4 month old baby with eczema since she was 1 month old, we are unable to control her eczema. What should we do?

Question

My 4 month old baby has had eczema since she was a month old. She has it on her face, neck, stomach, arms, back, thighs and behind her knees. We give her a warm bath every 3 days. We have tried several moisturizing creams (attitude for eczema, repairing balm for baby owls, cutibase, glaxal base, lipikar laroche posay) as well as Hyderm 1% and Elidel. With Elidel it diminishes, but it keeps coming back. She has respite for about 1-2 days. Is it bad in the long term to put Elidel cream twice a day for 3 months now? Her doctor tells us that it's normal because eczema doesn't go away? But a nurse clinician told us that the inflammation should go away for a few months and not only for 2 days. We don't know what to do anymore. Is this normal? Do you have any other tips or should we see a dermatologist? Yes, it's a great answer! Thank you very much!

Jean-Sébastien Lecompte · Accepted Answer

Hello, Your question includes several elements. I will try to answer each of them as precisely as possible Normally, a cortisone cream should not be used for more than 14 consecutive days. It is sometimes possible to exceed this period on medical advice or when the eczema is really badly controlled. Elidel cream, which is not cortisone, can safely be used for longer periods. This cream is generally prescribed for more refractory cases. Hyderm 1% cream, although safer for babies, is not very effective for more severe eczema. It is a relatively weak cream. For the affected areas on the face, I do not recommend using a stronger cream. For the rest of the body, I would tend to recommend a cream like Elocom 1%, which is low to moderate strength. Elidel is used more as a maintenance treatment. When there are still active lesions, it's best to increase the cortisone strength a bit and treat that episode properly Another pillar of eczema treatment is optimal hydration. I recommend Eucerin Original cream (there are several kinds, but it's really the big 450g jar with a red lid). It is the most moisturizing cream on the market. It has very few ingredients (vaseline-water-glycerin mainly). I have often had very interesting results with many patients with persistent eczema lesions. I hope this answers some of your questions Jean-Sébastien Lecompte, pharmacist