Posts Tagged ‘triamcinalon’

Should You Treat Eczema With Steroids?

Wednesday, April 25th, 2012

When my son developed eczema, we had been seeing a naturopath for his well-baby check-ups. Once we were sure he had eczema, she began to try different things to try to bring relief. She said we could use a little .5% hydrocortisone as needed, but to use it sparingly. She also discouraged us from using steroid cream of any kind, because, according to her, suppressing the reaction could make it go other places, such as the lungs, and cause other problems. Plus I had heard all kinds of stories, such as the eczema coming back worse when the steroids were done, and I was afraid that it would suppress the reactions so much that I wouldn’t be able to see when he was reacting to a new food.

At first, this arrangement worked okay. Because his eczema didn’t start with a bang, but built up gradually. However, I watched with increasing discouragement as it spread, starting with his face, then down his torso, and finally down his arms and legs. At the worst point, it was everywhere except for his hands and feet, but beginning to encroach on them.

By the time he was nine months old, I was a nervous wreck. I could barely function as wife and mother. Cleaning house was overwhelming. I just wanted to escape my problems, and there were times I would let him cry in the back room while I tried to cope by watching a movie or playing some game online. Going back to get him would just rind me of my helplessness to do anything for him, and it was more than I could take.

We decided that we needed to move closer to my husband’s work, and with the move came the decision to find a new doctor. We had reached our limit for alternative care with the insurance company, and naturopaths are expensive–not to mention that most of their treatments are not covered by insurance. A little research turned up Dr. Paul Thomas, a pediatrician who liked to integrate natural methods into his practice as much as possible.

One of the first things he did was encourage us to use more hydrocortisone. And I was to the point where I just couldn’t deal with the eczema anymore, so I started using it generously wherever he seemed irritated. I also started using 1% on his body and .5% on his face. We found ourselves spending $20 a month or more on this over-the-counter cream, but it helped. His face stopped weeping, and he became a happy baby again. Sure, he still reacted to food and scratched a lot, but he didn’t start rubbing his face in the carpet every time I put him down to learn to crawl.

We continued this regime for about a year, taking different tests and trying a few things the doctor recommended. When he was about a year and a half old, the doctor asked me if I would like to try a stronger steroid cream, just to help alleviate the symptoms a little more. This was the second time he had suggested this, and I decided to try it.

So for the next nine months, we used Triamcinalon, a medium-level steroid cream. And I learned some things during this time that I wish I had known when my son was younger.

  • A topical steroid only treats the current irritation; it does not prevent new reactions.
  • There are several levels of steroids; they are not all the same.
  • Eczema is most likely to break out on already irritated skin.
  • Stronger steroids should not be the first line of defense, nor the only treatment.

Let us look at these more closely.

Topical steroids do not prevent breakouts. I was under the false impression that if I used a stronger steroid than hydrocortisone, that if I cleared his skin up with steroids, then I wouldn’t be able to tell what foods he was reacting to. Nothing could have been further from the truth. Sure, if I had been giving him oral steroids, this might have been the case (I will discuss oral steroids in a future post). But a topical steroid cream or ointment only treats current symptoms. It does nothing to prevent an outbreak. So I could still see when he was reacting to foods, depending on the severity of the allergy and the amount of food consumed.

Not all steroids are created equal. When we visited an allergist,I learned something about steroids that the no-steroid advocates had failed to mention: there are various levels of steroids. Hydrocortisone is the weakest steroid, and the difference between .5% and 1% is the concentration of the drug, not a different drug. We even used 2.5% hydrocortisone for a while–this was only available with a prescription. Triamcinalon is a medium level steroid. There are 5-7 levels, depending on whom you ask, and most doctors will prescribe the lowest level that gets results.

Eczema tends to show up on already irritated skin. So many mothers and natural doctors on the Internet were saying to avoid steroids at all cost, but after I started using hydrocortisone more liberally, I realized that he was much more likely to have a reaction on already irritated skin than he was to break out on healthy skin. As his skin healed, the irritation reduced from basically all over to select spots here and there. As a result, I was able to use less steroid cream, because I didn’t need to use it all over, but only on the irritated areas. At this point, a good moisturizing routine began to really help too. It hadn’t made much difference back when he was at his worst.

