximum of 1 hour at a time which is starting to really take its toll). On occasion when he's managed to rip off a glove, he's managed to tear the skin off large parts of his body and bleeds horribly. This is so very distressing for us.

We've tried/trying numerous moisterisers to arrest the dryness, we're looking at dietary issues and probiotics, etc, etc - I just want answers based on alleviation and not causal.

Thanks

posted by a non e mouse to health & fitness (34 comments total)

Have you tried hydrocortisone cream? It is available over the counter. My sister-in-law used it on her six month old's eczema with some success.
posted by crazycanuck at 2:39 AM on February 15, 2007

Bear in mind that this is something that will need to be used frequently - probably daily. Cortisone isn't really appropriate - especially for a small child. But thanks for your suggestion.
posted by a non e mouse at 2:45 AM on February 15, 2007

a non - did you ask your pediatrician about hydrocortisone? It might be worth asking. Otherwise things like Aquaphor and eucerin are good, but these are moisturizers. I don't think diet makes a differrence. Make sure you bathe baby daily to prevent infection. The idea that bathing dries out skin and is therefore contraindicated for children with eczema has been debunked by the dermatologists and pediatricians.

You could look up "atopic dermatitis" online too, the medical term for eczema, though you probably alrady knew this.
posted by cahlers at 3:21 AM on February 15, 2007

These guys make special nightwear for kids that's supposed to sooth eczema. I seem to remember seeing a post pop up on one of the blogs I read about special 'cool pajamas' that are impregnated with lotion, but my Google-fu is failing me currently.

I grew up with eczema, and half the battle is reducing or stopping night-time scratching. It's when the kid wakes up in the morning and is raw and itchy all over that they end up scratching all day too - vicious circle.

I'd say hydrocortisone is a bad idea for someone so young, it's a steroid and can be pretty bad for your skin if used extensively and for long periods - it's best used for short term spot treatment of particularly violent flare-ups. IANAD, so consult yours.

I'll see if I can turn up those cool pajamas.
posted by Happy Dave at 3:32 AM on February 15, 2007

oh, yeah, and have you tried Nivea? People react in horror when I suggest it, because it's perfumed etc, but damn, that stuff instantly takes the sting out, and keeps it out, plus it doesn't go all greasy, it just absorbs in. I'd be screwed without it.
posted by Happy Dave at 3:33 AM on February 15, 2007

flash-back time : looks like a post my mom could have done around september 1969...

as an adult with eczema I swear by something marketed under the name "atopicalm" by a company called dermagor. Itching stops in a matter of seconds. In my case it's a godsend. Maybe some pediatric version of it exists.

The best advice I could give is to consult a dermatologist as soon as possible.

Also consider asking yourself if this is not the body of your child telling you something without words like "you know what, mummy, maybe you protect me a bit too much". Maybe you do, maybe you don't. In retrospect that's how my 4 months-old at the time, bad-enough-to-be-hospitalized eczema means to me.
posted by Baud at 3:35 AM on February 15, 2007

For whatever it's worth (which may be not much; a non e mouse is currently in an undisclosed location), here is the webpage for Atopicalm, with picture. It seems to be made in Monaco, so I don't know if it's available outside Europe.

I do not know what Baud was trying to say in that last paragraph.
posted by Kirth Gerson at 3:44 AM on February 15, 2007

Ah yeah - in Australia, but I'll check with the chemist ... I'm not sure what Baud meant either - Baud?
posted by a non e mouse at 3:50 AM on February 15, 2007

In my case and I'm not saying this is is universal, the eczema question reared its head in therapy and what I found was "too much protestion" on the mother side. Technically, eczema is skin cells growing too fast, new cells arriving ahead of schedule generating too much protection. So, in my case, my eczema could psychologically speaking be a too-early for words way of saying "I receive way too much protection".

