Treating eczema while nursing?

[Liziz]

Has anyone treated eczema (on yourself) while breastfeeding? I've had eczema for years....usually well-controlled w/o meds, but it flares up every once in awhile, and to get it back under control I've always had to use some pretty potent topical steroids for a couple months.

Well, I made it through pregnancy w/o any flares, but it flared up after DD was born, and has just been getting worse. I'm EBF at this point, and hope to keep nursing for quite awhile.

If you've treated eczema while nursing, what did you use? Almost all of both my legs are affected, so we're talking some pretty significant body surface area, I'm skeptical whether the high-powered topical steroids I've used in the past are safe. I'm seeing a dermatologist next month (gotta love derm waiting times), but wanted to go in prepared, because I know that many docs aren't that well-versed/comfortable dealing with med safety and nursing issues. TIA!

[Liziz]

Just bumping this to see if anyone has any thoughts or experience to share! Thanks...

[Trigglet]

I'm sorry to hear you're suffering - it can be so miserable! I developed eczema during pregnancy and it remained for a few months after I gave birth, so it was all new to me and it took four months of trying to deal with it myself before I was able to get an appointment with a derm. So, I know a little about OTC stuff too!

What worked for me when it was at its worst (so bad that it shocked the dermatologist - not really what you want!) was a combination of things:

- dilute bleach bath (about a cup of bleach in a cool bath) - helps kill the staph bacteria which is essential - weekly
- never having hot baths or showers - only short cool showers
- using non-soap cleansers - cetaphil, I think.
- applying a thin layer of steroid cream on the worst parts
- slathering myself in aquaphor when my skin was still damp
- repeat three times a day
- avoiding getting too hot and sweaty
- if you have really bad spots then wrap them in plastic wrap after you've applied the aquaphor.

When things started to get a little better (usually within a day or so) I would scale back the steroid cream over another day or so, and then just continue with the cool showers, weekly bleach baths and aquaphor on damp skin.

I had the same concerns as you about the steroid cream, but I was sooooo miserable that I decided it was better for me to be comfortable and happy and take the tiny risk that it might pose. I had the same feeling about the steroid inhaler I take for my asthma - as my OB said - it's more important that you're able to breathe!

I can't remember the name of the steroid cream I used, but I can dig it up later if you like. I do remember it was expensive, though!

[DrSally]

I would try the diluted bleach bath and aquaphor. I've used this on the kids. By diluted, i mean1/4 cup per bath.

[Liziz]

Thank you for the reply and suggestions! It's rough trying to decide between keeping myself comfortable and feeling like I'm doing the best thing for my DD. My appointment with the dermatologist is tomorrow, so we'll see...things have been getting worse lately so I may have to give in to a bit of steroids, too...it's good to hear you successfully used one, at least that means there's something out there that isn't too risky!

[Katigre]

Ugh, that is really hard. I have dealt with eczema over the years - i found it was tied partly into immune system reactions (it seems to be triggered when I get a vaccine, at least the last few times it got bad in my teens/early 20's were connected with outbreaks). Since the outbreak is bad right now it needs treatment, but once it's under control maybe there are ways to keep it from coming back.

I have found HUGE HUGE HUGE relief through diet changes - I haven't had to use a topical steroid in years since I cut out dairy/refined foods. If I eat a bunch then I get itchy again. The difference in my skin is amazing though - my entire neck and creases of each elbow used to have the eczema and the changes I made in my diet over the past 5 years have really taken it away altogether, even in the dry winter months.

I also do the skin-soothing strategies of layering lotion on before I get in the shower AND immediately after - that provides a better protective barrier than just doing it afterward. I also avoid all fragrances/perfumes/scented products in our home/laundry/skin care and that helps too.

[Aishe]

I also do the skin-soothing strategies of layering lotion on before I get in the shower AND immediately after - that provides a better protective barrier than just doing it afterward. I also avoid all fragrances/perfumes/scented products in our home/laundry/skin care and that helps too.

My legs are my problem areas as well and I have at times used triamcinolone on them while breastfeeding. Since it is sometimes prescribed to breastfeeding women for sore nipples I assume it must be fine in limited doses. And one of the ingredients of Jack Newman's all-purpose nipple ointment is Betamethasone, which is also a topical steroid. If you google Hale and topical steroids you'll find that he approves of low to moderate potency steroids for short-term use while breastfeeding.

But I highly recommend the strategy of liberally applying lotion both pre- and post-shower. Maybe use the steroids to get the flare-up in a more manageable state and then switch to the heavy moisturizing?

ETA: is your ob more accessible than the derm? S/he should be able to give you some guidance on this.