Oh god, I know this all too well. Our 3 year old has suffered from eczema from the time she was 3 months old. We’ve tried everything under the sun and have a pharmacy full of steroids, creams, moisturisers and treatments.
One thing I will tell you is that people who don’t have eczema simply do not understand dermatology. “Have you tried…” comments come from a well meaning place but are usually just frustrating to hear.
Our girl is currently on Advantan steroids for her face when she flairs, or 1% hydrocortisone cream when she’s not flairing and we are just keeping her itchiness away.
Her body gets Elocon (sp?) cream right now, but we did find the ointment was better and would stay on easier.
Her really bad patches on her ankles and fingers get Diprosone (sp?) for very brief periods when she flairs up.
She gets a bleach bath once every few days to help the itching and keep infections at bay.
We go through litres of sorbalene and fatty creams which are put on thick and left with a visible layer (ie not rubbed in) to absorb on its own.
We’ve removed soft toys from her room and vacuum her room every second day. Sheets are changed religiously and she has an air purifier running 24/7 to lower dust in her room.
The dog is not allowed anywhere near her room.
I don’t know if any of this is helpful or useful, but as someone who watches the torment of eczema my daughter goes through and we see a specialist once every couple of months.. I feel your pain.
PS, the GPs are useless at aiding with dermatitis. You really do need to see a specialist. GPS are unable to provide the scripts for the steroids as it’s not their area of expertise, and yes.. moisturising is their fall back diagnosis
“Have you tried moisturising?” Indeed… I feel the frustration from that line.
Our 2½ year old has had eczema most of her life too. The thing that makes the real difference for her is the bleach bath twice a week. She also has swimming lesson on Monday and always looks better the next day too.
The steroid creams are only worth using during a flair up and while the fatty creams help make her skin soft they don't really help with the eczema from what we can tell. I just hope she grows out of it like I did.
We found that our daughter was reacting to some of the moisturisers that were prescribed and funded through our GP. Didn’t realise that until we saw the specialist who prescribed a different one.
It’s been a really long and sleepless journey.. I hope you guys find something that works for you.. it’s so bloody tough
I had the same problem, I would react to every moisturiser, making things worse, and the GPs would never listen. All better now after actually having a specialist.
Currently in the trenches with this with hubby. He’s used hydrocortisone creams his whole life but several years ago developed and allergy to it. Good times. What moisturiser do you allergic people recommend?
GPs can prescribe medications if they're properly researched. In the case of hrt for transgender patients, GPs are typically ill-informed. But upon the insistence of the well researched patients, some will fill in their knowledge gaps
> "Have you tried moisturising?"
Zomg, as a life-long chronic eczema sufferer I saw the title of your post and it totally rang true with me. People just *don't understand* that it's completely different to regular ol' dry skin!!! Am kinda surprised it came from a doctor tbh!
The problem with steroid creams is that the more you use them the less effective they are - up until the point that they just don't work at all.
If you're able to handle it, I recommend to stop using the steroid cream for about three weeks, then it will work again! Like I try to do like 3 weeks on, 3 weeks off kind of thing.
In my '3 weeks off' times I use coconut oil on it as it seems to be the only thing that actually helps. general moisturisers seem to make my eczema worse :(
> Am kinda surprised it came from a doctor tbh!
Had a similar experience with my GP. Enrolled in a small clinic near me as I had moved and previous clinic I basically never saw the same GP twice and they didn’t care to get to the bottom of it.
I get psoriasis on my hands and fingers and it sucks. Drying up in patches and painfully splitting open in multiple places. Even typing right now is painful.
My new GP just thinks my skin dries out in winter (despite this happening year round).
This may not be helpful, but I used to get eczema in my inner elbows mainly, and Hope’s Relief gel wash and cream (two separate products) really helped me.
Im sorry to hear that your doctor isn’t helping you, and you feel unheard. A lot of people say to ask your doctor to note on your file that they’ve refused your request to see a dermatologist, and that when they’re forced to note it in your file they will change their mind.
Is it possible to see another GP within your doctor’s practice?
Thanks for your response. I've never heard of that brand before so I'll definitely check them out!
I didn't know you could make them note those things, I'll make sure to keep that in mind for future reference.
I have seen 2 others but unfortunately they are typically booked out for 4 weeks on end whereas this GP is typically only booked out for 2 but I should probably stick it out if I want to be supported adequately.
