Eczema is one of those things I never gave a second thought to in my pre-kid life. I knew it was some ooky skin thing, but otherwise had no idea. Until BabyT showed up.
Starting at a couple of weeks old, she had this weird patch of skin behind her ear that was raw and oozy and never seemed to heal. We consulted the pediatrician many times and tried all sorts of ointments and lotions - antibiotic, OTC eczema creams, hydrocortisone, anti-fungal, stronger steroids. The strong steroids worked, sort of, but as soon as we stopped using them, the patch came back.
As she got older she got a couple more of these spots - on her neck, under her arms, behind her legs, and worst, on her wrist - sometimes red and inflamed, other times just dry and itchy. Nothing really worked, including a vist to a fancy local dermatologist who didn't seem all that comfortable with babies. He just sent us on our way with another strong steroid, which helped temporarily.
We lived with this for about a year, and by that time we had to tape up BabyT's wrist with gauze and athletic tape so that she couldn't scratch it and make it worse. Luckily her other spots were covered with clothing so she couldn't get to them.
The mystery of *why* this was happening was solved when we figured out that it was related to her dairy allergy, but the spots still wouldn't heal completely, even once I stopped nursing and we removed all traces of dairy from her diet.
Several people at work recommended Dr. Julie Francis, a pediatric dermatologist in Bellevue, WA. They raved about her. I made an appointment, despite the 3 month (!) wait.
And wow, was it totally worth it. At that first appointment she laid out our "plan of attack":
1. Bathe her every day.
Use Cetaphil Restoraderm Body Wash and California Baby Super Sensitive Shampoo and lukewarm water. This floored me. We were bathing her just a few times a week, figuring that getting wet was making her skin worse. But it's better to keep everything clean and the Restoraderm actually helps the skin heal. No bubble baths (sad) or bath oils.
Amazon seems to have the best price on the Restoraderm, though I can find it at Target for a few dollars more. Target has the big bottle of California Baby, and after a year, we're only about halfway through it.
2. Grease up 2x/day.
Morning and night, use Cetaphil Restoraderm Skin Restoring Moisturizer everywhere, including her face. She also gave us a prescription ceramide cream called Neosalus to use on the spots more prone to eczema patches (behind knees, elbows, wrists). She recommended plain Vaseline over Aquaphor for the dry patches - she said Aquaphor can be irritating to sensitive skin. (Another surprising thing since all the eco-advice is to avoid Evil Vaseline.) She stressed not using *anything* else on T's skin.
3. Use special laundry detergent.
Dr. Francis recommends All Free & Clear or Seventh Generation. She thought even Tide Free, which we had been using, was too harsh. Do a double rinse on clothes to make sure all the detergent is out. No fabric softener or dryer sheets, but if you must, use the Seventh Generation dryer sheets.
TJ has extremely sensitive skin as well, and the All Free & Clear works for him, too.
4. Keep her covered up.
This is pretty easy in Seattle, where we rarely have days hot enough for a tank top and shorts. Dr. Francis recommended loose cotton clothing (no synthetics and no wool touching the skin!). BabyT nearly always wears long sleeves and leggings or long pants, just because of the weather. This keeps her opportunities to scratch very limited and also keeps the sensitive areas covered up from dirt and environmental allergens.
5. Limit pet exposure.
This was a hard one for us, since our dogs are part of the family and are nearly always indoors, wherever we are. Dr. Francis suggested keeping the dogs out of T's bedroom and vacuuming it and changing her sheets regularly to keep the pet dander out. This minimal effort seems to be working for us.
Armed with this plan, and a course of oral antibiotics to clear up an infection on one of her spots, we got to work. It was a hassle to bathe her so frequently and grease her up twice a day. But within a couple of weeks, we already saw VAST improvement. Her spots healed up. Within a month we didn't have to bandage her wrist anymore. It was amazing how well these simple steps worked when literally nothing else I tried did.
We still bathe her every day but we've been able to scale back a bit on the lotion. We definitely put it on after baths, but not twice a day anymore, unless I notice her skin looks a little dry. If we miss a day of bathing, but put on a little lotion, we're usually ok, but missing two days in a row and no lotion leads to tiny dry patches reappearing, usually near her hands. So we do need to stay on top of this.
But we almost never need the steroid cream to reduce the inflammation - I think we've used it maybe 3 times since we started this plan, and not anywhere close to the full week each time. We haven't needed any more oral antibiotics.
I'm hopeful that she'll grow out of this sensitivity like she seems to be outgrowing her dairy allergy. But 3 months after our first appointment with Dr. Francis, she told us we didn't need to come back unless things got worse. Yippee!!
I've written this up in email for coworkers so many times I figured I should post it here and just point people to it. I hope it helps others, especially if you have a long wait to see a dermatologist. These steps are so simple that you can start right away.