My three year old has had severe excema, mostly seasonally, since he was about five months old, and now, at age three, has had an episode of "reactive airways disease" with wheezing and labored breathing. His skin is very dry, and the excema moves around to different areas depending on various factors. It's most severe (cracking, open sores, widespread over a large surface area) in the winter, but he does have more mild episodes in the summer. At the moment it is mostly around his mouth, eyes, and hands/wrists. He also often gets hive-like outbreaks that cover most of his trunk and legs for a few days and then fade to smaller, more irritated areas that hang around for weeks.
About a year ago he had an IgG test at a naturopath, and tested in the "no reaction" category to all foods except those containing gluten, to which he had a very mild reaction-- a 1 on a scale of 1-10. We took him off gluten (and me as well, as he was still nursing) and maintained a very strict no-gluten diet for the whole family for about nine months. Challenges were inconclusive. Basically, he got a little better-- could have been coincidence-- and then rapidly back to the usual. We started eating gluten again recently, and there has been no clear worsening of his symptoms (well, except perhaps the reactive airways episode a month into eating gluten?).
We give him fish oil, probiotics, and a vit D supplement, and use Desonide and Triamcinolone pretty constantly, in addition to all the usual excema-care routines (moisturizing, clean detergent, short baths, etc.). The reactive airways was treated at urgent care with a nebulizer and oral steroids, then an inhaler at home.
The allergist I talked to would want to do skin tests, and I can't imagine holding him down for that at this age, but I want a "next step" to look forward to. The excema really impacts his quality of life, and is poorly controlled even with the topical steroids. I've taken him to two naturopaths, who have both basically said he's genetically predisposed and will hopefully grow out of it. Both prescribed expensive, ineffective topical treatments and expensive, proprietary probiotics. Neither thought an elimination diet would be very informative. I am hesitant to ask the doc for help controlling the excema, because I know the answer is just stronger steroid creams.
I feel kind of stuck. Is he just destined to be the kid with weeping cracks in his face, waking up scratching and crying every night? Is he headed for asthma (as the doc sadly predicted)? Any suggestions for the next step?