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From: [e-mail] (Anita Graham)
Subject: misc.kids FAQ on Eczema Part 1/2
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                        Misc.kids Frequently Asked Questions
                                                Eczema

======================================================================
Collection maintained by: Anita Graham ([e-mail])
Last updated: September 14, 1996
======================================================================
Copyright 1996, Anita Graham. Use and copying of this information are
permitted as long as (1) no fees or compensation are charged for use,
copies or access to this information, and (2) this copyright notice is
included intact.
=======================================================================
To contribute to this collection, please send e-mail to the address
given above, and ask me to add your comments to the FAQ file on Eczema.
Please try to be as concise as possible, as these FAQ files tend to be
quite long as it is. And, unless otherwise requested, your name and
e-mail address will remain in the file, so that interested readers may
follow-up directly for more information/discussion.

For a list of other FAQ files, look for the FAQ File Index posted to
misc.kids weekly or check the misc.kids.info newsgroup.


=======================================================================

                                                                Eczema FAQ
=======================================================================


Laura Dolson was the original keeper of this Eczema FAQ. She wrote the
first part of this FAQ (down to the statement: And now for the "answers
from the trenches"!) If you have questions about what she has written,
she can be reached at: [e-mail]

Laura writes:

While I was pregnant, and we were contemplating the possibilties of
what our child would be like, I remember saying to Mark "Well, I do
hope she doesn't get your skin!" (Mark has a lot of trouble with
rashes, reactions to sun, etc.) Well, no such luck! Eczema is a fact of
life off and on, and probably will be for a good while yet. :-( But we
have been able to keep it under control, for the most part, by
following many of the suggestions outlined below. For example, unless
Emily is really DIRTY, we don't use soap at all, just a soak in the tub
and a warm wet washcloth for the face.

We tried to figure out if it was allergies - milk products are often
the culprit, apparently. But cutting out the obvious allergens (milk,
wheat, eggs, etc) didn't seem to make a differencein our case. (Or me
cutting those things out when I was still nursing.) Emily's seems to be
worse in the summer, and almost always starts in "creases" - backs of
knees and elbows, wrists, etc. Some children have it worse in winter
when the air is dryer. Emily's has gotten better (or should I say "less
bad") with each year - she is 3.5 now and last winter we hardly had a
problem at all. This summer it came back, but was pretty mild and
easily controlled.

Best wishes, and good luck!

Laura


This first section is taken from a handout we got from our
pediatrician, which I thought was quite helpful.

Definition: Eczema is a recurring skin condition characterized by rash,
dryness, and itching.

Cause:  There is no single known cause, however, allergies are
sometimes implicated.

Cure:   There is no cure for the condition, however it may clear
spontaneously.

Treatment: The key to preventing a severe rash is early treatment of
skin changes and itching. (Our ped says eczema has been called "the
itch that rashes" and recommends aggressive early treatment before it
gets worse. LD) There are number of things that you can do to decrease
the frequency and/or severity of your child's eczema.

1. Avoid soap, use soap substitutes. -Cetaphil (less expensive)
-Emulave (expensive) -Neutrogena * Never use bubble bath as it has a
disastrous effect on eczema.

2. Decrease baths to 1-2 times per week and pour one capful of oil over
bath water, blot dry. Recommended oils: Keri oil, baby oil, mineral
oil. (Note from LD: This has been discussed in misc.kids, and the
consensus seems to be that any unscented oil would be fine, i.e.
vegetable oil. However, Keri oil in the US, and similar oils in other
countries are specifically made to disperse through the water, and not
leave such a bathtub ring.)

3. Moisturize: Recommendations: Keri lotion, 10% urea cream, Eucerin *
Avoid Vaseline and ointments because they can block sweat glands and
worsen rash.

4. Steroid creams are often used for eczema. Don't use more than .5%
the face. You can try over the counter steroid creams, but if they
don't work quickly, you can get a stronger cream by physician's
prescription. Follow MD's directions on usage.

