Worried about flare up after Prednisolone

[Stacey]

Hi,

My 3 year old daughter has been put on a 5 day course of Prednisolone as her eczema got so sore and infected, antibiotics did not work. She has her last dose tomorrow and I am worried that she is going to have a big flare up when she has come off it. She was so bad before, it looked like she been burnt on her face and groin area, and behind her legs would weep and crack making it hard for her to walk. We have finally got a referral to an allergy clinic to see if she is allergic to anything, but waiting for appointment. I really hope she does not get sore like she did a week or two ago, her doctor nearly admitted her to hospital.

I would be very greatful if anyone could share their experiences with me so I know what to expect.

Also I have not been giving her Cetirizine at night whilst on Prednisolone incase they reacted, but she is hardly sleeping on a night due to the itching, does anyone know if it is safe to give them together?

Thank you,

Stacey x

[Becky Dennis]

Hi Stacey

I'm really sorry your little girl is suffering at the moment. Do you have steroid creams at home too? i am not sure about the big flare up after oral steroids, however my understanding is that with strong steroid creams you need to wean them off them slowly or else another flare is likely.

So i wonder if it would be wise to have the steroid cream handy? What we have been told with the creams is to use them daily until all areas are clear then every other day and then twice a week. If the skin flares then you step up to once a day again. I know it doesn't feel ideal. Then try to get onto milder creams of 1 percent. Not sure if that is helpful for you. I am sure someone else will be along with more advice soon....It is also apparently ok to put the steroid on broken cracked skin (which i hadn't realised). The specialist told us that.

I'm glad you have an allergy referral. We are waiting on one too...
With regard to the meds question i am not sure. You could ring/go to your chemist though as they will be able to tell you if you can use the two together. i don;t see why you couldn't though. As ultimately sleep should help her itching and help you to cope better too.
Hugs. I know how tough it is
xx b

[Stacey]

Hi Becky,

Lucy is on 3 different steroid ointments (Hydrocortizone for her face, Eumovate and Betnovate RD for everywhere else). The Betnovate works well but a day or two after I stop applying it, her skin gets bad. The nurse at the hospital said use Betnovate for 5 days then the milder on for a few days after that, but it still comes back again so it seems silly plastering her with all the steroid creams for it to just come back as bad again.

I am trying 2 different creams / balms from Greenpeople at the moment as all her emolients make her flare up and the Greenpeople suncream in excellent, it even helps her skin to heal.

Thanks for your help,

Stacey x

[AnnaB]

Hi Stacey
Speak to a chemist they will know what can be mixed or call NHS direct they can advise. Would piriton/chloraphenamine be a better night option as it can make you sleepy. My children are allowed to take cetirizne and piriton together. Plus my daughter is on a third anti histamine which is used for it's sedative effects.
When we are struggling to control a flare we are told to use the steroids for 2 weeks to heal deeper skin layers. Also it is better to use a stronger steroid to gain control faster than keep using mild steroids a lot of the time. It sounds like you need an urgent medication review with the dermatologist.

Good luck
Anna

[Paulapip]

Hi Stacey
I'm in the same boat for my 2 nearly 3 year old.
He's always had a small tiny patch of eczema behind his knees and arm creases. I used the steroids cream Alphaderm far to much to keep in at bay. And i knew when he had certain dairy products he flared up. So back in Jan i replaced all his dairy product with Soya based products, which made him flare up ten times worse, and he caught the hepes Virus infection (Eczema Herpeticum) Which the doctors did not pick up till to late, and he ended up in the childrens hospital for a week on a course of IV steroids.
Since then we have been back and forth to different doctors/ Dermology dept but to no real help. Feel like my son is being used as a human gunnie pig with all the new creams they give us to try. He has just finished another 7 day course of prednisolone today, and as like you say i feel that once again the flare up will come back. They have reccomended he goes on a 6 month course of azatrhioprine, this is the same drug that people are given to stop there immune system rejecting a new organ. the side effects are nasty. They say he needs to go on this to suppress his immune system because it is on overdrive and making his eczema react to most common foods and viruses, but i am doing my hardest not to end up down this road.
I pushed for a allergy test, which took 3 months! But in order for your child to have the skin prick test your child must be free from any antihistamine and steroid cream for 3 days prior. So by the time we arrived for the test he was red raw and itching no stop, he left a trail of dead skin when he was sitting. They had to do a blood test in the end as there was no area to do a skin prick test. So far we are waiting on results, but they have said that most things are showing, especially tomatos/ strawberrys and dust mites. He is off all what they have mentioned, but had to change things like capol and his pirtion as they are strawberrys flavoured.
He is back at nursey today with his wet wrap comfort suits on which he hates, i feel better when he's there as i think children need those social skills , plus i work full time shift work. but i know how and what you are feeling, every day is a battle, and i have a crying session maybe every two weeks as the sleep deprevation gets to me. But finding this forum and hearing that i am not the only one makes me feel i'm not alone in this battle. I've lost faith in the medical profession, i hope it's something he will grow out of, and we get some more results from the allergy test. Please if you need help, don't think your alone x

[AnnaB]

Hi Paulapip
I too was offered the immune supressing drugs for my son but turned it down. It really is a mind blowing position to be in. It is so tough to find someone who understands. I'd stick to your guns and the allergy testing route. Ask for a dietitian to do a full exclusion diet with you. Have you been offered patch testing? It is good to know if the creams your putting on are making things worse or not.
Anna

[EMozley]

Hi Stacey! I am curious how your child reacted after stopping the Prednisolone? My 5 yo daughter is on a course currently to reduce her current flare, which has been out of control for the last 3 months. We were given a very long taper period for the same reason as your fears - a re-bound flare. She is also on a sulfur-based antibiotic for the current infection.

We have battled this terrible disease since she was born. The ezcema just doesn't get any better, if anything it is getting worse. We have had skin-prick tests, blood work (RAST) and patch testing. All show she is allergic to many, many things from environmental to food. It is almost impossible to keep her away from all the triggers. We are waiting for the results of the latest blood work test to see if anything has changed since the last one over a year ago.

We constantly are treating symptoms, which is incredibly frustrating. I just want her to feel good and good about herself. For antihistamines, she takes 5mg Cetirizine twice a day. At night she takes Hydroxyzine, which does seem to help calm her anxiety of being alone with the itch. Has anyone here been given or tried Dioxepine? This is something our docs are talking about trying, but I don't like the side effect profile and am curious what other's experiences are.

Lastly, one thing that I have noticed with her skin is the loss of pigment in her legs and arms from either the eczema, the steriod use or a combination of both. She is fair skin, but in the summer when she is outside, it becomes particulary noticable and it just breaks my heart. Good luck to all and it is good to know that we are not alone!!