Sunday, March 11, 2012

Our "magic" baby and toddler eczema solution

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.


  1. What great advice! I always figured fewer baths was better, too. Our eczema hasn't been too bad - if I'm paying attention I can usually knock it down with my favorite lotion (Neutrogena Norwegian Formula Body Lotion, fragrance free). I'll have to give some of the other tips a try!

  2. @Stephanie - yay to finding something that works! I tried about a million lotions, though not that one and none of them really helped like the Cetaphil. Crazy!

    Yeah, I was surprised at how much of the plan was NOT about prescriptions. I think the detergent swap helped a lot too.

  3. DS had the behind the ear stuff, we were also recommended Cetaphil and it worked.

    I can't handle any perfumed laundry detergent so we already use 7th generation (usually) or Free and Clear (when we can't get 7th generation).

  4. @n&m - I was totally going to buy the 7th Gen stuff but figured I'd try the cheaper option first :) TJ is super sensitive and I swear I had tried something 7th Gen before and he got all itchy (but maybe it was their non-chlorine bleach and not the detergent).

    I have skin of steel, so dealing with such sensitive peeps has been quite a lesson for me :)

  5. I just took Ben in to see Dr Francis; he has a weird looking mole that she's going to remove next month. I was able to get an appointment with one day's notice; her receptionist told me to go buy a lottery ticket. :)

  6. A lot of what you write here has been ingrained in me since I was quite young, as I, apparently like T, am one of the unlucky ones. The laundry detergent thing makes a huge difference, and was drilled into me from birth. I blatantly ignore the pet thing... my parents never let us have pets when I was young partly because of eczema, so as soon as I got to college, I got a cat. To make up for that, the cats are never allowed under our covers (we actually ban them from the bedroom now), and clothes get washed after one wear (except jeans, which I keep away from my other clean clothes)

    My mom taught me to use fragrance free Dove, but I found Cetaphil was better about a decade ago. I've also done extensive experimentation with lotions, and settled on Aveeno fragrance free. Also about a decade ago, protopic/elidel came out; instead of steroid, this medication specifically targets immune cells that are dysfunctional in the skin. With those 3 things in my arsenal, my skin is now the happiest it's ever been in decades.

    In my case, daily bathing makes my eczema worse (there is little bacterial component in the vast majority of my eczema, and drying my skin out via bathing causes more inflammation, which is the trigger for eczema).

    So I was forearmed with all this knowledge when J came along, and as a precaution, I have never used anything but Cetaphil and Aveeno on him (and fragrance free baby shampoo on his hair). He gets the same skin treatment I do (lather up with Aveeno after his every-other-day bath). It seems like he has inherited some of my family's wackiness, what with both the peanut allergy AND eczema, and it seems that already having him on this routine has managed the eczema really well. We rarely have to treat patches.

    When something does pop up, though, I deviate from the treatment I give myself, mainly because protopic is not recommended for kids as young as him. Instead, we use some of the lowest percentage prescription steroid cream we have (prescribed for me to use on my face when I was pregnant; your face is where steroid cream can do the most damage, so if this was safe for my face, I trust it on J) for a day or two till the inflammation dies down and he no longer scratches it, at which point the patch goes away.

  7. @Allison - you should absolutely get a lottery ticket :) I've never heard of such a thing. I tried to change our followup appointment due to some other commitment and the receptionist basically told me I'd have to wait another 3 months if I wanted a slot other than the one we had ;)

    @Wedge - that is so great that you had experience with it and knew what to do!

  8. Aquaphor is our anti-ezcema greaser-upper of choice. It's also great for preventing chapped lips.

    There was a study out about how putting a small amount of bleach in the bathwater can help keep eczema at bay:

  9. Wow, this was an amazingly helpful post. I wish I'd read it back when our kids were babies, but our middle child still gets patches so I'm ready to sign up for the program. Thanks!

  10. How did you find out about the dairy allergy? Did you have your child tested by an allergist?

    1. Hi Nancy -

      We discovered it for sure when we tried to feed her yogurt:

      The ER doc said allergy tests weren't too reliable until 1 year, so we waited until then to see an allergist, who confirmed it with a skin test. If you search on the tag 'allergies' here you can see all my posts.

      By age 2.5, our daughter passed her last allergy test to dairy so she's technically not allergic anymore, though she still has stomach issues and skin issues when she gets a lot of dairy. But we don't have to be as careful anymore about ingredient lists.

  11. Thank you so much for posting this. I'm so glad you were able to go steroid free. A a long term steroid user since childhood, I can vouch for the fact that steroids are bad medicine. I blog about how hard it has been for me to withdraw from addiction to these potent creams.

    I am so glad you found a steroid free remedy for your beautiful baby. Docs are too quick to prescribe hydrocortisone as a cure-all. It is good to see that with a little perseverance, it is quite possible to clear the skin without resorting to potent prescriptions.

    I wish you all the best. You are giving your child the best start in life. X

    1. We did get the ok from the doctor to use OTC 0.5% or 1% hydrocortisone and they were useless so we stopped. I didn't want to go any stronger than that without finding a good solution to the underlying issue.

  12. What did you use for your alternative to milk?

  13. I'm curious what your alternative to milk was? We started out after we got off formula getting these little patches in her arm folds and one wrist. Then recently we got these tiny bumps on her lower back. Looked nothing like her eczema.. It wasn't inflamed.. Didn't itch.. They looked like a bunch of goose bumps so I tried this lotion some mom recommended when I googled. Well it helped and then the last time I used it she screamed like it burned and now it's bumpier and red so now I'm thinking was it eczema this whole time. I'm going to try this regimen which I read a review where the lotion burned pretty bad so I'm hoping that's not the case. My next step is to try removing milk if this doesn't help but it throws me bc we used regular formula all through her infancy. So I also decided to add a probiotic since that was in her formula thinking removing that has played a part. I'm just hoping I find a solution before this starts to become uncomfortable for her. Thanks so much for posting this. I pray this is our solution.

    1. My girls have not complained about the lotion, though I'd be careful about applying it to open wounds, if they've scratched a lot. No complaints here on the dry patches, but I don't put it on the oozy ones.

      Our alternative to milk has always been soy milk, because of the high protein. I wish it were higher in fat, so we do try to make up for that, especially during age 1-2, with things like nut butters, avocado, etc.


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