Tag Archive: Eczema/Topical Steroid Withdrawal

Going with the (eczema) flow

Things that work now,
may not work later;
things that do not work now,
may work later.

This was what the Chinese physician, Dr Mark Chern wrote in our online consultation.

It is very true, after having going through this eczema journey with my little man for the past 4 months. Every time when something works and makes his eczema better, I am so happy and prayed for complete healing. But every time, this happiness is short-lived, because the eczema will somehow stop reacting to the current remedy and go back to square one, or worse.

As mentioned in my last eczema post, we brought little man to see a 谢雅应医师 at Chung Hwa Medical Institution. Little man and I have been seeing a regular tcm physician at the clinic for my acid reflux and when little man’s cough and flu does not go away. So far, little man has been reacting well to her prescription. However, she is not expert in treating eczema, hence she once suggested that perhaps we would like to try the specialist in the clinic.

In a desperation bid to rid little man’s eczema, we decided to give him a try, despite the really bad timing of his consultation. Truth to be told, I was really disappointed by the consultation. He probably did not even take a good look at my son and his eczema. And he was not even listening carefully when I try to tell him that little man was developing a bad cold. On top of that, when I asked if I should boil the medication to rid the alcohol in it, he nonchalantly mumbled that we can heat it up if we want it to be served warm. I started to be rather doubtful as every tcm physician we go to will always remind us to boil the medication before feeding little man. But Hubby said that we should give his medicine a chance, since we took the trouble to go down despite the bad timing. I agreed to give it a try, but will probably search for other physicians if his medication proves to be not suitable.

Anyway, he prescribed little man with oral medicine consisting 四物汤 and 防风通胜汤. I asked Dr Chern and my regular tcm physician, both advised me to not take his medicine for the time being because of little man’s cold.

We went to see Dr Chern again after that visit to get some ointment to relieve his eczema as Chung Hwa Medical Clinic does not give out topical ointment according to 谢医师. This time, we (both of us and Dr Chern) were wondering if we should give acupuncture a try. Hence, we tried to distract little man with Peppa Pig videos, while Dr Chern tried a needle on him. Little man was so sensitive and could immediately sense that something bad is about to happen. That needle lasted less than a minute on his leg. However, his skin looked so good the next morning, Hubby and I have been discussing how to convince little man to give it a try again. It is difficult, given he has been so dramatic and emotional about everything lately, but we will try.

The search for a good tcm physician whose medicine works, is tough. But I am not giving up, because from my experience when my acid reflux was at its worst and I look everywhere for help, there will be someone who can help you if you do not give up.

Apart from TCM, we have reintroduced magnesium flakes to little man’s bath time routine, because ACV suddenly does not work anymore. Somehow, little man seemed to be able to tolerate the magnesium flakes and his eczema reacted well to it. For about a week, during the long National holiday, little man’s eczema looks so much better. It was not as swollen and red as before. Pity, this is short-lived as well. And now, we are back to using ACV again.

In the midst of struggling with work, little man’s terrible two/three-phase and his eczema, I came across this blog. It was heartbreaking to read the little child’s eczema story, but it gave me hope that eventually, little man will be alright too. I must not give up.

Hence, I will probably be trying out the lemongrass balm mentioned in the blog and praying hard for full recovery.

Go away, eczema. You are truly not welcome.

Let there be light

It pained me to think that for the past 4 months, despite all efforts and remedies, little man’s eczema was not cleared. Instead, it becomes bigger in area and looks worse than before.

We have been through quite a bit in these 4 months, and I just want to document it down so that I can refer back when the need arises.

Following the visit to my dermatologist, I went online to read more about all other alternative remedies and creams people have recommended. We have spent money and time on the following:

  1. Moogoo Irritable Skin Balm (ISB)
  2. Moogoo MSM cream (MSM)
  3. Dead sea salt bath
  4. Magnesium flakes
  5. The Home Apothecary zinc balm
  6. Oliva Forte capsules
  7. Apple Cider Vinegar wash
  8. TCM physician – Dr Mark Chern
  9. The Eczema Diet

The first 4 items have been recommended and blessed by an old friend whose daughter also suffers in the hands of eczema. She, like me, is still seeking ways to completely unroot it.

