I have been following the same exact skin care routine with Corey for the past 755 days. Sans for a few missed sessions it has been minimally twice a day, each day for over 2 years. And the results speak for themselves, we went from 80% eczema covering his body to just stubborn spots on his big toe and upper lip.
It started on the 2nd of June 2016, our first meeting with Corey’s (now regular) allergist. That day, I learnt a lot about chronic eczema and allergies in young babies. I was also introduced to a simple, straight forward skincare routine for which I still follow today, even though Corey’s skin is mostly healed.
Now before you suggest outgrowing had a part to play in the healing, I agree nature is finally tipping the scales in our favour. However, every decent eczema mama caring for an itchy baby with any amount of rashes (even mild eczema) will not stand by doing nothing. Thus every eczema mama would benefit from the following 4 simple steps to healing skincare. I have also advised adults who have healed their eczema using a similar routine.
A Need for a Simplified Baby Eczema Skincare Regime
Up till that faithful day of the 2nd Of June 2016, I had tried everything to get Corey’s eczema under control. From wet wraps to dry wraps, bleach baths to sea salt baths, moisturising him every 3 hours. I tried different types of moisturisers. Layered on different moisturisers. Changed his detergents and stopped using wet wipes.
You name it, i’ve probably tried it.
These were (and still are) good methods to keep handy for eczema sufferers. However, the shear amount of time taken to follow through each and every method consumed all my time and energy. It was not only a physical drain, I became an emotional wreak from having to juggle so many different therapies where none seemed to work consistently.
Through countless days and hours spent on all these different strategies, I am happy to say I have now reduced Corey’s skincare to just 4 simple steps.
A combination of what I have learnt from Corey’s allergist, adapted with a detailed observation of Corey’s reactions and feedback from his skin healing process.
This skincare regiment is affectionally termed as ‘doing routine’ in our household. Done minimally twice a day, once after a bath and the second session as part of a wipe down bedtime routine.
Corey knows when it is time for his skincare as he gets to watch his favourite youtube songs which is my secret weapon for getting him to stay still for the whole process.
Step 1: Check skin and journal observations
Method: take photos and add notes to photos at the minimal. Journal detailed entries on skin condition and changes over time, diet, allergen exposures.
At it’s worse, the eczema was everywhere. Daily, I was desperately patching holes with a combination of steroid creams and moisturisers. One patch would heal and the next day another would turn up somewhere else. The erratic behaviour of his eczema was consuming me whole. So I started to write things down. First on notes in photos taken of rashes, then detailed daily entries and then tracker tables.
In part, the journal was started as a process to remember things Corey’s doctor would ask. It developed into a tool which helped me identify new triggers (house dust mite allergy at 1 year old), wean off steroid creams usage as I recorded how often and where we were using it. A surprising byproduct was the therapeutic effect it had on me to know I was on top of things that happened to Corey. It also gives me strength on bad days to look back on how far we’ve come from 80% eczema covered body to normal baby smooth skin.
So I journal and track Corey’s eczema to this day, even when his eczema is now confined to stubborn patches on his big toe and upper lip. I check his skin daily and note down his skin conditions, among other details.
Step 2: Clean skin and DISINFECT PATCHES if necessary
Method: Use cotton wipes to clean patches with cold chlorhexidine gluconate.
When you have eczema of any degree of severity, your skin barrier is defective and prone to bacterial infections. In the mildest forms, moisturisers might suffice to fix flaky dry skin. In the most extreme cases like Corey’s, the skin is constantly in turnover mode. Before the skin has had a proper chance to heal, the staph bacteria wreaks havoc again and cause the patches to stay infected and worse, spread. The way to get past this horrible vicious cycle, is to disinfect the skin with chlorhexidine gluconate.
The use of antiseptics is very common in eczema treatment. Similar therapies include bleach baths, sea salt baths and wiping with apple cider vinegar. It starves off the bacteria and gives skin a faster chance to heal.
I have tried the bleach baths and sea salt baths and apple cider vinegar too. Introduced by Corey’s allergist, chlorhexidine gluconate to me is the best option for babies and children. Reason being it does not sting like the rest so I do not worry that a non communicative baby will be in pain. The last thing you want is an angry baby or child who refuses to cooperate during the skincare regime. I put mine in the fridge so it is nice and cold and comfortable for Corey. I wipe any rash patch with a soft cotton pad much like cleaning off make up.
