Hi there, I am a GP with first hand experience of severe eczema in my first child when she was 2months old. The facial eczema was most difficult to treat, and eventually we had to use a strong steroid cream, Advantan, which is not advisable for use for prolonged periods. (One of the concerns is that the skin on the face will start to show side effects such as new capillary growth; also that some of the steroid will be absorbed into the bloodstream).
I think referral to a dermatologist is an excellent idea as is allergy testing. In our case it was undiagnosed food allergies that caused the problem (egg and nuts). I was told it wasn't common but later read that 20% of children with eczema have food allergies that exacerbate eczema. Interestingly, dairy is often blamed as a culprit, but eggs are the main food allergy, and other culprits include nuts, soy and fish.
Keep your baby on the cool side, as heat aggravates eczema. If it is itchy, put a cool flannel on the itchy part to reduce the itch. Avoid baths and prolonged showers, as the water will reduce the natural oil barrier of the skin. Tepid short showers every couple of days are sufficient. I find that putting an oil based cleanser on my baby's skin before the shower helped - like Alpha Keri cream cleanser. Sand can also aggravate eczema, and dryness such as heating or airconditioning. Twice or three times a day you must use a very good emollient (moisturiser) specifically created for eczema, such as Dermeze, QV intensive ointment etc. An ointment is preferable for winter and for flareups. In between flareups, a lighter emollient like Sorbolene or QV cream may be appropriate. Do not use a general use moisturiser and avoid anything with perfumes or additives. Some people try some trendy new creams like Moogoo (which actually doesnt contain any dairy) and Billy goats soap, but I personally did not find these to be helpful. I would stick to the tried and true (and cheaper) options like Dermeze.
The Royal Children's Hospital has good information on eczema http://www.rch.org.au/kidsinfo/fact_sheets/Eczema/
Good luck - managing eczema is frustrating and time consuming for the parent. We now have two children with mild eczema only which is managed with emollients and the occasional use of a steroid cream for a couple of days.
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