My poor youngest child. He's had eczema since he was about 4 months old. It started on his cheeks (as you can see in the photo). It sometimes crops up elsewhere, but those spots are easily taken care of. His cheeks are a different story. We were told to use an over-the-counter hydrocortisone and Aquaphor or Vaseline. It had absolutely no effect. Then we were given a prescription strength hydrocortisone. It helped a little, but at the end of the week (the amount of time the dermatologist told us to use it), the eczema was still there. By eight months, the spots had grown bigger.
Here he is with the infection. It made his glands swell up, so he has this big double chin. Take a look at his forehead in this photo. We thought at first that the eczema was spreading, but I didn't think it looked quite like what I was used to seeing. I had taken one of my older kids to the pediatrician for another matter (a tick that had made a lymph node swell up), and at her urging, we made an appointment with an allergist. They did a number of scratch tests on his back - at this point, the only place on his body clear enough. It didn't seem that he had any kind of allergic reaction going on. We did find out he has a slight allergy to dog dander, but not enough to cause this. We had another dermatologist appointment for the following week, but the day after we saw the allergist it had gotten still worse, and was even on his eyelids. The allergist gave us a prescription for antibiotics, so we started giving him an oral and a topical antibiotic for the infection.
Basically, the herpeticum sores are going to get better in time, but if you can see his chin and cheeks here, you'll see that they already look as good (or better) than they did when this whole thing started. I'm delighted. Then, to top it all off, I met another mom at the playground who echoed my feeling that the Aquaphor made the eczema worse (her son had it just as bad as mine). Finally vindicated! It's a good feeling. Almost as good as seeing baby's eczema start to get better.
Back to the dermatologist. They gave us a stronger cream - Cutivate lotion. We had also already switched laundry detergents, I always moisturize after baths, have him dressed in cotton... all the typical things you're told to do. These photos are of him between thirteen months and fourteen-and-a-half months. As you can see, his chin is really bad now, too, and he scratches until he bleeds. And yes, we have tried covering his hands. So we started trying some other things we had heard about. We tried wheatgrass spray - no luck with that, and I think it stung, though it's hard to tell since he yells any time you do anything to his face (or change his diaper, or dress him, or...you get the picture). We tried Vanicream, TriplePaste, and Remedy Skin Repair Cream. Nothing. Then the eczema got infected.
Here he is with the infection. It made his glands swell up, so he has this big double chin. Take a look at his forehead in this photo. We thought at first that the eczema was spreading, but I didn't think it looked quite like what I was used to seeing. I had taken one of my older kids to the pediatrician for another matter (a tick that had made a lymph node swell up), and at her urging, we made an appointment with an allergist. They did a number of scratch tests on his back - at this point, the only place on his body clear enough. It didn't seem that he had any kind of allergic reaction going on. We did find out he has a slight allergy to dog dander, but not enough to cause this. We had another dermatologist appointment for the following week, but the day after we saw the allergist it had gotten still worse, and was even on his eyelids. The allergist gave us a prescription for antibiotics, so we started giving him an oral and a topical antibiotic for the infection.
In this picture, you can see how terribly swollen his eyelids are. This was two days after we had seen the allergist. I started to get worried, and didn't want to wait for the dermatologist appointment, so I started calling different dermatologists until I found one that could see him right away. (This was on a Friday morning.) When we went in, she told us immediately that this wasn't just eczema, and wasn't just a bacterial infection. My baby had eczema herpeticum; the herpes simplex virus had come in contact with the skin on his face, and while this wouldn't be a big deal for any of us (in fact, it happens to us all the time), he managed to get infected.
Despite how common both the eczema and the herpes virus are, this is not a very common condition and is misdiagnosed as allergies (at first) fairly often. The dermatologist was really worried about how close to his eyes this was, and wanted us to see an ophthalmologist right away. The trick, of course, was getting a last minute appointment on a Friday afternoon. We ended up at the NYU Medical Center ER. Finally, a bit of luck - the infection was not in his eyes. You can see here how this was all over his body. Like a monster case of chicken pox. Fortunately, this isn't contagious, so my other two little ones were okay. Of course, my next worry was how he'd gotten this, and how I could keep it from happening again. Unfortunately, the virus is everywhere. He could have pick this up absolutely anywhere. The key to not getting it again? Keep the eczema under control. Back to square one. We started him on a course of acyclovir for the eczema herpeticum.
At our follow up appointment with the dermatologist (the one who diagnosed this), she started talking to me about getting the eczema cleared up. She wrote out a prescription for a cortisone cream (is this sounding familiar?) and told me to slather Aquaphor on him. I tried telling her how I think that makes it worse. His skin seems to start bubbling up and getting weepy underneath it. Her response was 'it takes time for this to work'. She also wanted me to give him a lukewarm bath twice a day, every day, for 15 to 20 minutes. Okay - she knows I have two other little kids. How does she think I'm supposed to manage that one? My day is already so packed with preschool drop-offs and pick-ups (two different schools), vacuuming up after the dog (a daily occurrence - the shedding monster), fixing and cleaning up meals and the occasional trip to the playground. So I nodded and took the prescription, then decided to ignore her and do what I thought was working.
I use Renew lotion, from a company called Melalueca http://www.melaleuca.com/, on my beyond-ridiculously-dry skin. If it's good for me, I figure it should be good for him. I've been putting it on him as often as I can; about 6 or 7 times a day. It's not cheap - although compared to some of the prescription creams it's a real bargain. I love it. You can't order it directly from their website - you have to get it through one of their representatives or sign up for their program, but I think it's worth it. I get mine from my sister (thank you forever). I am using the cortisone, but only every other day, one time per day, instead of the 2x daily that was prescribed. We also give him Zyrtec at night before bed, both to help with the itch and because it seems to help him sleep better. I've been doing this for four days now, and here is where we are. I'll post another photo next week, since this one is a little hard to see (he wanted to hold the camera).
Basically, the herpeticum sores are going to get better in time, but if you can see his chin and cheeks here, you'll see that they already look as good (or better) than they did when this whole thing started. I'm delighted. Then, to top it all off, I met another mom at the playground who echoed my feeling that the Aquaphor made the eczema worse (her son had it just as bad as mine). Finally vindicated! It's a good feeling. Almost as good as seeing baby's eczema start to get better.
