Eczema, Skin Allergies, Hydroxyzine & Toddlers

[GinaG3]

Just to say I'm not after medical advice here, I have had that already. I'm after anyones experiences with this drug as I'm struggling to find experiences online in the UK.

My daughter has always had eczema, involving severe flares, she is 4.5 years old. Some people may be familiar with another of my long threads regarding eczema and toddlers. We are now using frequent steroids of varying potency low-high with short lasting results. We have strict skin regimes in place and are following the advise to the letter of a dermatology specialising GP.

Over the last few months things have got completely out of control with all over body breakouts including the face, eyes, neck, ears, whole torso and back. She scratches 24-7 with no let up even at night and is generally irritable. Along with the GP we are considering an environmental allergen such as pollen contributing to the outbreaks in her skin.

She is taking daily antihistamine already which is doing nothing to curb the rash or the itch symptoms. Today we have switched to a new antihistamine and been prescribed a sedating antihistamine for the night time. It is this sedating antihistamine (Hydroxyzine) I would like to know anyones experiences with, especially in a child my daughters age or younger? Pharmacy are having to specially order it as its not regularly carried and is prescribed in less than 1 in every 10,000 prescriptions in the UK.

Once again I am not looking for medical advice just good old experiences.

Thanks xxx

[WorkingMummy]

Wow.

Have no experience of that drug.

But just wanted to express concern and support as all three of my children have eczema. I think my most severely affected, at her worst, was about 70 percent as bad as what you are describing (which was bad enough). Really feel for your daughter and you.

If it helps at all, my younger two children are on non-sedative antihistamines for hay-fever and although the benefits are slightly hit-and-miss, I haven't noticed any bad side effects. Sorry, not much help.

All the best. Keep us posted.

Poor little thing!

[GinaG3]

Thank you WorkingMummy.

Its such hard work and torture to see her in such distress. I'm fine with the general antihistamine as a lot of people, children included, take them with no serious or long term side effects or risks so will continue with them as usual. I think its just the sedation side of the new antihistamine and the fact its so rarely prescribed, it also has other uses in the medical field which I'm weary of. Sometimes as a parent you are just faced with such hard decisions about whats right and wrong for your child, for and against medical advise. Its a really difficult situation especially when your already stressed, sleep deprived and feel like you cant protect or soothe your child. I'm just trying to remain positive and reassure her everything is alright.

[keane]

My eldest had severe eczema as a baby until about 4 then he gradually outgrew it which was lucky for him tho recently at age 9 it has started to come back a bit. I remember when he was smaller the constant cycle of scratching and discomfort and creams then starting all over again - and trying to find the 'reason' was so tiring. I found dr Elizabeth Higgins the head of the dermatology unit at kings very helpful u can get a referral to her through your Gp. I ended up on a regime of low dose steroid and epaderm or pure potion which u can get online from a little company in Brighton & seemed to work well. Currently I'm using the dermalex cream from chemist on northcross rd which seems better than most of the other emollients I've tried but comes in a tube rather than a tub so doesn't last as long. I also did dairy free for a while with him as he was worse when having lots of dairy but obviously that's different for everyone - hope it improves soon -the heat must be difficult at the moment..

[WorkingMummy]

Yes the equation is really hard: powerful drug you are nervous to use, versus the fact your child is suffering. I felt that way about high dose steroids and antibiotics, which were necessary in my daughter's case but which i was very reluctant about at first. (V glad I did it now.)

I'm no doctor but I do know the agony of a child with cracking bleeding skin and/or round the clock itching all over. Unless the possible side effects were as serious as, say, possible rapid organ failure, I would try the drugs prescribed, at least short term. The drug is probably rarely used because the situation you are in is rare.

Could you return to/call the prescribing doctor and agree a plan as to how long you need to try the drug before ditching it if no sign of improvement? (My experience of anti-histamines is that they work within 24 hours. Of course, you'd need to build in time to allow signs of repair to the skin on top of that. But I wouldn't try indefinitely.)

Really feel for you.

[WorkingMummy]

- deleted : duplicate post

[WorkingMummy]

Gina, I've now googled the drug you mention. I can 100% see your point!!!

But your little girl must be suffering very acutely for the medics to think she needs such a powerful drug to help her sleep. Which can only underline how much she needs it. I also see that, unlike other sedatives, it's allegedly non-addictive and shares "none of the toxicity problems" of other drugs used for the same therapeutic reason in psychiatry. At least, according to wiki. :-/

I would still do it, but agree a plan re length of a trial period first.

