Eczema treatment

Standard issue breakfast.

Feeling much better today.

Husband looks like he has bounced back too.

Only Isaac emo emo n clingy. But nothing worrisome.

How we manage Isaacs eczema

Well you all know Isaac has super eczema since 3 weeks old of life. Picture here is super filtered to make him look like he has rosy cheeks but it's in fact bleeding broken dry red scaly skin

Went to his first pead who only said "Wah skin very bad"

Forced him to refer us to a skin specialist at national skin center.

From then on we manage his skin good but he still had ongoing flares and baseline redness n dryness.

Then at 7 monthwe truly found out the hardway why he had all these eczema!

As his parents, who are both healthcare professionals (dad dr, mom pharmacist) we couldn't even tell that it was food allergy related.

In our defense, dad is not a dermatologist and we previously worked in a "village" where they just don't get eczema, allergic rhinitis, as often as sterile clean city folks. All we see were poor frail old ppl and pregnant ppl. My he occasional sick kid with cough and cold.

Sharing with you all what we've learned so far. Partly inspired by @delight Nates urea

Outdated treatment (😝😝) and @calistallicious eczema troll post!

Will slowly dayre throughout the day ah on this.

Glad he's back to his own self. Playing on the floor leaving toys everywhere.

#stalkermomseries

Treatment during flares

For soft baby skin like @delight Nate, it is recommended a very very thin coat of corticosteroids like hydrocortisone for persistent eczema.

The logic is, ur skin is like a ship, if it has holes in it, like in the case where eczema causes the skin barrier to be compromised, then u need to plug the ship/repair the barrier so that the ship doesn't sink!

If u worry steroids will have side effect, aiyah this one very mild and only use for 5 days! @serhonp has been using steroid for 30 yrs

He doesn't have side effect associated with the use of prolong corticosteroid.

He doesn't use much now since we changed our diet and I'm giving him less stress. Haha.

I used to wallop Isaac skin with the strongest steroid cream around which was his dad. It got better. Then I got paranoid that "oh I shouldn't be using such strong steroids on him" so I will stop and his eczema will come back again.

Ah if only I followed my own advice when I dispense to patient of tapering down the dose from

OMG I WON FIRST PRIZE!!!!

Our company had an internal weight loss competition amongst our staff. We sell a weight loss product so relaunch internally first.

It was a 1 month long duration and I am the biggest loser!! I lost 4% of my body weight.

Omg!!!

Ok now back to food post

#leftoverlunch

Steam cod fish topped with fried onions, fried garlic and spring onions. No soy sauce.

Side of simple salad

Opps interrupted post.

Steroid doses need to be tapered down and not to be stopped immediately. For instance if u r on twice daily dose, go with once a day for 3 days then once a day every other day for another 3 days and u can stop after

Elomet quite strong already @jennylau ! Can up to Dermovate but not for Arissa la.

Isaac had to use those with antibiotics + steroid because his was infected eczema!!

Eczema maintenance

The next phase after we've controlled the flare is to maintain the skins barrier level.

What I do for Isaac is bath in emollient based?? kind of shower gel. We use Physiogel shower gel. It's lipid base gel and we've been using since his few months of life until now.

For the dad when it was extremely dry the skin, he uses oilatum and qv shower gel.

After shower (never in super hot water cos it drys the skin) apply effing loads of moisturizer. We use Physiogel Cream (not lotion) for Isaac

And QV cream for daddy.

Amount use for Isaac
1 tube of 75mg Physiogel Cream a WEEK.

1 tube of 150gm Physiogel Cream lasts 2 weeks.

I think u guys get the idea right? To save cost, we use qv cream on Isaacs body/trunks (where it's not so dry) and everywhere else is Physiogel.

Daddy's usage not consistent. Got flare, use more. No more flare just simply plak plak apply.

But once it flares again, please repeat the steps above. It will save mummy and babies a lot of heart ache.

Recap: apply prescribed steroid creams 3 days full dose > 3 days once a day dose > 3 doses of every other day then stop. You may apply other special barrier creams. Ezra may help perhaps (but it did nothing for Isaac)

Note: Avoid all yellow soft paraffin/white soft paraffin/petroleum jelly based creams & emollients as it will clogged the skin and hamper healing!!
Check all the labels

For any petroleum based products. Check them aside or ownself use but not for eczema skin.

