What is causing eczema flare-ups in my 5-month-old baby?

Question

Hi doctor,

My 5-month-old baby has pretty bad eczema. Just recently, he had a bad flare-up in both legs, arms, hands, and cheeks, and he was weeping. For 80 % of the day, he is suffering from a rash and seems to have no relief at all. He scratches and cries continuously throughout the day and wakes up in his sleep. I have altered my diet to accommodate him accordingly. 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?
Is weeping a sign of infection?

Please help.

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

I understand your concern.

This is atopic dermatitis. It has many causes. The most common is due to allergies to various dietary proteins or external stimuli. We need to elicit the history properly and need to do investigations to delineate the cause. First, we will do a basic investigation, then we will proceed according to the reports. My suggestions are as follows:

Avoid cow milk or related formula milk, egg, and ground nuts. This restriction is applied to mothers also.
Take care of the baby's skin with a 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 one teaspoon once a day.
Give Atarax syrup (Hydroxyzine hydrochloride) one teaspoon (5 mg) two times a day.

We may need systemic steroids 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 (immunoglobulin E) level.

There are many modalities for the treatment of eczema. We need to step up the approach because systemic steroids can lead to a rapid response, but have more side effects. Please follow the suggestions and report back with the investigation reports, or provide a report if you have already done so.

I hope this helps.

Please feel free to reach out in case of further queries.

Thank you.