Hey Jordan (and all other skin care goddesses out there)

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Hey Jordan (and all other skin care goddesses out there)

I just wanted to compare notes with your ped derm and mine. Smile She has the bedside manner of a porcupine, but she's supposed to be the best - and she has several little peons that follow her around wherever she goes, hanging on every word... it didn't help that it was about a thousand degrees in the tiny exam room and Micah had a random coughing fit, but I think she knows what she's talking about and his skin is already looking pretty incredible after less than 24 hours on this new regimen.

First, how often do you bathe Fiona? What soap do you use? Dr. B said to bathe once a day without soap, except in necessary areas. She said that the CA Baby Super Sensitive that I got was fine, but also recommended unscented Dove and Cetaphil is her favorite. But I'm wondering if I NEED to bathe him every day or if I can wait every few days. I'll call her ofc to find out, but wondered what you do.

Here's the regimen: three times a day he gets hydrocortisone 2.5% ointment to eczema spots on his body and 1% on his face. As the eczema spots improve, taper the 2.5% to 1% and then to vaseline. Vaseline at every diaper change. Sounds so easy, but it's really time-consuming!! But like I said, he's significantly improved in less than 24 hours already, so it's worth it.

He also has had a persistent diaper rash for well over a month - here's the weird part: she wants me to mix Miconazole (Micatin) with the 1% hydrocortisone at every diaper change. But Micatin is for vaginal yeast infections! I guess she wanted to try it because I've been using Nystatin 4-5 times a day and it hasn't touched it (along with Triple Paste, A&E, airing out, etc., etc.).

Her other big thing is that she is really opposed to creams and strongly prefers ointments. She said that the steroid cream his pedi prescribed was too strong and that what happened was that when he went off of it, it would actually create a rebound effect and his skin would be even worse than it was before, which is totally what we experienced!

Finally, did your doctor talk at all about what causes these skin conditions? I much prefer to try to deal with the source of the problem as opposed to just treating symptoms, but this doc just said that you could drive yourself crazy trying to figure out the causes and to not bother. :confused:

Thanks!!

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oooh, lots to say but the kids are being real gems tonight. I'll come back once they're in bed, around 7pm.

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Last seen: 1 year 7 months ago
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I'll tell you what we did for her first month or two while she was healing, first.

Bathing- we did bathe once a day. A tepid bath with Oilatum instead of any kind of wash, or soap. http://well.ca/products/oilatum-dermatological-shower_3696.html It cleans the skin just fine and locks in moisture. It's inexpensive and easy to find at pharmacies. After bath, we'd treat her skin with her meds.

Medications- Treat 3x daily. For face and diaper area we were given 1% Cortoderm (steroid ointment) and for body a .05% Betaderm (a stronger steroid). She also was prescribed before bed Dermasmooth scalp steroid oil. As her lesions lessened we were to replace the ointment with vaseline. Eventually, we were covering her in vaseline entirely. It IS time consuming!! Very!! And it's NOT easy trying to lube up a wiggly baby with all sorts of creams and oils and ointments 3 flipping times a day! BUT- we noticed a significant difference in her skin within 24 hours and within 3-4 days she was looking amazing!!! By the end of the second week we were doing barely any treatments and mostly prevention with her daily bath with oilatum and vaseline. I did eventually start doing vaseline only twice daily. After bath and before bed. We do bath in the morning.

My Ped/Derm also prefers ointments. Less is used when applied and it absorbs easier than the thicker lotiony creams. That could be why he was rebounding, if he absorbed just too much of the meds due to it being a cream? I'm not sure though. One thing my ped/derm did say though was how we are now using our meds for Fiona, just touch ups, spot treatments here and there, we can continue to do so her whole life as long as the prevention is kept up well. He said there aren't much worries at this age, especially for steroid meds to do much damage to the skin since the skin turns over so very rapidly. The most important thing is keeping up with prevention once the initial clear has happened. I'm a stickler now. Though we are now down to every other day bath, with Oilatum, and vaseline. When her hair needs washing I use sensitive head and shoulders. She's reacted just fine to it.

About causes and how to avoid them...I know eczema is a bit different than psoriasis. Eczema can be triggered by dairy, climate, other hereditary health issues, like asthma. Psoriasis is different in that there aren't any known food triggers. So, I haven't worried about trying to avoid those. My ped/derm does have the same treatment plan for both his eczema/pso patients so I'm not sure what the protocol is on diet. My quick sheet doesn't mention it. One thing we do avoid is scented laundry wash and drier sheets, though I know you do your own, right?

My personal advice is be as gung ho as possible right now while getting rid of it. Once it's clear and you're just on vaseline entirely you'll find less of a chance of rebounding. If you skimp on the meds now, you'll only prolong the treatment.

When's your follow up with Dr. Porcupine? Sucks that she's such a drag!! I'm sorry...any person who is a doctor for little children and babies should be as awesome and friendly as possible. I hope his skin continues to clear fast! It's great that he's responding so well, this soon after starting! I'm sure he'll be back to his old self in no time. It'll make such a difference.

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"JorgieGirl" wrote:

As her lesions lessened we were to replace the ointment with vaseline. Eventually, we were covering her in vaseline entirely. It IS time consuming!! Very!! And it's NOT easy trying to lube up a wiggly baby with all sorts of creams and oils and ointments 3 flipping times a day!

good timing - just sat down to nak. Smile

yep, the plan is to get down to just vaseline and then use the cortisone for flair-ups. i love that we can use the cortisone all the time, if necessary. follow-up is in a month...

funny, we were just talking tonight about how difficult this would be if we were trying to put all this stuff on noelle... and how it's going to be possibly in a few more months when the boys get more mobile. maybe micah wil be so used to the drill that he'll hold still. haha

thanks for reminding me about the oilatum. meant to pick that up when you mentioned it before. and yes, she did mention that heredity plays a big role in this - and my DH has eczema and apparently his brother had a bad case of it as a child.

i had one more q but will habe to come back.
nak over... thanks!!! Biggrin

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Last seen: 1 year 7 months ago
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Fiona learned quickly that her daily massage is wonderful!! She really enjoys it now, and I find it's a very nice break to our day. I'm sure you and Micah will find it a nice bonding experience eventually, too.

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Ethan loves his daily massages too! Smile

We haven't seen a dermatologist yet, the last stuff we got from the pedi (derma smooth) has really helped clear him up. As far as triggers, our pedi said that if it's a food allergy/reaction then there will almost always be other signs along with the skin problems. She also tested Ethan for a zinc deficiancy because that can cause eczema on the extremities.

So glad he's already showing improvement!