If it's any consolation I had to take a full on sedative for about a week when 8.5 months pregnant, to help me sleep during an incredibly stressful situation at home. Baby as bright as a button, no harm to him at all.

[GinaG3]

We did use this last night after much deliberation as the pharmacy could get hold of it quicker than they thought. After 30 minutes she was her usual hyperactive self, trying to contain her to an area incase she just passed out asleep was near impossible. No sedative effect felt, finally sleeping at 10.30pm, still scratching here and there overnight and kept opening her eyes every time she turned over. Allowed to be smother her face in cream though if I got at least one good thing out of it. I wouldn't use this drug continuously just in times of hardship (for her sake, of course) I think. Her dad is happy with whatever choice I choose, thankfully.

Tonight I will try it again as she is still very bad in her face, but aim to give it a few hours earlier. This is definitely not eczema we are suffering with right now, it is a severe allergic reaction in her skin. Cant wait to be seen within by community dermatology but cant book until next week.. ARGH!

Thank you both x

[Saffron]

Actually, this drug looks like it's rarely prescribed b/c it's largely been overtaken by newer antihistamines. Hydroxyzine is quite an old drug with a lot of research and data behind its use for a variety of treatments. However, for its use as an antihistamine, it's mainly been superceeded by new antihistamines which don't cross the blood-brain barrier and are more selective for their targets.

It's confusing/misleading to refer to this drug (or any drug) as 'powerful'. Drugs are more accurately described in terms of 'potency' relative to other drugs in the same category, and 'selectivity' for the receptors with which the drug interacts.

In this case, hydroxyzine is a potent, non-selective antihistamine. In layman's terms, it hits several different receptor systems including histamine receptors, and it does so more effectively than other antihistamines. Its non-selectivity for histamine receptors means that it has a variety of side-effects which could be undesirable for general use as an antihistamine, due to interacting with other receptor types in addition to histamine (and considering that newer more selective antihistamines are widely available). However, its high potency means that it can act more effectively at smaller doses than less potent, selective-type antihistamines. And, at smaller doses, side-effects would be less likely to occur and would take longer to appear.

So although this is not a common drug, I can't see any reason pharmacologically speaking why a short course of this drug would present any serious problems. I agree with WM, a plan of action for trial length of taking hydroxyzine is probably a good idea. Were you given a short prescription with directions to check back with the GP or specialist by prescription's end?

[GinaG3]

Yes, I have seen the drug has been around for 54 years. I have done extensive research on the drug itself, that is readily available. What isn't is experience of people using the drug in the UK, especially in children. I can find few experiences from the US where it is slightly more widely prescribed.

We were prescribed 200ml to be administered in a single 5ml dose at night in the hope that next week we can be seen my community dermatology nurse next week. This is on top of a 5ml daily dose of cetirizine in the morning, where 7.5ml chlorphenamine wasn't working. I have to wait until tuesday to do choose and book for this appointment because of the referral having to go through triage.

Feeling so desperate, had to pick her up early from pre-school today because she was highly irritable, angry and frustrated. They are hugely concerned about her, as are we. No let up in the severity of the rash covering her face and neck mostly. Her skin around her eyes is so dry despite 3 times daily moisturising it is like sand paper and peeling also. I've just never seen her this bad ever even in the height of summer or when we've been dealing with bad skin infections. Its truly heartbreaking.

[Saffron]

UK data may be less available for a variety of reasons. There are bigger data pools in the US and Canada compared to the UK, and it may be cheaper to run trials there. Pharmacokinetics and toxicology would be very, very similar among these populations, so other countries like the UK would generally able to base their prescription policies on such data. In addition to which the UK runs a Yellow Card Scheme for reporting adverse drug events. So although the majority of research in some cases may be completed abroad, adverse drug events are collected from within the UK.

[Gooders79]

Poor little girl, sounds awful... No experience here so sorry, is it worth a trip to paeds a and e if you're having to wait so long for the dermatolgy appt? I can't remember how long we waited to see Zoe goss, community dermatology nurse but I think I was a couple of weeks, she was excellent and has helped hugely with our son but your situation at the moment sounds like it shouldn't wait at all...

[GinaG3]

Gooders, I've considered A&E as I do consider it an emergency and urgent situation but don't know how they would see it or if they could do anything?! Its like a rock and a hard place. I genuinely just don't know whats going on with her just feeling on my own with no-one to turn to for help right now.

[Gooders79]

I think they would see her and take it seriously, I'd feel really let down by kings if they didn't... Maybe early tomorrow morning when it might be quiet? If you need reassurance about any aspect of her management I think it is entirely appropriate to seek that...

