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Hives vs. Eczema in a Toddler

My child was diagnosed with eczema (atopic dermatitis) at 2 months old.  He is now 16 months and it appears that most of his symptoms related to food allergies which makes me think it's more of a chronic hives/urticaria issue.   The dermatologist says that food allergies don't trigger eczema but when my son eats foods he's allergic to (eggs, wheat, dairy, peas, etc) he usually gets an immediate face rash, contact rash over hands, arms, etc and then is itching by bedtime.   We've eliminated offending food but wonder if we should still be applying either Elidel or triamcinilone to his rashes (along with lots of daily Vaseline) or go the oral antihistamines instead of these prescription creams?   Does one apply cream to hives or only give oral antihistamines?  Does it matter if he's getting treatment for eczema when it's really more likely hives?
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Avatar universal
Hi,

Atopic eczema (aka infantile e., flexural e., atopic dermatitis) is believed to have a hereditary component, and often runs in families whose members also have hay fever and asthma. Itchy rash is particularly noticeable on face and scalp, neck, inside of elbows, behind knees, and buttocks.

Recent studies provide hints that food allergy may trigger atopic dermatitis. For these people, identifying the allergens could lead to an avoidance diet to help minimize symptoms, although this approach is still in an experimental stage.

Reference - Kanny G (2005). "[Atopic dermatitis in children and food allergy: combination or causality? Should avoidance diets be initiated?]"

'Anti-itch drugs, often antihistamine, may reduce the itch during a flare up of eczema, and the reduced scratching in turn reduces damage and irritation to the skin.

They do not cure eczema, but are highly effective in controlling or suppressing symptoms in most cases.

For mild-moderate eczema a weak steroid may be used (e.g. hydrocortisone or desonide), whilst more severe cases require a higher-potency steroid (e.g. clobetasol propionate, fluocinonide).

Eczema can be exacerbated by dryness of the skin. Moisturizing is one of the most important self-care treatments for sufferers of eczema. Keeping the affected area moistened can promote skin healing and relief of symptoms.

Light therapy using ultraviolet light can help control eczema. UVA is mostly used, but UVB and Narrow Band UVB are also used. Ultraviolet light exposure carries its own risks, particularly eventual skin cancer from exposure.

The first and primary recommendation is that people suffering from eczema shouldn't use detergents of any kind on their skin unless absolutely necessary.

Dermatological recommendations in choosing a soap generally include:[citation needed]

* Avoid harsh detergents or drying soaps
* Choose a soap that has an oil or fat base; a "superfatted" goat milk soap is best
* Use an unscented soap
* Patch test your soap choice, by using it only on a small area until you are sure of its results
* Use a non-soap based cleanser
* Use plain yogurt instead of soap'

http://en.wikipedia.org/wiki/Eczema

Let us know if you need any further information.

Regards.
Avatar universal
My story is similar to yours - my 4 year old boy was diagnosed with eczema at a very young age, and we have had quite a journey with it all.  What I have learnt, that may help you with the particular dilemna you are facing is this...
The doctors now know that eczema is a hereditary condition and it exists because the child was born without the protective protein on their skin. It dries easily and cracks from being unprotected.  Imagine then that it is like a sponge, with no protective barrier, being ever exposed.  Over exposure to anything can lead the body to believe that the substance is `bad', thus presenting itself in a form of allergy.  To combat allergies in eczema sufferers, the skin needs to be intact.  I know how hard this is when the itching is so bad that they are constantly bleeding and scratched.  Wet bandages are fantastic and keep the prescribed creams on regularly throughout the day with loads of moisturiser.  I find that my son's allergies are manageable when his skin is not broken.  All that said, this routine did not work in the long run for us.  My son is now on Imuran, an immunosuppressant (chemo), for his eczema and his allergies are not as reactive as his skin is not broken.  I hope this helps alittle.  All the best.
S
p.s. Claratyne and other antihistimanes are also very important in maintaining both hives and eczema.  It is super important that the hard work you have put in during the day with wet bandaging etc is not undone at night - so Polaramine is good to be administered at night to help them sleep well.  Talk to your doctor too because the maximum dose on the box can be exceeded to ensure they sleep all the way through.  
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