Since I did heavy eczema around the same age as your child, maybe should ask yourself : "am I giving too much protection to that new born and is it what's his body is screaming silently through eczema? "

Of course you have to subscribe to a whole lot of "body-and-mind are related" theories.

Clearer now ?
posted by Baud at 4:02 AM on February 15, 2007

Is it wet or dry excema?

If it's dry, there is a product available called Oilatum, that you put in the bath. It's basically a form of bay oil, that mixes into the water, instead of floating on it. Never used it myself, because I use a cheap "dispersing bath oil" from an aromatherapy suppliers.

If it's wet, be careful what you put on it.

Have you looked into causes for the excema? [Yes, you have.] When I was young, I would have an allergic reaction to long grass. I was fine being around it (no hayfever, etc), but within 2 minutes of being in the grass, I'd itch and come up in blotches. Certain washing powders also used to trigger attacks. My mother used to use eco-friendly products, like Ecover, and that used to help.

Hydrocortisone cream didn't help me at all. Also, keep the child's fingernails short. Obvious when you think about it, but it took me ages to catch on. :D
posted by Solomon at 4:04 AM on February 15, 2007

A friend's baby (5 mos.) had an excema (excemum?) that extended over the majority of his body. The pediatrician recommended hydrocortisone. Obviously, I don't know how severe your child's is, compared with their child's, but they applied it daily, and it took care of the problem very quickly.
posted by Alt F4 at 4:33 AM on February 15, 2007

Having had eczema all my life I would recommend (for dry eczema) a cream which is called Ultrabase or Diprobase (in the UK at least). It's fairly greasy but contains no colouring, additives or perfume, and importantly for me no lanolin to which I'm allergic (E45 cream does contain lanolin therefore is no good to me).

Things that set me off are wool jumpers, blankets etc and feather pillows and duvets. Might be worth making sure you keep him away from those too - you never know.

Oh and second steering clear the steroid creams - they work for a short time and then their effectiveness just stops. Did with me anyway.
posted by jontyjago at 4:39 AM on February 15, 2007

At some point eczema becomes becomes a game of managing the itching and not the itchiness. It can be difficult and take a long time to pinpoint triggers. So, run, don't walk, to wherever you can get the Miracle Blanket swaddle. This will keep junior's hands from scratching and will in turn (hopefully) get you all some sleep and reduce the itchiness. It's the only swaddle that I've seen actually work with flailers and older babies. You can keep him in it all night. It sure beats what my parents had to do: wrap my brother neck to toe in plastic wrap so he wouldn't scratch.

As for managing the itchiness some tips, many of which you may have heard already: hydrate, hydrate, hydrate; tepid, not hot, baths/showers; Aveeno oatmeal bath (or you can do as my parents did and put rolled oats in a sock and drop it in the tub); Eucerin creme (not lotion) works for us--apply any creme within about 3 minutes of getting out of the tub; jojoba oil mixed in the tub is very mild and won't block pores (some secondary itchiness is from the itched skin flakes themselves lying on the skin). That's all I can remember for now. If I think of anything else I'll repost.
posted by cocoagirl at 5:07 AM on February 15, 2007

I have had excema since I was a child, though it was worst when I was a teen. These are the that things help most.

1) Staying the f*** away from fabric softener. I can sort of tolerate Downy, but Bounce is instant death. Even shopping for clothes can make my hands blister and crack because I'm sensitive to the fabric finishes on new clothes.

2) Avoiding scented detergents. I use Tide Free or an unscented liquid laundry detergent from the health food store and both are safe for my skin. Ivory Snow is very bad. If you're using Ivory Snow for his clothes, switch now.

3) Vaseline. *Not* Vaseline Intensive Care Lotion, but the very plain, ordinary, unscented, non-SPF Petroleum Jelly. Try putting it on his skin after a bath, and on his hands before putting on his gloves at night. Eucerin didn't help me at all. I think there are a few things involved here. It stops the skin from drying, it provides a protective barrier against the outside world, and (pet hypothesis) something about the petroleum jelly itself might even help. (Coal tar used to be a common ingredient in anti-excema creams.)