Not first line of defense, nor only treatment. If someone develops eczema, using steroids should not be the first line of defense, nor should it be the only treatment. Not that you shouldn’t use a little hydrocortisone as needed (and you definitely should moisturize–sometimes that is all that is needed), but rushing out to get a strong steroid prescription right at first is probably not a good idea. You need to take a look at possible causes. In some cases, cutting a particular food out of the diet or getting rid of all chemical cleaners in the home will clear up the problem. In other cases, such as my son’s, the root of the problem is very deep and obscure. Most doctors in traditional practice are content with controlling the symptoms and never bother to look for the cause. That is why we keep going back to a naturopath: we are gradually identifying the cause and we are seeing results to such an extent that we haven’t needed the medium-level steroid cream for over a year. But I’m glad we used it when we needed it.

In summary, I do not believe that steroids should be avoided at all costs. I believe that the lowest level may be used to treat symptoms while the cause is being searched for. I also believe that topical steroids are a better choice for treatment of symptoms than oral steroids, though oral may be needed temporarily in a very severe case. Treating the symptoms will not cure the eczema, but it will make life bearable while the root cause is being sought out. Because “the curse causeless shall not come” (Proverbs 26:2); there is a cause for every disease, though it may not be readily discernible.

What has been your experience with steroids? Have you avoided them entirely? Used them liberally? Somewhere in between or back and forth? Please share your experience in the comments.

My Baby Has Eczema: The Cause Found and the Healing Begun

Tuesday, August 9th, 2011

It has been 5 months since the last post, and a lot has happened. Before I fill you in on the results of the stool test, what we did as a result, and the results, let me briefly review our journey with my son’s eczema for those who don’t have time to read all the posts from the beginning.

He developed eczema at 1 month old. It was diagnosed around 3 months, and we tried to avoid all steroids, even hydrocortisone. But he was a really miserable little baby. We tried everything, even goat’s milk formula (turned out all¬†dairy is off limits, not just cow), and I restricted my diet to the point of frustration until he was weaned at 12 months. We added Triamcinalon, a medium-level steroid around 18 months just to control the symptoms, and not long after that we started to see a naturopath who was recommended by his pediatrician. When I ended the last post, we were waiting on the results of a stool test.

Test Results

The results came late in February. For insurance reasons, they were sent to his pediatrician, and we received a copy in the mail as well, which we shared with the naturopath at the next visit. It just so happened that my son got a bad cold that turned into bronchitis just after the test results arrived, and before the scheduled naturopath’s visit–which I think got delayed for some reason, probably the cold. My husband took him (since I think I was also feeling under the weather at the time), and the pediatrician went over the results of the stool test.

In a nutshell, he had a gut full of pathogenic bacteria. Which confirmed his suspicion that the source of the eczema was in his gut.

Let me explain a little. You may have heard about beneficial bacteria in the gut. They help to digest food and do other things. They coat the surface of the intestines. If they are killed off and yeast (such as candida) is present, the yeast will multiply to fill in the gaps. On the other hand, they can be killed off by pathogenic bacteria–and they had certainly been doing that, because showed almost no beneficial bacteria in the test at all, in spite of all the probiotics he had taken for the past year. There were also neutral bacteria, neither beneficial nor harmful, but taking the place of the good bacteria.

The doctor, of course, prescribed antibiotics to treat the bronchitis. Normally I would have hesitated, but when I realized that some of the pathogenic bacteria was susceptible to the antibiotic, I figured this would be a way of killing two birds with one stone!

Not long after we met with the naturopath. He reviewed the test results and explained them to me. He asked us to up the Infaskin probiotics that had already proved to help him so much, to counteract the antibiotics. I think he also upped the Vitamin D from 1,000 IU to 2,000, because he felt Manny could be getting a little more of that.

On a side note, the results for the parasite test came in later, and they were negative. He also showed a little yeast, but it didn’t seem to be a significant problem. Especially since he eats mostly gluten-free grains and I sweeten his home-made rice or teff milk with stevia, so his sources of sugars are quite limited.

What Happened As a Result

Just around the time the antibiotic treatment finished, a tree fell on our house. It was quite a disaster, and we’re still not back in our home almost 5 months later. That was March 15th. We spent the next 10 days living with some friends in their house nearby, and during that time, we used the Triamcinalon for the last time. We haven’t used it since.