Avoidance of eczema triggers

This may be a bit tricky.

If u suspect food allergy that is causing this, please work with an experience allergist & immunologist.
He/she can also rule out environmental allergy like dust mites, pet dander, pollen, cockroaches etc.

Genetic lottery also plays a part in your treatment. Usually it's strong family history where both or one parent has eczema or allergic rhinitis or food/environmental allergy. Strong family history of asthma is also an indicator.

Therefore knowing your family

History also helps. Get those symptoms under control and the eczema will also be under control.

For Isaac, once we sorted out his food allergy and mommy avoided the allergy food (goes trough my breast milk) his skin totally cleared up! We don't use steroids anymore.

Just moisturise, moisturise and moisturise!

Ok that ends my rambling public service announcement on our eczema treatment.

Later I let you know the steroid creams from the strongest to the weakest and the common brand names and how to look for them by active ingredient name and not brand name.

Also I will post a treatment algorithm for eczema. Hehe. Share with you what the national skin center specialist shared with us.

But I don't think you can buy strong steroids over the counter so u may need to see a doctor for this. A pharmacist can help you only so much πŸ˜•πŸ˜•

Let the dr check out whether it's infected etc

@delight @shalinho @jennylau @calistallicious

This might be useful for you guys. We certainly still do follow it and it works.

Also it's a summary of my long ass post la. Hehe.

Let me know if any clarification is needed.

The pic above not so clear la. Maybe this one clearer.

@calistallicious must continue to use ur elomet la. For smooth n clear skin use for up to 4 weeks each time then review every 3 months.

Dinner today, baked spicy sesame onion chicken, cucumber noodle salad and steamed broccoli.

#portioncontrol

#stillrecovering so eating less.

Took Isaac for an evening walk after I got home today.

Went to say hello to Mei Mei and jie jie.

They sat on the curb and ask me to take a picture of them!!!

These kids are so cute la!! And Isaac just loves hanging out with them. He really loves the attention n the short burst of play time he gets with them.

So happy!!!

Topical Corticosteroid Preparation Potencies

MILD
– active ingredient: Hydrocortisone 0.1-2.5%
– brand name: dioderm, efcortelan, mildison

MODERATE
-AI: betamethasone valerate 0.025%, clobetasone butyrate 0.05%
-BN: Betnovate, Eumovate

POTENT
-AI: betamethasone valerate 0.1%(note the % strength), fluticasone 0.05%, mometasone 0.1%
-BN: Betnovate, Cutivate, Elomet

VERY POTENT
-AI: Clobetasol 0.05%,
-BN: Dermovate

All should be applied very thinly, against hair growth & not more than twice daily; once daily is sufficient.

Notes for Children

Kids r susceptible to side effects, but concerns on the safety should not result in kids being UNDER TREATED.

Aim is to control condition so we use a mild steroid. Can use moderate & potent steroid to treat severe atopic eczema and for the limbs
.
But
.
For 1-2 weeks ONLY, switching to less potent as condition improves!

If very "chialat" flare then use the most potent but short periods of 3-5 days.

Eg adults: use Dermovate twice on day 1, then once a day for Day 2-3, then go down to Elomet

For 1-2 weeks starting with twice a day for Week 1 then once a day for Week 2.

Must constantly review steroid application.

Also good to have different potency of steroid in the house.

Aiyah I type out so much no use.

Next time u all got flare ask me!!!

Let me work my brain juice again.

I need to feel useful. Hehe

@cikumuffin next time u want second opinion on the meds u or ur kids r taking I really don't mind going through it with you.

Seriously let me use my brains abit. Then I won't feel like a drone.

Ok over and out!!! 😴😴😴😴

End this eczema post with a picture of Isaac completely free of eczema on his face for the first time in his life.

This is after the first hospitalization for anaphylaxis reaction to egg. They treated him with adrenalin and anti histamines. The anti histamines worked wonders and totally cleared all his cheek flares!!!

Picture taken at 7 months old.

Hubby time now. 😘😘😘

Ok another one better angle.

I'm so amazed at the smoothness that many other parents take for granted.

My baby finally has baby smooth skin.

Ok ok. Good night!

Ps: dedicate this post to Nate! @delight

Hope he gets better soon!!!

Xoxo
Love, aunty Jo & Isaac korkor.

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