Hi XXXXXXX

Thanks for writing to us.

From the description provided and treatment being taken it seems your child is suffering from atopic eczema. Atopic eczema as such cannot be cured; however can be kept in remission or controlled to a level that it proves not to be bothersome for parent or child. Usually majority of toddlers get relieved of it in childhood or adulthood.

Please make it a point to read about the disease from link mentioned below.
WWW.WWWW.WW This would help you in understanding the disease and its prevention. Also it would help you in understanding about the treatment being commonly offered.

Now as far as managing a child with atopic dermatitis is concerned, these are the basic ways of management:
1) Aways use XXXXXXX warm or cold water for bathing. Add a capfull of bath oil or liquid paraffin or olive oil to bathing water
2) Use a mild soap like cetaphil cleansing lotion
3) Immediately after bath moisturise the child. Cetaphil restoraderm that you have been using is a good choice.
4) The key to treat a child with eczema is to hydrate the skin as much as possible. So if possible use cetaphil restoraderm at least twice to thrice in a day. Every time you use a moisturiser, just wipe your child's body with wet towel and apply moisturiser. This will help seal the moisture and hydrate skin. Intensive moisturising of skin also reduces use of steroids.
5) Another important keystone is to break the itch scratch cycle. This is done by giving an antihistamine like cetirizine, fexofenadine or loratidine. These are non sedating antihistamines, if result is not good with these sedating ones (which are more effective in reducing itch) like hydroxyzine or chlorpheniramine can be added.
6) Always make your child wear cotton clothes. Wool, synthetic clothes or harsh detergent washed clothes should not touch the skin as can irritate it. even woolen or synthetic socks should be avoided. In winters make your child wear a cotton sock first and then a woolen socks can be worn.
7) In some dairy products, eggs can induce or aggravate eczema. So if that's a case in your child avoid it.
8) Probiotics ( which contains good bacteria of gut like Yakult) has some role in preventing flare ups.

9) If these steps do not help then
a) use a mid potent steroid like mometasone twice in a day over affected area once result is achieved taper it to once in a day use and then alternate day use and then twice or once in a week use. This would prevent flare ups and also prevent steroid side effect from developing.
b) Sometimes steroid can be combined with tacrolimus or pimecrolimus or either of these two can be used as a replacement of steroid. But in many children tacrolimus or pimecrolimus induces slight burning sensation. so in such cases we have to use it according to child's need
c) Sometimes oral steroids are also added to control flare ups.

10) If it's possible take your child for narrowband UVB phototherapy. It's a light based therapy given two to three days in a week and offers wonderful results. Sometimes when a child is on this therapy we can wean the child off steroids or any other medicine. Just emollients and phototherapy offers good results.

Hope that answered your query. Should there be further query, please write back.

Take care

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