Eczema Part 3: The Allergist

So last time I posted about Baby S's eczema we were seeing a naturopath, avoiding gluten and doing some homeopathic remedies.  After 6 weeks of brown rice pasta and mealy gluten free bread Baby S's cheeks were still a red mottled mess.  We returned to the naturopath, hoping to get the okay to pick up some bagels on the way home, but instead were instructed to stay off gluten and eliminate about 20 other foods from our diet.  The 6 page list included corn, avocados, lentils, dairy and more.  I decided I just couldn't do it.  So after a 2 week binge where I ate absolutely anything I wanted, we proceeded to meet with an allergist.

The allergist did a scratch test which revealed Baby S is allergic to dairy, eggs, peanuts, dust mites and dogs.  So we are back to eliminating problematic foods.  We also ditched our down pillows, bought allergenic covers for our mattresses, started vacuuming daily and sent our dog for a 3 week vacation at my parent's house.  We're using coconut oil and CeraVe cream on his skin.  After 3 weeks Baby S's face was nearly clear.  It had been so long since his face had been smooth and just wanted to rub my cheeks against his all day long.  No toddlers pointed at him shouting "boo-boo".  No well meaning strangers told me I just needed to buy a tub of Aquaphor.  A week ago Baby S caught the stomach flu and the eczema flared up again, but it is starting to subside and I am hopeful that this new regime will keep it under control.

Eczema Part 2: The Naturopath

So I kept waiting to write a follow up post on Baby S's eczema.  I was hoping that if I tried enough treatments sooner or later I would find some lotion or change to my diet or strange folk remedy and I could come back to the blog and write "Hooray!  Baby S's skin is clear!  Here's the solution!"  Well, that has not happened, although I did try a lot treatments.  I eliminated dairy, soy and caffeine from my diet.  I tried various creams obtained from the corner drugstore, the herbal pharmacy, even the Indian Market.  Everywhere Baby S and I went some well meaning stranger claimed to know a miracle cure-- everything from rubbing Baby S's cheeks with banana peels (which I tried) to peeing on his face (which I did not).

In my previous post I noted that the eczema did not bother Baby S much.  That is no longer the case.  During the day he does okay, but at night he thrashes around and scratches at his cheeks.  He wakes every few hours and I pat or nurse him back to sleep. I cut and file his nails constantly but still wake to bloody sheets.  I pledged I wasn't going to use the steroid cream anymore, but seeing him so uncomfortable led me to start using it again.  The cream did help some, but even after using it for 10 days straight his skin was still red and mottled so that 's when I decided I needed to seek out additional help.  Our pediatrician and dermatologist just weren't cutting it.

Yesterday we went to see a highly recommended naturopath.  I'm generally not into alternative medicine, but since conventional medicine wasn't helping I decided it was worth trying.  The doctor took a detailed history and observed Baby S's behavior.  Because Baby S's eczema is primarily on his cheeks, as opposed to the more classical presentation on the elbows and knees, the doctor believes the root cause is related to diet or digestion.  And it is true that Baby S has had problems with constipation and still spits up frequently.  The naturopath  recommended we eliminate gluten from our diet (for 6 weeks - ugh!), add daily probiotics, multi-vitamins and cod-liver oil for Baby S.  He gave us a prescription for a homeopathic remedy and Tamanu oil to use topically.  I really hope this will help Baby S.

Baby S's Eczema

So Baby S has eczema.  We're lucky in that it doesn't seem to bother him too much and for the most part it is confined to his cheeks.  At the same time, it is bad enough that strangers will ask me "What's wrong with his face?"  and I've been putting off getting his pictures done until it clears up.   The thing about eczema is that pretty much anything could cause it.  Is it the detergent I'm using?  The food I'm eating (Baby S is exclusively breastfed)?  Our dog? Our non-organic cotton sheets?  The weather?  Although most doctors believe only a small number eczema outbreaks are caused by food allergies, most moms I talked to seemed to think certain foods aggravated their kid's eczema.  I tried going off dairy for 2 weeks (my brother did, in fact, have a milk allergy growing up, so it seemed a good place to start).  Baby S's skin didn't really improve, but I questioned myself constantly.   Did his skin look a little less red?   A little more red?  I switched to soy milk and his skin seemed worse, did he have a soy allergy?  He was particularly fussy after I ate grapefruit, maybe citrus is the cause?  I could easily drive myself crazy and end up eating nothing but brown rice and avocados.

After changing our detergent, lotions and soaps, going off dairy and slathering Baby S with calendula ointment for weeks with no improvement we finally saw a dermatologist.  He diagnosed Baby S with eczema and a mild bacterial infection and gave us Mupirocin ointment for the bacterial infection, Fluticasone cream for the the eczema and told us to use Cetaphil or Aquaphor on the rest of his body to help ensure the eczema didn't spread.  Baby S's skin cleared up within a week of using the creams, but as soon as we stopped the eczema came right back.  The dermatologist put us back on the Fluticasone cream and told us to slowly wean Baby S off it, switching from twice a day to once a day to Aquaphor only over 3 weeks.  So that's what we're trying now.

I know about the risks of using steriod creams and I am not thrilled about using them--  skin damage,  reduced ability to fight skin infections, permanent discoloration, etc.  My pediatrician is also not thrilled.  In fact, at Baby S's 6 month check up she urged me to stop the cream immediately and "see what happens".   I hate it when you get conflicting advice from doctors.  Her position is that eczema is a symptom of something happening internally and the steriod just covers up the problem, it doesn't solve it.  A valid point, but I also want my baby to be comfortable and, vain as it sounds, I want to see his cute smiling face unmarred by crusty red patches.  Or at least I'd like his skin clear long enough to get a nice photograph.  So, I booked his portrait session for a few days from now and afterwards we'll start weaning him off the steriod cream.  If the rash comes back I don't think will do another round of Fluticasone, we'll stick to baths and lotions and do our best to manage.