Sunday, May 20, 2012

Looking good

We had a pediatric dermatologist appointment on May 15th and it went well. Of course on the day of the appointment, Max's skin was the BEST it had ever looked and well, im just glad that I took some pictures during the height of his breakout to show the experts what I was talking about without having to describe it. However, they just needed to see Max's cradle cap, feel his dry skin patches on his body, and see the odd non facial red patch to diagnose him as having seborrheic dermatitis on his scalp and atopic dermatitis on his body. Essentially just fancy words for eczema.

They prescribed this scalp oil called Derma-smoothe/Fs aka Fluocinolone Acetonide Topical Oil 0.01% for his scalp and said to use it prn to make him more comfortable. I was of course hesitant as all babies get cradle cap and eventually grow out of it right? but the the specialist said based on the scratch marks on his head, it would stop the itch and make him more comfortable. Also that this scalp oil was prn so i don't have to use it all the time, just when i notice that he's scratching his head plenty again. I THINK this has a steroid in it. I used it twice and his cradle cap is all gone. If the dry scalp comes back, I will probably use this if he starts scratching and bleeding again, but so far...there's small flaky scalp patches, but no further scratching.

For his face and body, they prescribed hydrocortisone 2.5% in aquaphor. To bathe him daily and apply cream to affected areas. I used it hesitantly for 3 nights and his face is all clear and body baby soft as it should be. YAY! But let me emphasize how hesitant i was to use the hydrocortisone especially since his skin cleared up 98% with the emollients i was using. Right now, we are just water bathing him for a few minutes as part of a night routine, still on his probiotics, and im still using the same california baby and aveeno cream. The prescription was really vague and even the pharmacy who made it didn't give me an clear cut answer. with all the stuff i've been reading about undertreating eczema and for it to come back once the steroids were stopped, i wasn't sure how i was supposed to use this cream...

use until i no longer see a rash? (gone in 1 day)
use until i no longer feel a rash (gone in max 3 days)
use until the container is done? (it's a big container)

I chose the "until i no longer see and feel a rash route." We have a follow up appointment in July.
I'm still not convinced that hydrocortisone is the best route if this is a chronic issue (which i hope it isnt). The doctor did explain the benefits of treating with the cortisone...blah blah blah..went way over my head, but it had something to do with "you don't need to use as much if you use it right." She also did say that his skin inbetween flareups was great, so this may just be something he'll grow out of but we won't know until that does happen. I still have no idea what caused it though! Ugh! Is it wrong to be in the medical field and not be comfortable with what the doctors are prescribing? At work, i freely (yet critically) give out so many meds and tell patients how important it is to comply...yet in my own world, it's a different story.

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