4) Quitting cortisone treatments entirely. Cortisone provides short term relief, but it also thins the skin making it more vulnerable in the long term.

These are the things that sometimes helped:

5) While I was quitting the cortisone (on the advice of a dermatologist) and still had excema, the dermatologist suggested bathing in Alpha Keri bath oil instead of using soap. If you try this, be very careful because your five-month old will be both very squirmy and extremely slippery. You'll probably need to pick him up with a towel.

6) Black walnut ointment from the health food store. Black walnut is an antifungal and as a teenager I was once treated with an oral antifungal that made my excema completely disappear while I was taking it.

7) I also got some relief from using antibacterial soap (the kind in the blue-and-white bottle in the dermatology section of the drugstore - PhisoDerm, I think).

My pet hypothesis relating 6 and 7 is that I would get an opportunistic colony of something living in my oozing blisters that would irritate my excema further, but doctors don't agree. Whatever. All I have is anecdote.

Other suggestions:

8) If your son has more excema in the diaper area, he might be sensitive to the perfumes in disposable diapers. You could try using cloth diapers from a diaper service in the day when you can change him often. (Diaper service diapers get a more thorough rinse than you can get from a home machine, so if he has sensitive skin I would suggest them first.) You can use flat diapers (very absorbent and softer than flannel) inside a fitted velcro diaper cover. Tell the diaper service you need breathable covers because you don't want him heating up inside plastic pants.

9) Cool water for bathing is also supposed to be good.

10) If none of these things help enough, ask your doctor about giving him Benadryl at bedtime.

Anyway, things to try. Excema is awful, and losing sleep is torture.
posted by kika at 5:14 AM on February 15, 2007 [1 favorite has favorites]

First, if your baby is itching that bad get him/her to a pediatric dermatologist who will be able to access the source of the eczema and be able to prescribe the appropriate medication; second, if you are not using something like Dreft soap for your baby's clothing do so now -- some infants are sensitive to bio based soaps and industrial cleaners; third, do not bathe your baby every night, once a week is fine unless they are truly dirty because you are washing away their skin moisture. If you do bathe them makes sure it is a moisturizer laden wash liquid with preferably, no perfume, soap or other additives and make the bath real short. You just might want to switch to a simple sponge bath followed with moisturizer.

Until the dermatologist gives you an idea of a product start moisturizing your child with Eucerin or any other completely hypoallergenic moisturizer (ask your chemist/pharmacist)

Products that have worked for infant eczema include Eledel or Dermasmoothe which can be prescribed for under 2 year olds by a dermatologist.

Things a parents should have on hand for VERY serious diaper rashes are 1-2% hydrocortisone, 1% clotrimazole and bactroban/muciprocin (a great anti-bacterial). For mild cases there is always nystatin and what American pediatricians call "butt paste". Alot of what very severe diaper rashes take is a combination of hydrocortisone and clotrimazole (check out links to infant skin issues); actual cuts, scrapes and wounds work with bactroban. Most diaper creams are 9-13% zinc oxide based - you might need a higher concentration, take a look at the ingredient labels.

I have experience with infant eczema, almost too much, and have managed it for awhile now with my son.

Your pediatrician may also recommend an allergist as well. Your child maybe allergic to dairy or something else.

But seriously, YOU MUST GET YOUR BABY TO A PEDIATRIC DERMATOLOGIST

Good luck.
posted by jadepearl at 5:32 AM on February 15, 2007

Regarding Elidel: my youngest has suffered from excema since babyhood, and used to use Elidel. However, there were studies done over the last few years that connected Elidel to cancer . My daughter's dermatologist took her off of it. We have used prescription strength cortisone cream on her for short periods for very bad flare-ups, and then moisturize heavily in between. The key is to stop that itch.