5. Antihistamines, such as benadryl, can be used to control itching,
which tends to be worse at night.

6. Keep nails clean and short to prevent scratching and infection.

7. Avoid skin irritants such as animal danders (dogs and
cats),feathers, harsh fabrics (denim and corduoy), tight clothing, and
even sometimes wool and silk. Cotton clothing is recommended as much as
possible.

8. Launder clothing with mild soap or detergent (Dreft, Ivory Snow,
certain sans-additive detergents such as Tide Free). Use no additives
such as enzymes, fabric softeners. Wash new clothing prior to wearing.

9. Avoid temperature and humidity extremes, don't over-dress or over
heat. when humidity is low as during the winter in heated homes, a
humidifier may be helpful.

10. Avoid swimming in chlorinated pools. Lake and ocean swimming is
fine. Apply moisturizers afterwards.


And now for the "answers from the trenches"!

--------------------

My own experience has been that Eucerin lotion and cleansing bars
instead of soap do a great job. Also in areas that get really dry I
found by accident one day that vaseline does a great job at curing the
dryness.

--------------------

My daughter had eczema from about 8 months to 2 years. Then, she
outgrew it. My husband has bad eczema on his hands. My baby boy is
developing eczema on his back. I summarized what we do (having seen a
dermatologist's whose own baby had eczema).

It's not something you've changed that is causing the eczema. In my
experience, it just seems to take this long to show up.

1) Switch from Tide to Dreft of Ivory Snow.

2) Moisturize with a rich lotion (we use Eucerin). Cover with a moisture
barrier (we use Aquaphor). Do this twice a day and after baths. After
baths, apply the lotion + ointment combination to dry patches while the
baby is still damp (trap the water).

3) Apply 1% cortisone OINTMENT (not cream!) to
the dry patches as necessary. We found that, by using really good
over-the-counter products (Eucerin and Aquaphor) we only needed
cortisone a few times a week. Cortisone can thin the skin, so use
sparingly. For faces, you may want to use 1/2%. We use 1% there because
we need it very rarely.

4) Switch from soap to Cetaphil. This is a
unique, expensive ($12?) non-soap cleanser. Eventually, we were able to
switch Laura back to unscented Dove (i.e. when the eczema was gone).

5) Don't let them stay in the bath too long. We broke this rule a fair
amount, but tried to compensate by adding Alpha-Keri lotion to the bath
water. Laura loves the bath so much, we let her stay in quite a while
sometimes.

It is possible that the eczema is caused by diet (often milk causes
rashes) but with our family history of eczema, I didn't believe this.
Besides, Laura and Brian are both on soy formula. The good news is that
often babies outgrow the eczema.

--------------------

You might check for allergies. My niece 'developed' eczema about a year
ago -- it turned out that she was sensitive to chlorine. She had to
give up swimming lessons but that cured her allergies. Her pediatrician
is recommending that she waits a few years before trying to take up
swimming again.

--------------------

This exact same thing happened to my son. Without any skin problems his
first year, he suddenly developed eczema at about a year old. It
started on the backs of his knees and the insides of his elbows and the
back of his neck. In addition, his skin seemed dryer all over. Our
pediatrician told us to wash his clothes and his sheets in soap, not
detergent, so we switched to Ivory soap. I had been using liquid
detergent, like All, and Downy fabric softener. I started using the
Ivory soap and eliminated the fabric softener. We also used cortisone
cream to cure the rash. The rash seemed worse when he was hot, so I
tried to keep him cool, and I dressed him in cotton clothes. I bathed
him every other day without soap, and after his bath he'd get lotion
all over. All these measures seemed to help some, but he'd still have
occasional outbreaks that required cortisone. Eventually he grew out of
it--after a year or so. I was surprised that he developed a sensitivity
to the laundry products I'd been using since he was born, but he did!

--------------------

My son, now 3 yrs old, developed eczema at about your son's age. I
think the introduction of dairy products into his diet brought it on.

Anyway, things you want to consider:

1) Infrequent bathing. We were bathing my son every night; we cut it
back to twice a week. If you don't like the thought of bathing that
infrequently, bathe your son with *water only* every other bath (if
your normal schedule is bathing him every other day, e.g.). The idea is
to limit contact with soap (or other cleansing products), which brings
me to...