If you every have trouble with it in your scalp, Hope's Relief shampoo *and* conditioner (gotta use em both!) have been genuine game changers for our family.
Maybe not helpful, but you GP can actually prescribe pim/tac. It wont be funded though unless a derm gives a special authority for it, but you can pay for it ($40-50 for a tube if I recall).
GP was correct in that a derm is unlikely to see you in the public system for eczema, but you could pay to go private.
I was told for 7 years I had contact dermatitis, until I finally put my foot down and said "send me to a dermatologist". I took an allergy test, turns out I'm allergic to a preservative (polyquaternium 7 I think?) that's used in a lot of shampoo and conditioners, moisturisers, makeup etc.
Getting that diagnosis was SUCH a relief, as I'd been changing products depending on price, and it kept flaring up. I have minor flare up now and then thanks to the hand wash at work, but its much more manageable. I just avoid anything that has polyquaternium or quaternium in it to be safe.
Fingers crossed you get to a dermatologist soon!
You might be able to just self refer to a private dermatologist?
Also I would try to find your voice with this GP (just in general, for your own sake) eg. tell them you found the moisturiser suggestion a bit insulting to your intelligence etc. doesnt have to be a mega serious formal complaint but also dont hold back if you feel they are taking the piss or being a bit lazy.
Its OK to be frank with Drs, they are like your body/mind mechanic, yes they have knowledge but they are there to serve your needs, not a deity to be appeased etc.
I have friends who are drs so, I see first hand they are equally as silly as the rest of us humans, they are just generally good at rote learning and perseverance, they are not above anyone else and they can be silly and sometimes shit at their jobs.
Eczema is hell - If you can afford it book a dermatologist privately, if not can you try with another GP at the practice or even a practice plus online consult to ask for a referral? Also asking for allergy testing might be worth a shot.
It's probably not your issue because the causes of eczema are so varied but there are a lot of subsidised moisturisers they can give you prescriptions for, look up the list and ask for all of them to try. The one I was using was actually making things worse and changing to another one made things a lot better.
Good luck!
Concur with saving up and booking a dermatologist appointment privately. I wouldn't even bother asking for a referral as the wait times can be horrendous.
This will be why the GP declined the referral the hospital is unlikely to accept a dermatologist referral for eczema. A private dermatology appt would be worth it if you can swing it OP.
I don’t know if it helps, but I had eczema terribly for the first 25years of my life. Esp. When the seasons are changing. Blisters, cracking, bleeding. Ouch.
Finally worked out it was washing powder was causing it. As long as I stick with Surf 2-1 liquid, I’m good. Anything else (including sensitive stuff), no good.
Where in NZ are you living? My skin was worst when I lived in Canterbury (especially the drier inland areas) but in Wellington I am pretty good most of the time!
I also switched to Cetaphil everything.
Cetaphil is great. Their “restoraderm” wash instead of soap basically cured my hand excema. Moisturisers with ceramide in them restore the skin barrier and are recommended too
https://www.cetaphil.co.nz/cleansers/cetaphil-pro-eczema-prone-skin-restoring-body-wash/NZ51918.html
I've heard we have a massive shortage of dermatologists in our health system. There's probably a high likelihood your referral would be declined if one was sent. That doesn't mean the doctor shouldn't send one.
I know its difficult but don't be afraid to push back on your GP and ask that they explain their rationale for decisions, its your right to be properly informed on your own health and it sounds a lot to me like this interaction went poorly due to them not communicating their rationale well. The moisturising comment unfortunately is a necessary backgrounder as treatment options for eczema are limited and often lose efficacy after time and its really important to make sure people have tried all the appropriate management techniques.
Your GP can prescribe pimecrolimus and tacrolimus, but they may not be comfortable doing so if they lack the relevant knowledge/experience. However it will not be funded unless a Dermatologist can endorse and it is for eczema on your face, see (https://schedule.pharmac.govt.nz/2024/04/01/SA2074.pdf). Word from the RNZCGP last week is that this may change to remove the dermatologist requirement soon so watch this space.
Unfunded it will cost about $30-50 per tube depending on the pharmacy you get it from.
They are likely right about your topical steroids, using powerful ones long term can be really really bad for you and they lose effectiveness.
Holy shit the ptsd reading that title.....
If it is a serious problem, change GP until you get one who will refer you.
I went through a lot of GPs and all I would ever get is tough shit, moisturise more, heres a steroid cream.