Excema, asthma, and allergies are all related, so I suspect that your child is allergic to something. I second using detergent with no perfumes or dyes, and delete the softener. California baby has a line of nonallergic baby (and adult friendly) products that have been a lifesaver for my daughter. She is sensitive to everything - soaps, shampoos, creams. They're sold in health food stores as well as on-line. When he's older, you could consider allergy testing, although for dermatitis, it's really try-and-see for things that irritate the skin.

I would absolutely recommend taking him to a dermatologist, and if a prescription is given, be sure to ask several times if it's safe for babies. It's important to get that itch under control, before he starts getting infections which will introduce another layer of complication.
posted by Flakypastry at 5:51 AM on February 15, 2007

Amalah's baby has eczema, and she swears by plain old Curel.
posted by robinpME at 6:03 AM on February 15, 2007

Regarding the second comment in this thread: hydrocortisone cream is perfectly appropriate for daily use.

There's a 7-step scale for ranking the power of various steroids. Hydrocortisone is the weakest. It's true that the most potent steroid drugs require care in their use, because there can be serious side-effects. Hydrocortisone is not really subject to those, which is why it is available over the counter. Do not be afraid of the word "steroid". If your kid is *tearing his skin off*, you need to weigh the dangers of hydrocortisone (none) vs. the dangers of tearing his skin off (many) and decide which one is preferable.

Hydrocortisone might not be strong enough. In that case, you'd need to get a prescription for the next step up, and try that. You keep moving up the potency scale until you get something that works.
posted by jellicle at 6:47 AM on February 15, 2007 [2 favorites has favorites]

The usual friend's-kid-a-long-time-ago second hand advice: They insisted that certain foods made it worse, especially sugar. (My pet theory is that giving anything that makes an itchy kid hyper is just trouble anyway, but who knows.) Their solution was to avoid obviously over sugary foods at all times and to specifically avoid the kid eating anything at all for ~2 hours before bed. You don't say how old your kid is so this may not be viable but you might want to keep it in mind to try later on. Good luck.
posted by anaelith at 7:02 AM on February 15, 2007

Although I think the anecdotal and personal experiences given here will be of good temporary use to you, I think this problem is severe enough for your child that you need to immediately, as someone suggests above, seek the assistance of a pediatric dermatologist. With it affecting your child's quality of life to this severe an extent, this is not a time you want to be relying upon anything except the advice and guidance of a medical professional.
posted by WCityMike at 7:35 AM on February 15, 2007

Isn't that what Baby Oil is supposed to be for?
posted by JJ86 at 7:50 AM on February 15, 2007

Seconding Jellicle's very correct comment regarding hydrocortisone's safety. On the scale of steroid potency, it's like comparing near-beer to vodka. If you want to control a bad infant eczema problem, there are anywhere from five to twenty potential regular facets of daily management you will need to practice. One facet is the periodic, possibly daily, use of a mild to moderate potency steroid cream.
posted by docpops at 8:00 AM on February 15, 2007

Although clearly not as bad as your problem, with moderate to severe eczema we had good luck with the previously suggested Aveeno oatmeal bath, the Aveeno baby lotion (I still use for dry skin), Dreft infant detergent for washing everything that touched him, very snug swaddling at bedtime, and cortisone cream for itchy outbreaks. Our doctor specifically prescribed cortisone after Elidel got the black box warning.

His condition cleared entirely as he got older.
posted by nanojath at 9:51 AM on February 15, 2007

The only, and I mean ONLY cream that has ever helped my eczema is Cetaphil lotion in the tube - it's the "Shea butter" formula.

Cool water, never hot for baths and cool compresses can help as well.
posted by agregoli at 10:47 AM on February 15, 2007

I don't think diet makes a differrence

If it's eczema related to allergies, then absolutely it can make a difference. You might want to ask your pediatrician about seeing an allergist.