Related post: Read more about chlorhexidine gluconate – ezcema skincare beyond moisturisers.
Step 3: Apply Medicated creams (if necessary)
Method: ALWAYS follow your trusted doctor’s instructions on medicated cream applications. Ask about safe maximum dosage and frequency of use. Work your way down to lesser dependence as the skin heals.
I used to be terrified of steroids. Everyone and anyone who has had any form of skin issues has opinions on them. Even doctors gave me differing opinions so it is no surprise there is so much fear surrounding steroids. This is why finding that trusted doctor who knows his shit is the only way to ensure you are following the right treatment plan. The only way you are going to find that right doctor is through communication. If you get sketchy answers, it’s time to seek a second opinion. Keep asking till you are satisfied.
I know some doctors recommend moisturising before use of steroids. I am not a medical professional so the order of this step is purely instructions from our allergist. His take is that we need to have clean skin for the steroid to be more effective. And to moisturise only after the steroid has been absorbed into skin. Again, I would say follow your doctors trusted advice and take note of whether their method works and feedback if it doesn’t. In our case, his instructions work for us and has been what I have followed for the last 2 years.
I remember lamenting to Corey’s allergist about when will we be able to stop the steroids. His answer was clear and loud that as the skin heals and patches get smaller, we will use lesser and lesser. True to his word, we have been weaning steroid creams over the past 6 months to now very minimal applications, if at all.
Related post: How I use a bullet journal tracker to wean steroids usage Eczema Tracker October review and new November tracker 2017
Step 4: Moisturise generously
Method: The operative word is GENEROUSLY. Take no prisoners and cover everywhere. Pay special attention to stubborn areas. If your chosen product is too expensive and you find yourself using lesser than necessary, its time to research into another product.
After having found the one moisturiser that worked for us, I stopped the rest. I cover each and every inch of his small and growing body. I even double back on fingers and toes, behind ears and areas of folds where sweat and heat accumulates. We go through a 400ml bottle of his moisturiser in 2 weeks. Quick math will tell you that this can become a costly endeavour so weighing the cost versus efficacy of product is highly needed. You need a lot of patience and persistence to give a chosen moisturiser time to work. This means working with the product for at least a week or two to see if any visible improvements follows.
Conclusion: Why these 4 steps worked for us and how to adapt it to suit your own eczema
These 4 simple steps have been repeated day in day out for over 2 years. They have served us well for the following simple reasons:
Consistency produced consistent results
Because they are easy to follow and straight forward I was able to observe consistent results of improvements or otherwise. It became second nature to keep my journal, disinfectant and moisturiser handy every time I had to deal with some skin issue or when allergic reactions occur.
Easier time observing Skin Responses and anticipating skin changes
Because I developed a system for observing Corey’s skin and responses to the regime, I was also able to notice when something out of the ordinary happened. Like when he broke out in hives at 1 due to dust mite allergy. I didn’t know what is was then but I knew it was not his usual eczema. And when he happened repeatedly it was a sign I had to investigate further. Had I not been keenly taking notes I might have mistaken it for his usual eczema (since he eczema was already erratic) and missed diagnosing this new allergy of his.
Adapt and change as baby skin changes – but always keep it simple and consistent
I adapted the number of moisturising sessions and also the amount of steroid cream used on patches as his skin got better. I also stepped down the steroid strength when he skin permitted it through trial and error. The journal was a life saver for this as I was able to note down whether his skin was responding to lighter steroids or whether he needed it at all.
As he got better, I reduced our moisturising from four times a day to now twice a day. Now when his skin flares from a bout of sickness, I increase the number of moisturiser applications back to four to speed up his healing. Even on days when his skin is good I keep up the twice a day and never waver. The key is to adapt these 4 steps to whatever situation and severity your baby’s eczema is in.
As mentioned at the start, I know adults who have also benefited from these 4 steps. I even use it on my older son and myself when we get cuts and scabs.
See the thing with baby eczema is that it’s a constant learning process. Changes can happen faster can you react to. That’s why I stick to the same 4 steps. I stay focused and don’t get distracted with the 101 different therapies available out there. Give it a try and leave me a comment if you think it works or doesn’t for you. ______________________________________________________________________________________________________________________________________ Share or like this article and help others who are struggling with eczema or baby eczema. Connect with me at email@example.com if you are an eczema mama with similar struggles! Or follow our progress and get latest updates on new posts at my Facebook Page @projectsimplicitysg