My 8yr old Daughter has just been diagnosed with (atopic) eczema, any advice on treatment and care please.?

Question

She was prescribed with some Aqueous cream to keep the area moisturised and some 'Fucibet' cream which contains an anitbiotic and a steriod to clear the mild infection she had. I don't like the idea of using too much of a steriod on her so wanted some other solutions. I am monitoring different foods to see what triggers it and have changed from biological washing powder.

Answer 1

Atopic dermatitis is a chronic inflammatory skin disease that is considered familial with allergic features. It often occurs in patients with other atopic disorders such as asthma and allergic rhinitis.The terms "dermatitis" and "eczema" are frequently used interchangeably. When the term "eczema" is used alone, it usually refers to atopic dermatitis (atopic eczema). "Eczematous" also connotes some scaling, crusting, or serous oozing as opposed to mere erythema.
The atopic disorders affect 8 to 25 percent of populations worldwide and the incidence of allergic diseases and atopic dermatitis appear to be increasing. They may occur in any race or geographic location, although there appears to be a higher incidence in urban areas and developed countries, especially western societies .The vast majority of atopic dermatitis has an onset before age five years, and prevalence data in children show a slight female to male preponderance.
The precise immunologic mechanisms involved in the pathogenesis of atopic dermatitis are not completely understood, and there is no marker for the disease. The importance of allergic triggers is suggested by the observation that approximately 85 percent of patients have elevated serum IgE concentrations and positive immediate skin test results to a variety of food and inhalant antigens.Food allergies are rare in adults, but avoidance of aeroallergens, particularly dust mites and animal danders, has resulted in clinical improvement in some patients with atopic dermatitis.Most patients have manifestations of atopic dermatitis by age five to seven years. In children, acute skin lesions that appear as intensely pruritic erythematous patches with papules and some scaling can be seen on the face, scalp, extremities, or trunk; diaper areas are usually spared.
Advances in the therapy of atopic dermatitis have focused upon immune regulation as more is understood about the immunology of this disorder. Nevertheless, standard modalities will continue to be important in the long-term management of these patients, centering around the use of topical antiinflammatory preparations and lubrication of the skin .Most cases of atopic dermatitis are chronic. Thus, the goal of therapy is to improve symptoms while minimizing exposure to potentially toxic drugs.

Exacerbating factors in atopic dermatitis include excessive bathing, low humidity environments, emotional stress, xerosis (dry skin), rapid temperature changes, and exposure to solvents and detergents. Avoiding these situations is helpful for acute flares as well as for long-term management.

Adjunctive measures that can be helpful in all patients with dermatitis include
1-Avoid trigger factors such as heat, perspiration, low humidity
2-Treat bacterial colonization with washing and selected antibiotic use
3-Treat viral skin infections such as herpes simplex
4-Use antihistamines for sedation and control of itching
5-Treat stress and anxiety
sleeping environment with minimal dust and upholstery reduces exposure to house dust mites and may potentially reduce the severity of atopic dermatitis.

In infants, avoidance of certain foods can be helpful. Common food triggers include eggs, nuts, peanut butter, chocolate, milk, seafoods, and soya.

Patients with atopic dermatitis frequently have allergic responses to multiple allergens, including type IV reactions to aeroallergens [25]. Immunotherapy (desensitization) has not been useful for the management of atopic dermatitis, in contrast to its success in treating patients with other atopic disorders.

Evaporation of water on the skin leads to xerosis in patients with atopic dermatitis; skin hydration is a key component of their overall management. Lotions, which have a high water and low oil content, can worsen xerosis via evaporation and trigger a flare of the disease. In contrast, thick creams (eg, Eucerine, Cetaphil, Nutraderm), which have a low water content, or ointments (eg, petroleum jelly, Aquaphor, Petrolatum), which have zero water content, better protect against xerosis. Emollients are best applied immediately after bathing when the skin is well hydrated.

Some controversy exists concerning whether showering or bathing is preferable in patients with atopic dermatitis. Most authorities recommend a hydrating bath followed by immediate emollient application, but others recommend a shower of short duration, which better removes surface antigens that may be acting as trigger factors. No well designed studies have been published to address this controversy. We feel that either option is reasonable but suggest bathing to most patients; whether bath or shower, rapid application of emollients or prescribed topical preparations is important.