(Allergies here, too, my allergist was my primary doctor growing up).
posted by agregoli at 10:49 AM on February 15, 2007

Definitely try and see a pediatric dermatologist (ask your pediatrician for a referral) and perhaps an allergist too. I suffered from eczema as a baby, and on and off since then. My eczema is definitely allergy-related, sometimes stress-related too (which is a vicious cycle). I second the cutting out of fabric softeners, perfumed washing powders, dust the room thoroughly and keep any pets out of the room too. Allergy tests (done by drawing blood or a skin test; skin tests suck) can narrow it down. A regular doctor can do the allergy tests.
posted by Joh at 1:16 PM on February 15, 2007

second the use of oilatum in the bath, and diprobase as a topical cream. Worked for us on our first daughter (now 5) when she was a baby. But really see a doctor to get more advice.
posted by crocomancer at 2:35 PM on February 15, 2007

I was just like your child 30 years ago. Maybe some of this will be helpful:
1. Use natural fabrics around your child. To this day I can only wear cotton.
2. Keep your child cool. I still have to be careful in the summer. Perspiration really irritates the eczema. Lotion on heat-irritated skin can result in prickly heat/heat rash which is not in any way enjoyable.
3. I can actually second the Nivea suggesiton - it was very soothing when I was a child. I've since discovered Aveeno products. Their colloidal oatmeal bath is incredibly soothing and I'm sure you can find an equivalent. The company's lotions are excellent too.
Best of luck and do know that your child is likely to largely outgrow it but also be careful for other allergies developing - particularly peanut allergy.
4. If you have any pets, by the way, this could be making the problem worse.
5. Cortisone cream can thin the skin so do use it sparingly if you go that route.
posted by ChuckLeChuck at 4:59 PM on February 15, 2007

Some great advice here.

Of course we've been seeing doctors/witch doctors/etc, all of whom have suggested a variety of approaches in an attempt to rid our lives of this most insidious of skin problems (particularly for babies). It's hot here; humid - when the windows are open, swarms of mosquitoes add to the dilemma. We've been told not point powered fans directly onto him, etc., so attacking the main source of his frustration is paramount, working on the longer term eradication is the other prong of the attack. There is no cure for eczema, only strategies for avoiding the causes.

I'll mark the best answers (but based on their relevance to the question). Thanks for the additional advice you have all provided.

SV.
posted by a non e mouse at 7:42 PM on February 15, 2007

One of our friends swears by Emu oil, which is hard to get up here in the U.S. and quite expensive. But as you know if your kid has it bad: I'd gladly pay big $$$ to fix it.

So far, we haven't found any great topical goop, so we are trying to be creative with the restraints. Swaddling is fine in cold weather, but summer is coming and I dread it.
posted by markhu at 11:30 PM on April 9, 2007 [1 favorite has favorites]

If you're still checking the thread, I'd love an update. I have a 6 month old with eczema that we are managing pretty well. The only problem is that since he outgrew the swaddle, he wakes himself up several times a night.

What did you try from the advice above?

Anything work?
posted by twjordan at 10:27 AM on April 15, 2007

Hi Tw - sorry to hear you're having a similar issue. Here's an update:

One of the other issues with eczema is poor weight gain - our son is a whole kilogram (2.2 lbs) beneath the lowest percentile. Not good.

Our GP continued to suggest cortisone for flare ups - but decided to continue to moisturise his skin daily (using a really thick base called Eucerin). We stopped bathing him as much, also - as this depletes some of the oils and heats the skin up making it worse. We got the eczema under control - but didn't get rid of it.

We had a blood test and discovered that he was seriously anaemic - this is where it gets interesting. My wife developed a rash under her wedding ring (white gold) during pregnancy - I later discovered that iron deficiency (which causes anaemia) increases the bodies absorption of nickel. When nickel gets to a high level, your body develops reactions to it - locally, the white gold ring (white gold contains nickel) caused a rash. She wasn't showing signs of anaemia - but we're pretty sure she was iron deficient.