Sad to say, little man does not seem to agree with the dead sea salt, magnesium flakes and zinc balm. He will complain of pain after soaking (just for a few minutes) and his raw patch will turn redder than before. Zinc balm made it worse. I have tried twice, and twice the patch became worse, hence I totally stop using them for the time being.

The 2 Moogoo creams work briefly on him. I was so elated to see mild improvement in the appearance of his patch, that I immediately when to Kiddy Palace to buy a new tube each. I layered the creams, first with ISB and then MSM as instructed by the eczema group members. With these 2 new friends in hand, I was hoping for a miraculous heal during our trip to Taiwan. Sadly, the improvement was short-lived. The patch grew bigger, and we are back to square one, and worse.

Then I heard raves about Oliva Forte capsules, how taking it long-term can help heal one’s leaky gut, which is said to be the reason for eczema. I went ahead and spent a bomb on 3 boxes of it. Little man has been taking it for almost 2 months now, and I didn’t see his eczema get better because of consuming Oliva Forte (just like Lacto GG). However, I must say that his immune system is getting stronger, likely to be due to this Oliva Forte, according to my gut feeling. He recovers so much faster from his illnesses ever since he started on it, hence I am still continuing him on this supplement.

Apple Cider Vinegar (ACV) is one thing that I have often read about online, but hesitated to try. One can imagine how acidic can ACV can be, and applying it on one’s raw skin is almost inhumane to me. But it came a time one day when I was feeling really desperate and it happened that I suddenly developed eczema on one foot, hence I decided to buy a bottle of cheap good ACV, dilute it with water and apply to my own eczema. Surprisingly, it felt really cooling and my itch went away shortly. After a few days, my eczema actually died down. It gave me the courage to try it on little man, and I must say, I think it is working, slowly but surely.

At this same time, I also brought little man to see Dr Mark Chern for the first time. This TCM physician was recommended by the eczema group members. Dr Mark saw little man and commented on how hard it is to “cure” him because his eczema is unlike most of his patients who have wide-spread eczema. Nevertheless, he gave us a cream containing 黄芩, asking us to try on little man to see if it works. Initially, his cream works a little. Little man’s patch started to turn brownish and peeled. I was so happy, thinking it is the start of healing. But Dr Mark advises me that the cream is just to control the eczema, and probably is not able to heal it. Just like what he predicted, the patch came back, and the process of peeling and turning brown just happens over and over again, without any healing. In our 2nd visit, Dr Mark gave us an herbal wash together with the same cream. Again, he was doubtful that these can “cure” him. And he is again right.

Personally, I think Dr Mark is a great TCM physician who does not see patients to earn money, like some private physicians do. However, because he himself professed both times that he is quite lost about what else to do with little man’s condition due to his age and his “not-so-serious” patch, I have decided to seek a 2nd opinion.

However there are a few things I have learnt from our visits to Dr Mark.

Steroids Withdrawal Syndrome is like a drug allergy. Some people gets it, some people don’t. There is no explaination, just whether your body accepts the drug or not.

  1. Different cream/solutions work for different people. One that works for others, may not work for you. You will just have to keep trying and figure out a formula of your own, one that fits you.
  2. Trust your first instinct and feeling after applying a new cream/ointment/solution. If the first application feels irritating, time to try something else.
  3. The Eczema Diet by Karen Fisher

The next thing i want to talk about is a book recommended by Dr Mark. The Eczema Diet. I borrowed the book in times of desperation. I am glad I did. It gave me a lot of new insights about eczema, and I am really relief to know that there are so many other solutions I can try on little man.

Because I am a working mother and little man attends a full day childcare, it is more difficult for me to strictly control his diet. Hence after much discussion with Hubby, we have decided to take dairy products and eggs from his diet for the time being. I am delighted to say that after 5 days of dairy and egg-free, his eczema looks so much better, with everything else going status quo.