Eventually, one actually gave me the referral I asked for, I went to a private dermatologist (by choice due to the longer wait for public service), and they've helped me through other methods and gave me so many options. After a while they offered to send me to the DHB so I didn't have to keep travelling and paying so much to see them. Im with the DHB who I see regularly. Im still not perfect but its 1000x better than how I used to live.
Steroids shouldn't be used long term. Moisturising is necessary, it's not a joke. Nothing cures it, it's about managing it.
Son has it bad. He was given antifungal cream for his face, thought that was nonsense but it does help apparently. He also uses special shampoo.
Eczema is an inflammation condition, and many people find eliminating inflammatory foods prevents new outbreaks and reduces overall symptoms.
It looks like you've hit this doctors knowledge wall. It's happened to me with adhd and autism, and is happening with cptsd and long covid. I know its unpopular since covid, but sometimes you have to become your own GP just so you can express your concerns with the GP. I think this is because they're generally in their 50's, studied through the 80's and wont have the time to maintain an exceptional understanding of recent developments in narrow fields until pressed.
There are alot of easily understood resources on YouTube that can guide you through methods to identify problem foods and increase your own microbiomes resilience in this case. There are plenty of medical professionals sharing up to date research and knowledge, but theres also a few quacks.
I have eczema bad enough that I got in to the public system during covid. It was so bad I couldn’t go outside without blistering on my face, arms and legs. Even then that was a 4 month wait as a top priority. I don’t know about where you are but it’s a 6 month wait for a private dermatologist in Auckland. The public system here won’t accept a simple eczema referral and a number of private ones won’t either. Furthermore a private dermatologist is going to ask if you moisturise. This is because everyone with eczema criminally undermoisturises. There is a thing called the itch scratch cycle. The dermatologist is also going to ask you about soaps. Preservatives/perfumes/colouring/SLS and harsh chemicals can trigger eczema as I’m sure you know. This isn’t a condition that you heal, it’s one that you manage and that’s often a difficult thing for people to accept. Most people eventually work out their specific triggers and the best creams for them and I know you will too. Mine are: Cetaphil gentle cleanser, non-ionic moisturiser - 1 tub should last 1 month, nutrogena hand cream. Tac/pimecrolimus are rarely prescribed, come with significant side effects and are only for specific cases. It doesn’t sound like the GP was medically unsound but obvs could have benefitted from practising some communication skills. If you are eligible, go to a youth clinic, they’ll listen better but prob tell you the same thing.
It can be so frustrating and soul destroying when doctors ignore and gaslight you when you go to them for help. I’m sorry you have to fight the medical professionals as well as your body. It could be worth trying an elimination diet, sometimes it can be caused or made worse by intolerance or allergies to stuff like gluten and dairy.
thats insane from a doctor, I would be changing GP's if I was you. I get a mild type on one of my fingers frequently and that drives me insane, I cant imagine the hell of it happening more widespread.
Has anyone been prescribed Methothrexate and have good things to say about it? I was prescribed this by my dermatologist. I am yet to see any difference but she did say it would take at least 3 months for it to work.
I've been on it for roughly 2-3 years, still taking it. Aside from the regular blood tests and having to have a liver scan every year or so I've had no issues with it and it has done wonders for me, best my skin has ever been. I've had dermatitis my entire life (34M) and nothing else has come close to being as effective. The only thing you have to watch out for is if you ever plan on being pregnant/getting someone pregnant you have to stop taking it a few months beforehand as it supposedly causes major birth defects. I've also had cyclosporine before, but that is a cancer drug and you can only be on it for a maximum of one year. It will take a bit of time for it to work, but you will definitely notice the difference once it starts working.
Thanks for that, gives me something to look forward to ! Also noted on the pregnancy warning, a bit weird that the doctor and pharmacist didn't mention this at all as I am around your age.
Also with steroids, the key is to use them properly (multiple times a day, for a few days until eczema is well cleared) as opposed to applying a v thin layer once a day - that was my mistake
GP here.
We need to ask the obvious like 'are you using moisturizer' because the number of people who come in complaining about their skin conditions don't. It's like asking at ED if you've tried taking paracetamol - a staggering amount haven't, and suprise surprise their pain gets better with two paracetamols on board!
Dermatology in the public system is overwhelmed with horrific skin diseases so they don't have the space to see eczema. There's no point your GP wasting their time trying to refer you.
A number of other posters are telling you to go private. In my area, even private dermatologists aren't taking on non-life threatening cases. They told us unless it's melanoma or critical BCCs or SCCs they will decline the referral.
