After getting our pediatrician's approval, I hurried home to register with Dr. Aron. In addition to a brief history of Penny's condition and the details of her current treatment, I sent off these (and a few other) pictures to Dr. Aron.
|Her knees actually look pretty good in this picture.|
Before Dr. Aron, they were often red all over. She scratched them every time she went potty.
|Her face was often redder than this picture shows.|
Her skin is still very dry here.
Dr. Aron prescribed a compounded mixture of Vanicream, a topical steroid, and an antibiotic and instructed us to apply sparingly 4 times a day. Our mix had 30 g of steroid to 300 g of Vanicream, to give an idea of the level of dilution we're talking about although it does vary from patient to patient. We could easily go through this amount of steroid in a week or two before if she was flaring a lot, so the amount didn't concern me.
The unaffected areas we were to leave alone. No other moisturizers or anything. That was a little scary when we were used to slathering on Vanicream many times a day, but I knew I could email him if it wasn't working.
My husband and I did the first application together so that we would both be treating the same areas every time from then on. We made sure to get any spots that had flared recently or that she itched frequently even if they were currently clear.
"Apply sparingly" took us a few days to get the hang of since we were used to the soak and seal method of spreading lotion on as thick as icing after a bath. We didn't mind the change at all because Dr. Aron's method is much cleaner.
Penny's glasses aren't constantly smudged with lotion anymore. We don't have lotion stains on all our clothes.
Penny's one week update pictures:
|Pardon the goofy eyes, but look at that clear skin.|
And it stays this way!
|These little hands didn't flare once.|
Now, we had been able to clear some of these spots before with undiluted topical steroids and wet wrapping, but some areas like her hands would only stay clear for a day or so before flaring again. Her face used to change hourly some days. This time they stayed clear.
Clear is skin is well and good, but I was still used to seeing her scratch perfectly clear skin. After all, eczema is nicknamed by many "the itch that rashes."
I can't tell you how many times her hands have been clear only for me to find her rubbing them raw. I used to check on her all the time, not to see if she was up to mischief like most parents of three-year-olds do, but to make sure she wasn't tearing holes in her skin.
The itch I'm describing most of us have not experienced. Some adults with eczema have described the itch as "bone deep" and from watching the way Penny used to tear at her ankles and wrists, I can only imagine that's what she felt. Once the skin is red and inflamed, many also say it burns.
Sometimes Penny hid to scratch so I wouldn't stop her. Sometimes I didn't look because I didn't want to try.
Doctors have told some of us eczema parents that our children scratch clear skin "out of habit." Dr. Aron says it's because of staph.
Well, after only a few days on Dr. Aron's treatment, we quit giving Penny Atarax to sleep at night because, as Penny said, "I'm not so itchy anymore!"
Five little words. But they mean so much when itching is all she has ever known.