So now, these are currently what we will still be doing:

  1. A capsule of Oliva Forte & Lacto GG every day
  2. ACV wash as often as we can
  3. Oat bath
  4. TCM cream given by Dr Mark
  5. Dairy & egg-free diet
  6. Cod Liver Oil
  7. TCM medicine to bring his immune system back on track

Dear God, let us see light at the end of the tunnel. Let there be light.

Trusting Mama’s instincts

Little man has been having this raw rough patch around his ankle since early March this year.

I did not give much to it initially as I thought it was probably skin sensitivity that will go away with some constant moisturising. However, a pediatrician whom little man sees for his vaccinations noticed it and told us it is likely to be fungal infection. She gave us this Daktacort Cream and told us we could apply for a few more days after the rash go away.

I do not have experience with fungal infection, hence even though when the pediatrician told me that it contains steroids, I did not think of rejecting it. From what I read online, fungal infection can be rather stubborn and contagious. I was petrified by the information I found.

However, after applying for the 2nd time, a white ring started to form around the rash. That instant I decided to seek a second opinion.

I went to another pediatrician whom I trusted more and her diagnosis was unfortunately the same as the first. This time, she gave me Neoderm instead.

Now, I have researched about Neoderm Cream before as I was once given Neoderm by my gynecologist for some rashes over my tummy when I was pregnant. It is a very strong steroidal cream. But like what I’ve mentioned, I have no experience with fungal infection, hence I put my trust in this particular pediatrician. Like the first pediatrician, she instructed me to apply for 1 more week even when the rash is gone as “fungal infection can be very stubborn”.

Miraculously, the rash went away within a week. But as soon as I stopped applying, it came back again, fast and furious.

I then called the pediatrician and asked for her advice. She told me to apply once more following her instructions and go back to see her if it comes back again.

And without fail, it came back again.

I was telling Hubby that if it comes back again, I will bring little man to the National Skin Center instead. She might be a good pediatrician, but she is not specialised in skin problems. Boy was I glad I go with my instincts and made that appointment with my dermatologist, Dr Hazel Oon.

A visit to NSC today helped me find out that this rough patch is not fungal infection at all. All along, little man has been misdiagnosed. A simple scrap test tells it all.

Dr Oon was surprised to hear that little man was prescribed Neoderm. She said that it is a very strong cream even for adults, and told me to stop using it on little man. (No worries, I threw that tube of Neoderm out when I read so much negative reviews about the side effects it can cause.) She then prescribed some mild steroids (Desowen and Elomet) suitable for little man, and told me I could use them if I want. (I told her I prefer not to use steroids.)

So now, my game plan is to diligently bathe that area with oat bath twice a day, and moisturise, moisturise and moisturise till it slowly go away (fingers crossed). On top of that, I will try Annique Rooibus Tea, hopefully to fasten the process. Ohya, and Lacto GG is also ongoing.

I have been through many episodes of eczema with little man, with the recent few episodes without any use of steroids. I hope I will persevere with not using steroids. After seeing how an old friend’s daughter suffers from Steroids Withdrawal Syndrome, I try my very best not to use them at all. It is quite sad to see how Singapore doctors are dispensing strong steroids such as Neoderm so freely without warning patients about its possible side-effects.

We will be alright, my baby. We will get through this like we always do.

A visit to the pediatrician in Seoul

I had wanted to write about this ever since we came back from Korea, but too many events got in between, hence I only have the chance to write about it now.

As mentioned, little man developed some serious rash on the second day of our trip and on the sixth day, I decided to bring him to a pediatrician.

It was not an easy decision as we heard from some sources that usually Koreans will go to the hospital rather than the clinics. We felt uneasy just thinking about the hospital. There were many concerns and language barrier is a major part of it. We worried about miscommunications and misdiagnosis, hence I seek advice from my airbnb host. She told us that there are not any pediatricians nearby our apartment, and suggested for us to visit the clinic in the same building, offering to go with us. I had to decline her offer as I am still more comfortable with going to a pediatrician.