2) Switch to a non-soap cleansing product for bathing. I believe the
"baby bath" you're using is soap, which dries the skin. We use Eucerin
cleansing bar. Dove, which is soap but has an added moisturizer, is
another alternative.

3) Use a *good* moisturizer daily. We use Eucerin lotion and/or cream.
After bathing, leave your son's skin a little damp, then apply
moisturizer. This will help "lock-in" moisture. Other good moisturizers
include: Keri, Moisturel, and Complex-15.

4) Use hydrocortisone cream--sparingly--at first sign of a flare-up.
Hopefully, these will be infrequent if you follow the steps above.

5) Keep your son's nails clipped (this was always a battle for us!) to
minimize scratching.

6) Also, if your son is willing, consider showering with him instead of
bathing, since bathing usually involves sitting in soapy water for an
extended period.

We were able to keep my son's eczema under control using the above
steps. He still has an occasional flare-up, but hardly ever. Now we
apply moisturizer after bath only; it doesn't seem to have had a
detrimental effect. We may need to start up daily application again,
what with dry weather approaching.

--------------------

My son has suffered with eczema since he was three months old. At that
time the doctor said to stop giving him baths, just to use a wash
cloth. When he started crawing and walking, he found that his natural
element was sand, and we had to start baths again which of course
brought back the eczema. My current doctor recommend Eucerin lotion. I
smear him with it when he gets out of the tub. It does seem to keep the
worst of the rash away. During the winter when the rash is at its
worst, I don't bathe him as often (he can't play in the sand box), and
I don't use soap unless he really needs it. When I shampoo him I do it
last and pull him out of the water so the shampoo doesn't get too much
on his legs.

--------------------

My doctor recommended two things for Adele's eczema:

1. Eucerine cream (there was a second similar brand, but I don't
remember the name)

2. Do NOT use baby magic soap. Just "spot clean" with bar soap. For
everything else, just let her sir (oops - SIT) in clean water with no
soap.

We don't follow rule #2. But then again, we never had a case as severe
as yours sounds. Whenever we see it starting to act up, we whip out the
eucerine and that clears things up pretty fast.

--------------------

My husband has always had trouble with eczema and he gets a
prescription ointment for it - I'm not even sure what's in it, but it
clears up the rash in a couple of days. I don't know that you'd want to
use a prescription ointment on an 11 month old, though. It's probably
better to avoid it if you can.

I am 5 1/2 months pregnant now and I have started getting some dry
patches which I treat with OTC hydrocortisone - it works, body/hand
lotion DOESN'T.

Also, taking oatmeal baths can help. Aveeno sells an oatmeal bath
powder you can just add to a tub of water as you're drawing it. I
wouldn't use regular oatmeal in the bath - I've tried it and it forms
ungodly clumps! :-) Maybe that will help your little one when he gets
itchy.

--------------------

Our 5 year old daughter has mild problems with eczema. She has red
spots around her mouth now. They aren't oozing, but don't want to go
away. We've been putting hydrocortisone cream on them.

She also still gets cradle cap at at times, which I also understand is
related to this.

She has also had foot eczema. For that, we need to have her wear shoes
no more than is necessary. The shoes need to be leather or
breathable--no plastic stuff. Sandles are good. She also can't wear the
normal footed blanket sleepers--the plastic in the feet bother her. For
the sleepers, I was replacing the feet with fleece feet at first, with
puff paint on the bottoms for skid resistance. They wore out faster,
then we just cut the feet off. At this time, we have been finding a
brand of sleepers, called Riegel, which have breathable feet to be
acceptable for her. If they start causing problems, I think I'll just
cut the feet off and have her wear socks if the feet get too cold.

--------------------

I've had eczema since I was very young. Today it flairs up with work
pressures, by exposure to chemicals (cleaning supplies) and/or the dry
air. My now 18 month old son had some patches of eczema at about 9
months, it reoccurred once, but has been good since (though our driest
season is almost upon us).

Dryness is a big cause of those of us that have the tendency towards
eczema (did you doctor mention eczema is in the allergy family and many
with eczema will often have other allergies - food or respiratory?). I
recommend, from experience, do not bathe too often or too long - water
dries the skin. Use a mild soap. Cetaphil is popular now (fairly new),
but very expensive. Another very mild soap is Lowilla and much cheaper
than Cetaphil.