We saw David atherton consultant paediatric dermatologist at the Cromwell with our son, appts every Tuesday and Friday I think. We were lucky to be able to go on our health insurance attached to partners work but he was very reassuring.

[Saffron]

If your gut is saying it's urgent, I'd go to the A&E. Even if they don't change any meds, you'll at least have received a complete second opinion and lots of reassurance. Xx

[keane]

I am wondering if it might be worth asking your Gp if they can get u an urgent appointment with dr Higgins at Kings? She has been there for years & I found her very helpful with my son when he was bad. Or you could phone kings dermatology dept & see if she does any private work & pay for a one off consultation but then try and get put back on her nhs list? Might be worth a go.

[DenmotherSmith]

Hi GinaG3

My son had six months on Hydroxyzine (10mg/5ml) when he was seven. It was to bring a very severe case of hypersensitivity under control and stop him scratching at night. I found we had to time the dose just right or else he was very difficult to rouse in the mornings. It did make a great difference and brought his skin to a level where the topical steroid and dermabase could actually work, after six months he was moved on to levocetirizine at a quite low dose and we have really turned a corner. He has many scars but inflamed skin is at an all time low, with one or two very small patches only on his legs (was whole body before) I feel such a relief seeing it clearing. We also spent weekends at the beach and I found paddling in the sea really has helped those last patches recently. He was treated by dermatology specialising GP at the surgery on Burbage? Road, Herne Hill.

I really hope your daughters starts skin improves soon, it can feel like such a relentless battle.

X

[WorkingMummy]

Hi again GinaG3.

Still feeling for you and your little girl.

I am sorry that the drug did not give her and you the sleep you both so desperately need.

But don't give up on it. And it sounds to me like - even if you only use it for a short time - you should use it continuously, not just as and when for its sedative effects. What DenMother says - as well as being hugely reassuring and hopeful - illustrates that the drug might well kick in to help with improving your daughter's skin. Do you think this will work unless the drug is given a continuous stretch in which to work? And in light of Saffron's explanation that the drug is nowhere near as scary as a google search makes it sound to a lay person like me, I would give it a good (but finite) innings before ditching it as a possible answer.

How difficult for you and your daughter! I am now re-categorising the level of gravity of my own children's eczema in my mind, several levels downwards.

[Ginster]

Sorry to hear about your daughter's eczema.

I just wanted to suggest something incase you haven't tried it.

After just suffering a few isolated patches I randomly got eczema nearly all over me in 2000 and as well as trying dermatologist suggestions and steroids I also tried a few other alternatives, some more successful than others (for example Sudocreme just made it worse). I can't be sure if this is the one that helped the most but it was after using it that things completely cleared up (and there are also quite a few testimonials on their website).

http://www.beewild.com/

Looking at the site they also have an infant version of the cream I got (I used the one in the green jar)

Good luck and hope it clears up or improves soon!

[GinaG3]

Thank you all. Lots of good info! Your all great xxx. Another night of Hydroxyzine, better last night, full nights sleep with barely any itching. AMEN! Left her to sleep this morning and didn't send her to preschool, they completely understand that it probably is best to focus on getting her better right now as opposed to her attending. Her attendance is terrible, she is probably home more than she is there but I cant help that! House is on complete lock down today to try and eliminate pollen entering, no windows open just fan circulating air in the living room as its so hot in here. We awoke to a swollen eye this morning, so I immediately tried to contact surgery who booked me in for a telephone consultation. Doctor wants to see her again this evening to see what else can be done as she doesn't feel anything will be achieved at A&E. She is fine in herself, running around happy, playing, just looks terrible. Scratching here and there but nothing major. Moaning about any cream being put on it now, even just her usual Diprobase.

[GinaG3]

GP has agreed to a hopefully urgent referral to be seen under Dr Higgins at Kings. Urgent referral should see a wait of no more than 4 weeks as opposed to 11 weeks from what I can see on their website. Fingers crossed. Choose and book system wasn't working today but hopefully the referral will be sent ASAP and I can be seen by community while we wait.

[WorkingMummy]

So happy to hear this - about the relief of sleep and the referral.

Well done. You must be exhausted!

[Trish]

I've seen Dr Higgins for psoriasis over the years - I've had it for 25 years now. She's the only doctor i've seen who has properly listened to me and prescribed ointment that can sometimes clear it up entirely but at worst manages the condition adequately. I'd highly recommend her and I sincerely hope your daughter and you find something that offers some relief. Skin conditions are miserable, particularly for little ones.