10 y.o. with SEVERE eczema - need help!

[Yo Becca]

Hi. I have just moved to China with my family, along with another family who has an 8 and 10 y.o. The 10 y.o. girl had very mild eczema in the US - just a small patch of dry skin. In the 6 weeks since she's moved here, it has gotten tremendously worse. The dry patch on her arm spread from mid-forarm up to her armpit area and was swollen, itchy and covered with open sores. Her mother took her to a derm, who prescribed 2 topical meds. They seemed to work - the swelling reduced and the sores began to heal. But now she has it as bad or worse on the other arm - literally her entire arm is covered with itchy red rash, scaliness and open sores, while the other arms has scars and scabs. Her scalp is itching when she gets hot. Now the skin on her lower back and butt is getting scaly and rough, and she has sores and swollen red skin between her shoulders.

She's itching badly, and scratching at night (hence the open sores). the meds are no longer working. In addition to the physical discomfort, she is miserable b/c the bratty kids at her school are talking about her and pointing - and it looks really awful. She's started wearing jackets b/c if her arms are visible she's completely withdrawn. She's done a lot of crying over it, and it's breaking our hearts.

She went to see a more traditional Chinese doctor today and was given liquid herbs - so those may have effects. She has cut seafood and spicy food out of her diet on recommendation from the derm (although I've never heard about spicy foods causing such reactions), and has stopped eating eggs (although I don't think her parents are cutting out products with eggs yet - not sure).

We are trying to find an allergist here who will do allergy tests on her to figure out what she might be reacting to. But I have NO experience with eczema, and neither does her mom. Any resources, advice, websites, etc. anyone can recommend would be TRULY appreciated. I'm just starting to research eczema. We are feeling pretty isolated since negotiating medical care here is tricky.

Thanks so much.

[Pauli]

That sounds awful! Poor kid!

Eczema is an allergic condition and the allergy can be to absolutely anything. It's been my personal unscientific observation that it is most often food although environmental factors can certainly cause it (like pets, dust, mold, pollen). My guess is that she has an allergy to something that in China but not so much in the US. What is she eating significantly more of there? (BTW, my dd is allergic to rice and her eczema flares when she eats it). I would look closely at her diet now as compared to her diet in the US. Also at the environment, like does the new house have mold or dust?

I think allergy testing is definately a good step although with being so rashy they may not be able to do skin test. A blood test would be a good starting point though. Seriously, if she can do it, an elimination diet might help a lot. I bet she won't have much trouble with it if it makes her look better....looks are so important to girls that age!

As far as meds, I have no idea how it works in China, but Zyrtec did wonders for us (I thinks Zyrtec is meant more for respiratory symptoms but it accumulates in the skin so it's great for eczema). Can you get hydrocortizone ointment? That might help to control the itching although it's not a long-term solution (but better than scratching your skin off), and the same with Elidel. I'm just throwing out some things that I've used and heard about for something to ask about or look up on the net....

Honestly though, finding and avoiding the allergens is the best thing to do. It's tough but with some detective work I'm sure it can be done. Since it flared so fast after getting there, I would really look at the things that are different from where she lived before, esp. food.

Let us know what happens. I feel so bad for her! I remember being 10 and it can be rough without all that!

[ledzepplon]

I think current studies are showing that eczema is actually a genetic skin disorder in which a certain protein found in the outer layers of skin doesn't get produced at all or in enough quantity. This has two results: excessively dry skin because there is no effective barrier to keep water in; and skin that's more more susceptible to foreign elements entering through the skin (the immune response causes the red inflammation).

There's no cure, but you can try to find out what substances might be exacerbating the problem. Try doing a google search for eczema. There are a lot of great sites out there.

[ledzepplon]

You might look into trying something like Benedryl for the nighttime itching. I have eczema, too, and I notice that if I'm too hot at night, it makes the itching worse. Long sleeved pajamas with less cover might help (the sleeves discourage itching in the sleep).

I've found that a soak in warm bath with epsom salts is very soothing for the itch.