Moisturize a lot, in between flairs to help prevent them. I use a mild
cortisone (over the counter) ointment on the affected spot during a
flair up. I'm not excited about using cortisone on my baby often as it
is said it "thins" the skin. On myself, I need a prescription strength
cortisone ointment and have sometimes had to take cortisone pills when
it's at it's worse. But, the most important thing is to help prevent
flair ups by moisturizing. I like Eucerine lotion (or longer lasting
the cream). It's available at most drug stores.

Last, before this gets too long. Even though you've used them in the
past, I try to stay away from scented detergents on your child's
clothes. Also stay away from those scented dryer sheets.

--------------------

My son (2 yrs) has had eczema since about 10 months. It seemed to start
when the variety of foods he ate increased. At that time, his eczema
got worse with certain types of food (such as chicken, orange or orange
juice, corn). He was especially vulnerable to processed foods in baby
foods jars that contained any type of wheat product. I tried giving
more basic foods like rice cereal and very soft rice cooked with pork
and it helped. You should also use a fragrance-free moisturizer
(Eucerin) where eczema seems to occur most. I limit baths to once every
5 days or less. I use a lotion called "Cetaphil" instead of soap and
put lots of Eucerin all over his legs and arms immediately after the
bath. Make sure the water is not too hot and limit the length of the
bath to avoid excessively drying out the skin. I washed his laundry
with Ivory Snow. Now I am trying Dreft to the pediatrician's
suggestion.

Wherever there are patches of eczema, I apply a medicated cream
(hydrocortisone 1% for his face) and something called TAC (.25%) for
the rest of his body. When he is really trying to scratch, I give him
ATARAX, a liquid that he drinks to relieve the itching. This works
quite well most of the time. It is best to limit extensive use of the
hydrocortisone because it can have long term effects on the skin.

The irony is that with all that I do for the eczema, it still does not
go away completely. I can only reduce it a little and my son gets very
temperamental when it is bad and he needs to scratch it. Scratching
will only make it worse until the broken skins heals. I just try to
keep his mind off it by keeping him busy with other things.

On the bright side, my sister's two kids both had eczema, and they
started growing out of it at about 3.5 years. There are different
levels are severity in eczema. I think my son has it more on the severe
side. If your cortisone does not seem to work as well as it did, you
need to see your pediatrician or a dermatologist for something
stronger.

--------------------

My baby (5.5 MO) has eczema only on her cheeks, but it goes away when I
am diligent with moisturizer. I use Lubriderm. I have sensative skin
too, and know that anything with fragrances in it is likely to cause
problems, so make sure that the lotion that you use is fragrance free.
(My doctor recommends Lubriderm and Eucerin.)

You might consider trying another detergent. We use Arm and Hammer with
no ill effect. But my daycare provider put something on Karen last week
that she had washed because Karen had pooped on her two outfits. By the
evening she had little red bumps all over her chest! I will find out
what kind of detergent my daycare provider uses.

--------------------

Nanette, we went through eczema with my son Joshua from birth to about
a year old, then it went away. He had it all over his scalp and
eyebrows like really bad cradle cap. He also had it on his face. We
used the hydrocortisone cream, prescription strength. I hated using it
because there are side effects listed on the information sheet, but it
worked. When we slacked off the problem got worse. So, we just kept
using it and finally the eczema went away.

The ONLY think that worked for me was the hydrocortisone cream. We also
used dandruff shampoo.

--------------------

>From [e-mail] Tue Dec 7 07:02:30 1993

Alot of the articles recommended Eucerin lotion. We used it and thought
it was a waste of money. Our daughter had a fairly bad case at 3-4
months. Eucerin didn't help *at all*. We used something called
"Vanicream" (name sounds suspicious) which is sold through the Mayo
Clinic pharmacies in Rochester,MN and Jaxsonville, FL. It was
recommended to my mother for eczema after visiting the JAX Mayo Clinic.
It's used as a pharmaceutical base and is a petroleum based
moisturizer. Rita's eczema was in control within a week and we continue
to use twice daily (she's 3 now- her eczema is still in control but we
are now fighting allergies).