Corticosteroids are also helpful,but i prefer to tell u visit your doctor before using them because of their adverse effects.Antihistamines are also widely used as a therapeutic adjunct in patients with atopic dermatitis to treat both pruritus and eye irritation .The topical calcineurin inhibitors appear to be effective for the treatment of atopic dermatitis ,they have minor side effects too.Oral calcineurin inhibitors is effective for severe atopic dermatitis (some studies showed that)
Many patients with atopic dermatitis can initially be treated by a nonspecialist. if you didn't get a good answeryou can refer to a dermatologist too.(it has some criteria itself ,which you can consult your doctor for )
If you need more information ,I can tell you via email.
hope fortune and happiness for you and your little daughter

Answer 2

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Answer 3

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Answer 4

Well, when my daughter was young she got into a few girl fights a few times and I suppose this is just part of growing up. However, the other little girls were around my daughters age and the 'fights' usually were no more than a little shove or push, grabbing each others toys, etc. You sort of expect this from three, four or five year old kids...certainly not from a 11 year old slapping an 8 year old. You have every right to be mad and concerned. Your son is a handsome young dude and there will be girl crushes on him. And young girls can get embarrassed easily. But there is no excuse for embarrassment having physical violence as a result. I really don't know what to suggest to you if the girl's mother isn't returning your call. What I would do is strongly encourage (if not force) the girl's parents to have her go to some sort of anger management counseling with a professional. EDIT: The 11 year old girl who slapped your daughter obviously knew right afterward what she did was wrong. She probably could have made things easier if she instantly apologized for her fit of anger. Instead, she tried to cover it up. Sadly, this may be a reflection on her parents and the way she has been raised so far. If so, either the mother or both parents will try to play the whole thing down instead of accepting responsibilities. If this happens your only recourse may be to report it to Child Welfare.

Answer 5

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Answer 6

I would suggest Prodigy Guidance which is part of the National Institute for Clinical Guidance. This is used by most GPs like myself for guidance. Hope she feels better soon

You can't cure eczema but you can control the symptoms and avoid certain triggers. Eczema is related to asthma and hay fever, all atopic conditions. There is usually a family history precending it. Animal hairs/washing liquids/certain foods/stress all can cause an exacerbation of eczema.

From now on she will have to avoid soaps, perfumed bath oils, bubble bath, etc...if it has soap in it hten avoid it. Oilatum bar is a good alternative. And so are Aqueous cream, Diprobase emollients, there are several out there. Usually adding balneum plus or oilatum bath formula/gel will help the condition. Avoid hot baths as the heat will make the skin itchy.

It depends on site as well? Is it on her hair ?seborreic dermatitis or face? or hands and limbs ? There are treatment shampoos out there as well, Nizoral, oilatum scalp.

There is a treatment ladder for eczema, if you uderstand it will be easier to go up and down according to need.

1. Emollients such as diprobase, aqueous, etc.. E45 contains lanolin which is not always advisable as may cause skin irritation

2. MIld steroid hydrocortisone 1% to use sparingly during an exacerbation. not recommended on the face.

3. Eumovate for moderate cases, not recommended in children

4. Betnovate for severe cases, not recommended in children

5. Dermovate, only underdermatologists care

May need to add fucidin, antibiotic cream for infected areas,. i.e. skin weeping. At times oral antibiotic may be needed such as flucloxacillin as long as she is not allergic to penicillin. This will be under GP only treatment and supervision.

Answer 7

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Answer 8

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Answer 9

I suggest treating it internally with all-natural Optiflora. This two-product system uses new technology to protect beneficial microflora during the rigors of shipping, storage, and the acidic journey through your stomach. Other products claim live microflora at the time of manufacture.

This system includes Probiotic (Bifidus & Acidophilus...microflora) + Prebiotic (FOS...food source for microflora. Patented guaranteed delivery of 500 million microflora to intestines.

A very successful topical product is Small Wonder Creamy Baby Oil. It's more like a cream than an oil. It provides the same benefits and protection, but it's faster absorbing and less greasy. It's pH balanced and dermatologist tested for delicate skin, and contains soothing vitamin E and allantoin to help prevent dryness and irritation.

Hope this is useful and feel free to contact me with questions or the website.

Answer 10

any steroid topical cream like hydro cortizone prescribed from a doctor works great....my 18 month old was diagnosed with the same and this stuff works great......but it keeps coming back and I'm hesitant to use a steroid cream so often....(there have been studies that large amounts to children affect neural development) so there is a non-steroid cream I find works great....its made by Baby Naturals and its called Baby Eczema cream sold at any Walgreen's......its greasy but it really works.......the good news is that if the onset of this condition is before puberty then there's a pretty good chance that it will be gone post-puberty

Answer 11

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