Hi doctor,
My 5 months old baby has pretty bad eczema. Just recently, he had a bad flare-up in which he was weeping from both legs, arms, hands and cheeks. For 80% of the day he is suffering with rash and seems to have no relief at all. He scratches and cries continuously throughout the day and wakes up in his sleep. None of the remedies we tried have produced relief such as wet wraps, bleach baths, ointments, eczema creams, cortisone, etc. Is there a product that is good and available OTC? Would he need something prescription based? Could it possibly be something in the environment that is causing the flare-up like dust? His mother has altered her diet to accommodate him accordingly. Is weeping a sign of infection?
Hi,
Welcome to icliniq.com.
This is atopic dermatitis. It has many causes. Most common is due to allergy to various dietary protein or external stimuli.
We need to elicit the history properly and need to do investigations to delineate the cause. First we will do basic investigation then we will proceed according to the reports.
My advice is as follows:
- Avoid cow milk or related formula milk, egg and ground nuts. This restriction is applied to mother also.
- Take care of skin by gentle lukewarm water wash.
- Apply coconut oil twice a day.
- Apply Cortisone as you are already using it.
- Give syrup Zn (zinc) 100 mg once a day.
- Give multivitamin syrup 5 mL once a day.
- Give Atarax syrup - Hydroxyzine hydrochloride 5 mL (5 mL = 5 mg) two times a day.
We may need systemic steroid to control this intractable eczema. But, first we need to do basic investigations.
Please get the following investigations. Complete blood count, liver function test (AST (aspartate transaminase), ALT (alanine transaminase), bile and protein), ESR (erythrocyte sedimentation rate), platelet size and IgE level (immunoglobulin E).
- There are many modalities for the treatment of eczema. We need to step up the approach because systemic steroid can lead to rapid response, but more the side effects.
- Please follow the things that I have advised and report back with the investigation reports or provide report if you have done already.
Revert back with the investigation reports to a pediatric allergy asthma specialist online --> https://www.icliniq.com/ask-a-doctor-online/pediatric-allergy-asthma-specialist
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