Hubby was rather reluctant initially. He felt that little man’s rashes although not getting better, were not getting worse either. But it gives me a heavy heart to see little man so uncomfortable every day. On top of that, there is this nagging feeling that it could be more than just the usual rash. It looked so red and angry and so possiblly full of pus. Hence, that night, I went online to see if I could find a recommended pediatrician in Seoul. Thank God for the internet, I found a forum for foriegners in Korea and there is this conversation about this particular pediatrician, Dr Kim. I gave him a quick search and found more information about him from this site. You cannot imagine how thankful I am.

We took a cab, tried to communicate to the cab driver who cannot speak English, and managed to make our way to the Richensia Tower. There are two towers. We went to the wrong one which makes up of apartments. Luckily, a sloppily-dressed uncle who spoke excellent English helped us to get our way to the right tower. He must be a resident at the tower. I was so impressed by his English, I reminded myself never again to judge someone by his attire. When we reached the clinic, it was not considered very full, given that it was a Friday afternoon. We probably waited for about 20 minutes before Dr Kim sees us.

Dr Kim is the only English-speaking person in his clinic. I called up the clinic that morning to make sure Dr Kim is in. After hearing that I only speak English, the receptionist passed the phone over to another person who spoke English. I believe that was Dr Kim who spoke to me.

Anyway, Dr Kim had a look at little man’s rash, checked his ears and temperature, and told us that it was a viral rash. He looked surprised when I told him I have been applying the steroid creams that was given to me by pediatricians in Singapore. He told me not to use any steroids on little man as the rashes will flare up and become worse, and to only apply emollient creams on him. He was also very surprised when I told him certain medication little man was taking for his running nose. He told us that these are pretty strong medication that usually will not be given to children here. But he also said that different countries have different regulations about medication. Little man was then given only antihistamine and some antibiotic cream (non-steroidal) just in case of any bacteria infection.

And guess how much I pay for this consultation?

20,000 won, which is about SGD$24.

The medication had to be purchased separately in the pharmacy, which is another unit in the building. That medication only cost us 10,420 won, which is about SGD$12.

I must say, I am pretty impressed by the whole experience.

Medication

Below are some photos that I have taken, in case anyone needs to bring their children to an English-speaking pediatrician.

Richensia Tower

Dr Kim’s clinic

If you happen to be there, you must go and try out this Japanese restaurant in the same building. It definitely picked me up with its excellent cuisine after a nerve-wrecking morning.

Little man enjoying his Pororo plate.

Seafood ramen with nice and rich broth.

Okay, I digress.

I had to write about this because someone wrote about this clinic and helped me tremendously. I am so grateful. Hence I hope that one day, my post can help some parents too.

Dr Kim’s Clinic (I have no idea how to read the Korean words)
Opening Hours: Monday-Friday 9-6pm. Closed 1-2pm for lunch. Saturday 9-4pm.
Address: #133-3 Wonhyoro1-ga, Yongsan-gu, Richensia Yongsan A-303, Seoul, 140-111
Phone: 02) 713-9340 Cell Phone: 010-2647-9340

There is this map which is very useful in helping us to get to the Richensia Tower. You can find it in one of the link in this post.

Alternatives to steroids

After my previous post on steroids for eczema, I had a few well-meaning friends who cautioned me about using steroids. It will definitely be be best to stay away from steroids, having read so many horror real-life stories online. But sometimes, after slapping on days of Calendula remedy and other alternatives, all you want is a little sign from your body to say that it is healing. I am very very careful when applying steroids (for myself, and more so for my son). I use just a teeny weeny bit, and that little bit makes a huge difference in sending signals to body for it to heal. Sometimes, after applying it for a day or two, I will switch back to the natural remedies, and my skin will continue with its healing. One thing I must clarify is, most of our eczema outbreaks are rashes-like, nothing very serious, dry or broken. (Thank God.) Hence, what works for us, may not work for you. I guess it really depends on individuals.

Although I do not stay away from steroids, I am still constantly searching and reading up for natural remedies that could help little man and I to be free from eczema. These are a few natural remedies we are currently using. They are said to have helped many eczema sufferers heal.

