eczema

my 2y/o has eczema. He has been on wescort which helped for a little while, then his MD switched him to desonide cream.  His skin is starting to have discoloration and is not getting any better. Is there something else you recommend in terms of diet or creams and ointments. His skin looking bad around his wrist,elbows, and behind his knees. Pleae help!

[HVM M.D. - EV]

Dear Trina
     Thank you for your question about your son.  As you probably know - eczema is a chronic condition - which sometimes requires constant care. Most often a mild to moderate strength steroid cream or ointment (like Westcort or Desonide) can control a child's eczema, but not always.  Sometimes vigorous lubrication with a neutral lotion - applied daily (or even twice a day) to wet skin - yes, WET skin - can help.  The idea is to trap in the moisture - and then use the steroid cream as needed.  Sometimes a stronger steroid cream is prescribed for a short term - just to break the cycle.  Other times a diet change can make a difference - as in removing dairy, or at the very least, by restricting dairy products.  Once in a  while a short course of antibiotics can temporarily improve the eczema.
     If your son is having pigment changes and his knees, elbows, and wrists are also being affected - I would suggest taking him back to his doctor to reevaluate his eczema.  It might be that your son would also benefit from seeing a Pediatric Dermatologist to help your doctor in designing a treatment plan. Meanwhile - I would suggest using neutral soaps, mild detergents - if you aren't already doing so.  If your son is scratching - consider using antihistamines, like Benadryl, at night.  Whatever you choose to do - I would encourage you to work with your child's doctor - since he/she knows your child best.   Hope this helps.  Dr. EV

[t]

i just realized there is great info on eczema in the archives. Sorry for the inconvenience.