What I'm getting at here is that because my wife was iron deficient during pregnancy, this deficiency was passed on to my son (obviously if there's not enough iron to go around - it's unlikely that you'll be able to pass too much on to a developing foetus).

It takes (up to) 2 years to build the iron reserves up in an infant - so we're giving our son a liquid supplement each morning. He is now putting weight on (1 lb in 2 weeks) and his eczema, although not completely gone, doesn't require the strict regime we were having to undertake prior to this.

This is where I out my sock-puppet - but only you're going to be reading this (so it's our secret). I posted some info here (in an unrelated thread about white gold allergy) - I'll keep on posting more as I find it.

Now for swaddling - in Australia we have these great things called Wondersuits - made by Bonds (+ looks like a little Elvis outfit). They have mittens built in to the arms (that fold over) that stop them scratching themselves when they're sleeping. Our kid's eczema was bad, but made worse when he scratched - as it then started to weep/scab up and get infected - if you can stop them scratching it, then the moisturising will stop the flare ups - they probably make something like this where you are - they are a godsend. Alternatively, use pressure bandages over some mittens (to stop them coming off) this was also helpful.

Good luck (and my email is in my other account, if you'd like to discuss further).
posted by a non e mouse at 6:09 PM on June 17, 2007

Just another update: It's coming up to Summer here in Australia and despite all the amazing aforementioned insights and seeming breakthroughs we thought we were having, my son's eczema has come back with a vengeance.

We took him to a paediatrician who convinced us to start using Betnovate (cortisone) to get rid of the rash once and for all* - we used it religiously for 3 weeks and it did manage to take the redness out of it, but the rash itself was still prevalent as un-inflamed raised areas of his skin - the moment we stopped using it and it warmed up, whammo - back to square one.

*the Paediatrician warned me that by not using cortisone (ie: getting on top of the eczema), the chances of my son getting an infection were quite likely (remember, he constantly scratches his skin completely off). He relayed a personal anecdote of another of his patients, whose eczema related infection got into his heart and almost killed him. Maybe an extreme, but good reason to act.

It now turns out that my son is still anaemic, despite the iron supplements - his iron stores are high, but he is not producing red blood cells - which is indicative of something more complex/sinister (possibly thalassaemia).

He is also allergic to dust mites and one/many of the staple food groups.

More testing for us - and the awful wait to see what exactly is causing his blood issue.
posted by strawberryviagra at 8:03 PM on September 26, 2007

An update to my earlier post in April:

Our itchy baby is now 14 months old (adjusted), and quite small for her age: in the 5th percentile or less. She is a little over 16 pounds, and about 28 inches long. (She started off small as a 2lb-12oz preemie 8 weeks early.)

We survived the hot summer by running the air-conditioner in her room at night which allowed us to swaddle her securely. By securely, I mean we have to wrap her quite snuggly, safety-pinning the stretchy cloth to prevent her from wriggling out and scratching herself awake. We have not found any fold-down cuffs to be secure enough to keep her hands inside, and now that she has grown a little they don't seem to offer fold-down cuffs in her size anyway.

We read somewhere that pro-biotics are good for allergies/itch, so we have been giving her some regularly and it seems to help a little (non-dairy since she is allergic to milk protein.) Her skin is mostly free from hives and rashes, but she is still extraordinarily itchy several times a day, and does get occasional outbreaks of hives (about 1 in 10 days on average).

We used emu oil for awhile, but like so many things we try, it only worked for about a month, then she had another flair up, so we moved onto something else. Prescription Dermasmooth, over-the-counter cortisone, etc.

Can the snug swaddling harm babies orthopedically? She spends about 10 hours swaddled each night. She has learned to crawl well, and seems on her way to walking soon, so maybe I shouldn't worry.
posted by markhu at 6:11 PM on October 3, 2007