I'm also suspicious of a skin infection (strep) since the skin sounds so open and swollen. I'd keep trying to find a good dermatologist. But even a GP can do a swab of the skin for bacteria. When the skin is infected, it just can't heal. She may need antibiotics and a stronger steroid cream to get things under control. Of course stress also makes this condition worse, and how can someone be relaxed when their skin is so miserable? It's really unfair.

Once things aren't so severe, you could try allergy elimination or the herbal/homeopathic route. But I really urge you to get some more aggressive medical care before she winds up with a serious skin infection.




(I have eczema, too, and it sucks .)

[DanAbimytwomiracle]

IME excema has always been allergy-related. It might be a detergent, soap, shampoo, mold, mildew, pollen, animal dander, or food - but all those things are worth looking into.
I also agree that with the skin being open that she needs to see a dr to see if it's infected first. they can give her Benadryl at night to help her sleep and keep the itching at bay.

[makawee]

last time we had an open would that wouldn't heal it was a staph infection. (my ds has eczmema) oral antobiotics were required. the docs gave us keflex for 10 days. please urge her parents to get her taken care of so she doesn't get sicker.

along with the antibiotics the docc prescribed us triamcinealone - which is a steroid. doc said it would clear up faster and look better sooner, but you have to be super careful with them - on my ds i saw skin thinning after two weeks use. it neeeds to be used sparingly.

we also take probiotics. lactobacillus was the species recommended to us by the allergist. he said that no other probiotic has been shown to make a difference in eczema.

also for the dust mites we have to get allergenic covers for our pillows and mattress.

lastly the doc said we should use a lotion that is like 'free and clear' (brand name) our is called vanicream.


i'm sorry that your little traveller, (expat?), friend is going through a hard time. it must be really rough, in a new place and stressed, and being bullied at school. i'm a teacher - maybe the parents ought to give a call to the teacher. good luck and update us!

[Yo Becca]

Thanks so much for all the tips and advice. I'm passing everything along. They have been treating it on the surface and have seen docs 3 times in the past 2-3 weeks. The open sores are caused by her scratching it, mostly in her sleep or absent-mindedly. the recommendation for benadryl is a good one. She has been given zyrtec, so hopefully that will show some results. They are travelling this week, but while they are gone I'm going to try to see about finding someone who will do allergy testing. We've been searching for "free and clear" detergent, and she's using mild and gentle soap.

Thanks again - she says, "I like China, but China doesn't like my skin" - it's spread to her chest and legs since I posted a few days ago.

A question on the staph infection: was the infection itchy, or did the scratching lead to the infection?

[Chinese Pistache]

Is she eating Chinese foods? I'm not sure about traditional Chinese foods, but in the US, they are loaded with soy sauce. My dd is allergic to dairy and soy and her eczema always flares when she is exposed to those foods. If the little girl's soy intake has drastically increased, perhaps that's the trigger.

[makawee]

the staph infection - the doc said eczema is the itch that rashes. so i think the itch, then scratch, then infection.

you can use baking soda in place of the detergent.

how's everything going for the 10 yo? it seems she has a good attitude from her liking china, but china not liking her statement.

and you updated your sig - expat in shanghai! i wil be checking out your blog for sure!

[*Lindsey*]

My DS (almost 3) has pretty bad eczema. We've been through all routes of treatment to no avail. We're currently doing a homeopathic remedy and hoping it works!

I wanted to advise maybe NOT using any soap when washing/bathing her. Even free and clear soap could dry her out more. For the last 2 weeks, we've been bathing DS in just water and then coating him in Aquaphor and it seems to be helping, a little.

Good luck! This is SO frustrating.

[huskermommy]

Our 2yr old daughter had severe eczema on her bottom especially. Laundry detergents will set it off. I'm not a fan of steroids so we tried numerous other lotions and washes. Finally, we are using Arbonne's baby skin care system and it has been working great! I'm sure every child's skin is different in what it can tolerate but I would still search for a derm who can help. The open sores seem serious! Good luck I know this is hard!