You can order this from the Mayo clinics via 1-800-445-6326 and is
roughly $10/lb. (You can ask for the Jaxsonville clinic if that is
closer to you - shipping will be less) though the shipping is fairly
reasonable. During a recent visit to Florida, I also saw this sold at
Target stores. We have no connection with the manufacturer- we had
absolutely no luck with Eucerin but are really sold on this stuff.

Maureen Chew

--------------------

I've had excezma my whole life - It has gotten better as an adult but
it still appears pretty consistently. (my poor daughter has inherited
my excezma too) Here are some suggestions:

1. Use dove soap. This is the only soap that did not dry my skin out.

2. If your son does chores like washing dishes (or anything where his
hands are submerged in water) have him wear latex gloves.

3. My doctor reccomended taking luke-warm salt baths (I don't remember
what kind of salt but the purpose is too rehydrate the skin) and only a
couple times a week. Avoid showers and very hot water.

4. Just after bathing, and before completely dry, spread moisturizing
lotion all over the body. This helps trap the moisture in the skin.
Have your son use lip balm too.

5. Clothing closest to the body - like underwear and undershirts, socks
- should be 100% cotton. Synthetics don't breathe.

6. When I was a little girl, my excezma was horrible on my arm. It
itched so bad that I would scratch, thus creating huge oozing scabs. My
mom cut the foot off of a cotton sock and then put the sock over my
excezma'd arm. This felt great! Perhaps the mild pressure from the sock
as well as the cotton helped reduce the itching. I was able to forget
about it for a while.

7. You can now purchase 1% cortisone cream over the counter. Use it
three times a day - religiously. (I'd check first with your doctor to
make sure the cotisone is OK for your son)

8. The humidifier is a good idea.

9. If you have hard water, invest in a water softner. This helped
enormously with me.

My skin gets better in the summer when it is not so dry out. Most of my
suggestions has become second nature to me so living with excezma isn't
so bad.

--------------------

My younger son was born with very, very dry skin. We used Hydrated
Petroleum upon doctor's recommendation, bathed him infrequently (same
as you), and used a different washing machine detergent (I forget the
name offhand).

--------------------

Melissa got it off and on until she was about a year old. Sarah has it
now too. We don't bathe them too often, or use stringent soaps, use
plenty of gentle lotion, the humidifier, etc., much like you.

The 1/2% hydrocortisone (with aloe) didn't help much. We resort
toTriamcinolone cream prescribed by the pediatrician. 3x daily and
Sarah is clear now except for one small spot on her back that doesn't
seem to want to go away. Unless you're really against the cream, I
recommend it. (and I'm curious why someone would be against it - tell
me if I'm missing something)

BTW, both girls have asthma and some allergies. Our allergist (and
pediatric asthma specialist) told me yesterday that the three are
associated - asthma, allergies, and exzema/dermatitis. Interesting.

TAMARA mommy to Melissa (5/1/91) and Sarah (5/3/93)

--------------------

I had eczma from infancy until age 18. It wasn't always at the save
severity. I can remember being very young (3 or 4) with my arms being
so "weepy" that my shirt sleeves would stick to my arms. My face would
be red and crusty. When I was older (8-17) I almost always wanted to
wear long sleeves, even in the summer, to conceal either the rash or
the scars (not permanent scars but eczma would remove pigment so that
years "tan" would would be "splotchy" - this was important when I was a
teen). The last "worse" case that I remember was the summer that I was
pregnant with Gregg, my arms, back of my legs, and face were "broken
out". I cried over this because I thought I would never "out grow" it
if I had it this bad when my body was pregnant (I equated pregnant with
mature). BUT I never had another "bad" episode. And have not had any at
all for over 19 years. So you do "out grow" it, but for some people it
takes awhile.

BTW - Neither of my children have had it. I hope number three doesn't
either.

Jeanetha - Mom to Gregg(20), Laura Jean(4) and ???(-30wks)

--------------------


End

Anita Graham
[e-mail]