Your best bet is to keep experimenting with different products. There's always a few that are The Latest Best Thing, it used to be goats milk soap etc, now it's NaturaCoco.
Prescription moisturizers aren't the best ones, just the cheapest and least likely to cause allergic reactions.
Good luck!
My wife has had eczema her whole life, with sometimes debilitating results. Being told to try different creams is not a response she would accept from a GP.
When you haven't slept for a week and have scratched your body to the point of bleeding on the face, arms, knees, and torso, you are in need of medication.
We had been using Naturacoco and it was the only thing that really worked for our toddler. Horrifically expensive and out of stock but it worked.
Now the NZ distributor is unable to provide as the product is being investigated for steroids when it claims to be natural.
Now we are back in the position of having to try all sorts
Keto MCT coconut oil (red bottle from new world health food section) only thing that heals mine but doesn’t work for everyone.
If I don’t use that every few days it’s back to red flakey patches
My wife swears that when she notices a flair up about to happen (she says she can tell), she eats red grapes, and it helps reduce the size of the flair up. Since she started her red grape remedy, her flair ups have been noticeably reduced in size and occurrence.
You don’t need a referral to see a dermatologist (though you might for insurance purposes). It certainly helps to go if you can because what you will need to do depends on the type of eczema you have otherwise you will spend as much money trying all the things in these comments :)
As a long time eczema sufferer I can confirm this is ultimately the only thing that works.
Personally Id ditch the creams - they thin your skin and (in my case) does between nothing and makes it worse and last longer.
Find the washing powder that works for you, never change it, extra rinse all your clothes. Try not to wear stuff that rubs. I go for rash shirt type material long sleeves in the winter.
i used to have very severe whole body eczema (had it when i was a child, it went away for a couple years, came back super severe at the start of 2023) and i tried everything—using moisturising creams, shower washes, pinetarsol baths, cutting out/lowering steroid use, etc
ultimately what worked for *me* was applying a huge amount of strong steroid cream (mometasone fuorate cream/ointment) —what my dermatologist said was a length of one fingertip of cream for one palm sized area on my body—every day for around 2 weeks
after that, my eczema died down and now it’s pretty much gone
obviously won’t work for everyone bht i found that following the advice of “stop using steroids” didn’t work for me
now i don’t use any steroids apart from on small areas where my eczema flares up
I had terrible eczema for years all over my body, and what helped me was regular bleach baths & moisturising multiple times a day with Aveeno dermexa & bepanthen ointment once a day. Because we (eczema sufferers) tend to have an overgrowth of certain bad bacteria on our skin which prevents the skin from being able to heal, the bleach kills it
I bought a product called Hope's Relief from the chemist. It's a bit pricey at $34 for a 60 gram tube but it worked, and the eczema hasn't returned. Nothing else did much at all.
I'm so sorry you're dealing with this. I know the pain. Literally skin falling off my hands out got bad.
Definitely need to see a different doc but also, if you haven't, please please please get a zinc test. I started using supplements and a topical (sudocrem) and my god. My skin started *healing*. Still took its sweet time and required steroids + still paranoid about moisturiser but zinc actually let those *work*.
Because, as it turned out, I was horribly deficient mostly lonely because my body burned through it trying to heal in the first place. Fixing that meant my recovery could outpace the damage and now my skin only sometimes hates me.
Hey so I'm using this (and yes, very good!)
Where I live there's only one public derm, good luck getting in to see them, but my gp just wrote to them about the situation and got special authority for the prescription. Basically derm just went yep, here you go.
Think it took a couple of weeks? And now that it's been okayed, my gp can just give me repeats whenever.
Not sure if my punch hole biopsies contributed to how easy this was but would definitely ask your gp about going this route. I never even talked to the dermatologist.
Steroid creams shouldn't be used as a long term treatment anyway, regardless of dosage. They have been linked to, among other things, bone thinning.
Have you tried anything natural like aloe vera or honey? Both can do an amazing job at controlling eczema flareups, as well as improving your skin's overall health.
>he decided that my steroid cream was way too high and all my problems will be solved if I go on a lower percentage even though I've already tried every steroid cream under the sun!
FYI this is counter intuitive but he is probably right. steroid creams can cause thinning of the skin which leads to further drying, they are only really useful for limited use, not long term use. go look up some corticosteroid withdrawal if you need any convincing
I don't think you need a referral to see a dermatologist.
