Student with very severe eczema

ruby_jane, BSN, RN · Oct 31, 2017

Referral to an allergist maybe? At the yearly school nurse update provided by our childrens' hospital they had a doc talk about eczema. Unfortunately, mostly home treatment options, but a lot of discussion about killing the allergic triggers. Good luck.

OldDude · Oct 31, 2017

I had a kid many years ago with similar circumstances. He had been taken to several allergists with results as you describe. There was a Pedi Rheumatologist that visited our area twice per month that I had worked with during one of my stints through the specialty clinics. I described the kid to him and asked if he'd take a look, he said he'd give it a go. Mom agreed, the Rheuma saw him, and things gradually cleared up. I saw the kid at the high school last year, a senior, and you'd never know he had battled such a condition.

lvnforschool · Oct 31, 2017

My daughter has this, but it was only extreme in her younger years. The doctor gave us topical lotions but she said it burned so I stopped applying it. She's older now, and has occasional breakouts. She just learned to avoid certain lotions, and soaps anything that would set it off. But, we did learn she has Lactose intolerance, and something called Fructose malabsorption so we changed her diet and it really helps clear up her skin.

Flare, ASN, BSN · Oct 31, 2017

photo therapy can be helpful too. I had a student years ago that had very bad eczema that had a uv lamp at home that was helpful.

ohiobobcat · Oct 31, 2017

I wonder what the rheumatologist did for your kiddo, Old Dude.

My own child has severe eczema. She had it really bad during 4,5 and 6th grade. The only pediatric dermatologist in our state told us that DD's eczema was too severe for her to handle (she was a pediatrician that held a dermatology specialty clinic 1 day a week- my state is kind of rural). We ended up at Children's Hospital in Boston in their Allergy/Immunology clinic and got it under control. It was a long haul, and it just sucks (for lack of a better term) to see your kid suffer like that. I remember her crawling down the hall to the bathroom because her feet were so sore, cracked and bleeding. I used to sleep with her and hold her hands at night so she wouldn't scratch.

When she was in full beak-out mode, the only thing we did at school for her is talk to her class, and explain to them what was going on with her skin and that it isn't contagious. Her class and teacher were super supportive, which was wonderful. We also asked for special permission for her to wear a hat at school, because she had eczema all over her head and she was flaky, and the treatment made her hair look greasy. She didn't wear a hat all the time, but when she was feeling particularly self conscious, she would. Most of the treatment for eczema happens at home. In our case, it involved daily baths (sometimes with bleach), lots of Aquaphor and topical steroids, sleeping in wet clothes ("wet wraps"), and hydroxyzine PO. Treatment can take up to an hour every day, and it is often painful (I remember applying medicine to my daughter's skin and her screaming and crying. That's when we learned that ointments are WAY better than creams for her.)

We know that her eczema is definitely tied to anxiety. She is in her senior year now, and she is super flared again right now (and stressed about where her life is going). We are back to doing bleach baths and wet wraps, much to her dismay. She hates it, but right now it's the only thing that is remotely helping. It's hard to wet wrap a face though.

So some things to explore for your student based on my own personal experience:

-is anxiety an issue?

-PO meds (hydroxyzine or something similar?) to help when itching/anxiety gets really bad

-cool packs for severely itchy areas

-allow hats if eczema gets bad on head

-PO steroids- ugh- my daughter had a rebound reaction after coming off PO steroids that almost landed her in the hospital with elevated LFTs so I am not a fan, even though they work temporarily

-Support for student and parents (guidance or a counselor of some type?)

-Referral to pediatric dermatology/allergy/immunology specialty group if that child is not already seen by one. When we went to clinic, we saw an allergist (nut allergy), immunologist, pediatric dermatology, psychologist, and a nurse practitioner who did a general intake (we would have seen a pulmonologist too if she had asthma as allergies/asthma/eczema are all linked but no asthma for her). They were 2-3 hour appointments, but boy did they know their stuff and they helped us out a lot.

You can check out the National Eczema Association's web site for some other resources as well.

Sorry this is so long! As you can tell, I have been there done that and still doing it with dealing with eczema for my kiddo.

OldDude · Oct 31, 2017

ohio...you should publish this! Talk about condensing the pertinents into one read! Your post dig tug at my heart as only a parent can relate to. The rheumatologist believed there was an element of autoimmune involvement in severe cases of intractable eczema. I don't recall exactly what the treatment regimen was but I remember it did involve methotrexate for a period of time.

lvnforschool · Oct 31, 2017

WOW Ohiobobcat!

Thank goodness my daughter never had it that severe. Im sorry:cry:

ruby_jane, BSN, RN · Oct 31, 2017

My own child has severe eczema.

Thank you for sharing all of that. I'm sorry you had to live it but your perspective is extremely valuable.

nursingon · Nov 1, 2017

PLEASE encourage parents to look into Dr Aron. There is a facebook group with literally hundreds of people who were helped by his regimen. He is not located in the US but a pediatrician can request a prescribing info from him to order a specially tailored compound for the eczema. Some of the before pictures of the kids just break my heart, weeping, scratched bleeding, all red , infected. The "after" pictures are amazing. His results speak for themselves. I struggle with eczema and so do my two daughters but ours are not so bad. Also bleach baths (yes, a little bleach in a tub full of water to kill of any staph- there is a strong evidence that staph colonization on skin causes eczema ) and another one if Eczema Diet book. hope it helps , I feel his pain because I know how it is to scratch raw

ohiobobcat · Nov 1, 2017

ohio...you should publish this! Talk about condensing the pertinents into one read! Your post dig tug at my heart as only a parent can relate to. The rheumatologist believed there was an element of autoimmune involvement in severe cases of intractable eczema. I don't recall exactly what the treatment regimen was but I remember it did involve methotrexate for a period of time.

I have seen methotrexate as a treatment option for eczema, but we never ended up giving it to my daughter. I honestly don't remember the decision making process surrounding whether to use or not use that medication for her.

Auto-immune, allergy (my daughter's IgE's were always elevated when they checked her labs)/overreactive immune system, and missing a certain protein in the skin's protective barrier are all pretty common theories about what causes eczema.

I'm glad to hear the kiddo who saw the rheumatologist is doing better.

CKPM2RN, ASN, EMT-P · Nov 1, 2017

This was the subject of my A&P "Homeostasis" paper years ago! I did that topic because I lived it too. I feel for all the little kids living with the horrible itchy, embarrassing crusty skin. Mine is pretty good now but I avoid milk, sawdust, latex and a few other triggers I can't recall just now.