Over the months since then, I have watched my son’s skin steadily improve. He went from breaking out in small patches most everywhere to breaking out only on his tummy, face, neck, groin, and folds of elbows and knees. And in the last month I haven’t noticed anything on his tummy. I ran out of the prescription 2.5% hydrocortisone and bought some 1% at the drug store recently. I remember when we would go through a 2 oz. tube in a week, but now I think that tube will last us a couple of months–and I don’t use it every day, at least, not on the same spot two days in a row. He scratches less. He’s a happy little 2-year-old when he’s not having a melt-down. And he’s steadily improving. At the last visit with the naturopath–back in May, I think–he didn’t change anything about his treatment and scheduled his next appointment for September, saying to only call if he got worse or stopped improving. Which he hasn’t.

So that’s the latest. He’s not cured, but he’s on the way. It’s going to be a while before we start trying things we have eliminated from his diet, though we occasionally try new things (like parsnips–he likes them and they don’t cause a reaction, yay!).

So now it’s your turn. Share this story with others or share your story. What have you done that has worked? What didn’t work? Every case is unique, and what worked for Manny might not work for the next reader. But what worked for you might. If you would like to share your story here as a post instead of just in a comment, let me know!

My Baby Has Eczema: Trying Natural Methods Again

Friday, February 4th, 2011

Last week I shared about how we found a new doctor when we moved and eventually started using the steroid Triamcinalon. Once the pediatrician had exhausted his store of resources, and after a couple visits to an allergist proved that we were already doing everything conventional medicine had to offer, we decided to try a naturopath recommended by the pediatrician.

Dr. Dramov in Tigard

Dr. Dramov has got to be one of the nicest doctors I have ever met. Unlike your average MDs, he greets his patients in the waiting room and goes with them through every step of the visit. If he has an assistant other than the receptionist, I haven’t seen one. He acted like he has all day, asking me several times per visit if there is anything else I want to ask–very thorough.

During the first visit, he went over Manny’s history of eczema and asked what we were giving him. Then he asked me to try several things: upping the probiotics he was already taking, adding quercitin, switching from the digestive enzyme we were using to one with ox bile in it, and adding in evening primrose oil. We were to make one change per week, and to not add the next thing if we noticed improvement.

Well, we did our best, but nothing made the slightest difference. I had gotten him to where I was using the Triamcinalon only every other day most of the time, but I couldn’t taper off more than that. He would just get worse if I tried.

B12 Shots and a New Probiotic

At the next visit, he told me that he had just been to some kind of medical convention to learn more about the treatment of eczema. He said there were two things that seemed to help that we weren’t already doing: B12 supplements, either sublingual or shots, and a special probiotic called InfaSkin. He had ordered the InfaSkin, but it hadn’t arrived yet. My husband picked it up later.

He asked me how I wanted to do then B12. Because I wasn’t sure how well the sublinguals would work on such a small child (by this time he was just weeks away from his second birthday), I opted for the shots. He showed me how to give them, doing the first one himself. Then he sold me the tiny vial of serum and enough insulin syringes to last a month. I bought a sharps container at the drug store, and have since gotten so good at them that my son actually likes his daily shot!

It was almost two weeks after that visit that my husband was able to stop and get the InfaSkin probiotics. We started him on them on a Tuesday or Wednesday. Within two days, I knew they were doing something; I hadn’t reached for the Triamcinalon since his first dose! In fact, he was able to go 4 or 5 days without it–his longest stretch ever! I still used the hydrocortisone 2.5%, but I was actually using less of it. As you can imagine, I was thrilled! This was the first non-drug anything to actually make a difference!

Further Tests

At this second visit, the doctor also ordered stool and blood tests. We will get the results of those tests at our next visit, which will be next Friday

A couple of weeks after starting the Infaskin, I received samples of Renew lotion. Rather than repeat myself, I’ll just refer you to the post that tells what results Renew had on my son.

This brings the story up-to-date. I will continue to post updates as they occur. Now it’s your turn. Would you like to share your story? If so, please contact me; I would love to publish others’ stories here on this blog.