1. Lacto GG

Lacto GG was first recommended to me by a pediatrician. Little man has sensitive skin and constipation then. Lacto GG is said to be able to help these symptoms. In addition, it can build the body’s immunity. I vividly remember the pd telling me that her fellow colleague took this when she was pregnant to help prevent such symptoms in her child. I remembered making a mental note to take those for my second pregnancy (not happening soon).

According to some articles I have read, something is lacking in the guts of babies and children who suffer from eczema. It has been found that by supplementing the body with this strand of probiotic, Lactobacillus GG, sufferers can recover from eczema conditions over a short time.

This Lacto GG is not cheap at all. A box of 30 capsules costs about $67++ depending on where you buy them from. But since it was so highly recommended, I decided to put the both of us on it long-term. Like what Hubby always say, if it’s a problem money can solve, then it is not a big problem. Money can still be earned. Nothing is more important than good health.

2. Four Cow Farm Calendula Remedy / Baby Lotion

I started out using California Baby Calendula at first. It was a bottle gifted to me by a dear 学姐 whose children also suffer from eczema. It has a nice smell and works for me for a while. But one day, while researching on it, I found that California Baby has changed some of its ingredients that are not so good for the sensitive skin. You can read more about it here.

Hence, I stopped using it and searched for other alternatives. FCF Calendula is one of the alternatives I have found and have been using. I like it that they have an online store here in Singapore and provide free delivery above a certain amount which is not hard to reach. I am also using their Baby Lotion for moisturising, alternating with my cheaper Nivea Whitening Lotion. But I am going to ditch Nivea products once I finished the 2 bottles I stocked up, because I just realised recently that they have added Dimethicone for both their lotion and deodorant. You can read more about that ingredient from the link I have provided. Currently, I am trying to stay away from silicone, SLS and SLE from our hair and skin care products, which are really not easy. Even little man’s Kodomo gentle cleanser contain a large amount of SLS 🙁   Anyway, maybe another post on that next time.

3. Angel Baby Earth Mama Bottom Balm

Having heard so much about this cream, I went on iHerb to buy it for little man to use. I like it and it works for little man so far for mild rashes. Although it is a Bottom Balm, I rarely use it on his bottom. Instead it has become a reliable rash/insect bite cream.

4. Oat baths

Oat baths works very well for little man in relieving his itch and moisturising and healing his damaged skin. What I do is wrapping our usual breakfast oats (about 2 tablespoons) in a small handkerchief, and soak the handkerchief in a small container of water. The water will eventually present a milky texture which I will pat onto little man’s skin after his bath routine. There is no need to wash away the milky substance. I just dry his body after that. This milky texture will help to retain the moisture around his eczema, helping it to heal better. And for some reason, it also helps to calm down the itchy skin. As I use this for myself as well, I can really feel the relief it gives me.

If you are ok with the mess it makes, you can actually create a milky bath in the baby bathtub for your child to soak in. But it is too messy for me, hence I came up with this mess-free idea. Works as well.

5. Rooibos Tea

I have also read a lot about how rooibos tea can help to heal eczema as it is high in antioxidants. Many recommended the Annique Rooibos Tea, which aren’t easily available. Hence, I just make do with the Twinning Rooibos Tea bought from iHerb. My take is, it is not expensive, so even if it doesn’t really help with the eczema, I just take it as a relaxing tea. Little man drinks that too. Actually little man has been drinking chamomile tea on days he is easily irritable as well, but that on another post perhaps.

6. Physiogel cleanser / Physiogel creams / Cetaphil Restoradum

Little man and I do not bathe with Physiogel cleanser on a regular basis as it is rather expensive to do so. But we always stock up on Physiogel whenever there is offer so that we can use it for periods when our eczema occur. One thing about eczema is, you do not want anymore harsh chemicals on those raw skin. So for those periods, we will use the mild cleanser and load on plenty of Physiogel or Cetaphil creams, whichever is available. Like what my dermetologist said, it’s all about moisturise, moisturise and moisturise.

I think there are more eczema sufferers out there than we thought we know. I myself have learnt a lot from what other sufferers have shared. I hope this post have helped you in some ways too.

PS: For those who are thinking of trying essential oil on eczema, I would say be careful. I have tried Lavender essential oil on my eczema, and I think it kind of make it spread. Essential oils, though natural, are potent stuff. They are like two-edged swords. Use them the right way, they help you tremendously. Use them the wrong way, they cause you more pain. Just remember to be very careful, especially if you are thinking of using them on your young ones.

Steroids for eczema

I do not remember when I started having eczema, but my mother told me that when I was very young, I was rather prone to having rashes. They call it 风莫 or 热痱 then, and usually just bought over-the-counter calamine lotion or cooling powder to apply to it. I personally do not remember any of those outbreak in my younger years. However, since don’t know when, I started having recurring outbreak of very itchy rashes, usually due to an allergy of some clothing materials (milder outbreaks) or weather changes (rather bad outbreaks).

As much as these rashes are irritating, it will always go away after I applied the ointment given by the GP. I do not know such creams are steroids until internet became more available to us (Yes, I am THAT old.), and I started having the habit of checking out the medication I was prescribed.

Anyway, I during that time, I had the worst acne outbreak of my life (never had acne outbreak before), and I took the plunge to visit a dermatologist at National Skin Center (NSC). Since then, I will go to NSC whenever my eczema get out of control. As a result, I had a full range of steroids which totally confuse me.

Hence, when I visited Dr Hazel Oon again for my recent outbreak, I told her about this and emailed her a photo of all the creams I possessed.

IMG_20140913_135300

I asked her for her professional advice on using these steroids and I am so grateful that she took time to reply. I really want to share this as many of us just use creams prescribe to us without knowing what exactly are we applying on ourselves. I think it is important to know more and protect ourselves. I know many of us have heard about steroid withdrawal syndrome and are very afraid of using steroids. But ALL (I have asked a lot of doctors) the doctors whom I have asked, told me that this syndrome usually only occurs to patients who have use steroids for a very long time (eg. months) and patients who take oral steroids. For people who do not have serious eczema or sensitivity that acts up once in awhile, there are actually safe steroids to use when neccesary.

This is what she said.

The most potent of the steroids is cloderm (clobetasol) – best to avoid as side effects can set in sooner.
Conazole contains 3 medicines – betamethasone diproprionate, gentamicin and miconazole – avoid this.

Slightly less strong than cloderm is beprosone (but still quite potent). This should be restricted to the thicker or more stubborn rashes on the body and limbs.
Then followed by elomet. Elomet is a very good cream that can be used to eczema on the body and limbs, as well as face, neck, jointfolds. It is more expensive because it is least lightly to cause side-effects.
Betasone 0.1% cream is slightly less strong than elomet but cannot be used on the face (only to eczema on body, limbs).
Less strong than betasone is dermasone 0.05%.
Use dermasone 0.05% only to eczema on body, limbs. Not the face, neck, jointfolds.
Dermasone 0.025% is for eczema where the skin is more delicate, such as on the face, neck, jointfolds.

Very rarely do you find a doctor who is willing to take time to explain to you in such details, and I am glad I have found one. I feel empowered by such knowledge and safer when I know what I am applying to myself. Since that email, I have thrown away most of the steroids, leaving only a few good ones at hand in case of the next outbreak.

I know that there are many like me looking for help and answers. Hope these knowledge is useful to you too.

PS: I think oat baths work great for eczema too.

~~~~~~~~~~~~~~~~~~~~~~

Updated on 31st December 2015:

I was looking through the blog statistics and saw a jump in the viewership of this post. I just want to state here that if you are looking for solutions for your eczema and are considering using steroids, please PLEASE have a good read at the rest of my posts under the tag “ECZEMA”. This post was way before my son developed Red Skin Syndrome due to steroids. I sincerely wish that no one will ever need to suffer like he is currently. There are other natural ways to try to ease eczema, which I have mentioned in other posts. Even if one does not work for you, does not mean others will not.

I wish you good health.

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