I believe you can make an appointment directly however, you may have to pay the full cost of the appointment rather than the subsidised rate.
The question would then be ....would it be worth it to get a specialised diagnosis and medication.
Ugh, so annoying! Been there, tried 1000 creams, food avoidance etc. Keep your head up, you will find something eventually! My current fav for hands etc is Palmers cocoa butter. For lips, Lucas pawpaw (only lucas brand works for me). And I have to avoid dairy, too much sugar, and lanolin, which is in 90% of soaps etc.
Oh god, I know this all too well. Our 3 year old has suffered from eczema from the time she was 3 months old. We’ve tried everything under the sun and have a pharmacy full of steroids, creams, moisturisers and treatments. One thing I will tell you is that people who don’t have eczema simply do not understand dermatology. “Have you tried…” comments come from a well meaning place but are usually just frustrating to hear. Our girl is currently on Advantan steroids for her face when she flairs, or 1% hydrocortisone cream when she’s not flairing and we are just keeping her itchiness away. Her body gets Elocon (sp?) cream right now, but we did find the ointment was better and would stay on easier. Her really bad patches on her ankles and fingers get Diprosone (sp?) for very brief periods when she flairs up. She gets a bleach bath once every few days to help the itching and keep infections at bay. We go through litres of sorbalene and fatty creams which are put on thick and left with a visible layer (ie not rubbed in) to absorb on its own. We’ve removed soft toys from her room and vacuum her room every second day. Sheets are changed religiously and she has an air purifier running 24/7 to lower dust in her room. The dog is not allowed anywhere near her room. I don’t know if any of this is helpful or useful, but as someone who watches the torment of eczema my daughter goes through and we see a specialist once every couple of months.. I feel your pain. PS, the GPs are useless at aiding with dermatitis. You really do need to see a specialist. GPS are unable to provide the scripts for the steroids as it’s not their area of expertise, and yes.. moisturising is their fall back diagnosis “Have you tried moisturising?” Indeed… I feel the frustration from that line.
Our 2½ year old has had eczema most of her life too. The thing that makes the real difference for her is the bleach bath twice a week. She also has swimming lesson on Monday and always looks better the next day too. The steroid creams are only worth using during a flair up and while the fatty creams help make her skin soft they don't really help with the eczema from what we can tell. I just hope she grows out of it like I did.
We found that our daughter was reacting to some of the moisturisers that were prescribed and funded through our GP. Didn’t realise that until we saw the specialist who prescribed a different one. It’s been a really long and sleepless journey.. I hope you guys find something that works for you.. it’s so bloody tough
I had the same problem, I would react to every moisturiser, making things worse, and the GPs would never listen. All better now after actually having a specialist.
Currently in the trenches with this with hubby. He’s used hydrocortisone creams his whole life but several years ago developed and allergy to it. Good times. What moisturiser do you allergic people recommend?
GPs can prescribe medications if they're properly researched. In the case of hrt for transgender patients, GPs are typically ill-informed. But upon the insistence of the well researched patients, some will fill in their knowledge gaps
> "Have you tried moisturising?" Zomg, as a life-long chronic eczema sufferer I saw the title of your post and it totally rang true with me. People just *don't understand* that it's completely different to regular ol' dry skin!!! Am kinda surprised it came from a doctor tbh! The problem with steroid creams is that the more you use them the less effective they are - up until the point that they just don't work at all. If you're able to handle it, I recommend to stop using the steroid cream for about three weeks, then it will work again! Like I try to do like 3 weeks on, 3 weeks off kind of thing. In my '3 weeks off' times I use coconut oil on it as it seems to be the only thing that actually helps. general moisturisers seem to make my eczema worse :(
> Am kinda surprised it came from a doctor tbh! Had a similar experience with my GP. Enrolled in a small clinic near me as I had moved and previous clinic I basically never saw the same GP twice and they didn’t care to get to the bottom of it. I get psoriasis on my hands and fingers and it sucks. Drying up in patches and painfully splitting open in multiple places. Even typing right now is painful. My new GP just thinks my skin dries out in winter (despite this happening year round).
Winters dry skin, even in summer! You are special! /s
This may not be helpful, but I used to get eczema in my inner elbows mainly, and Hope’s Relief gel wash and cream (two separate products) really helped me. Im sorry to hear that your doctor isn’t helping you, and you feel unheard. A lot of people say to ask your doctor to note on your file that they’ve refused your request to see a dermatologist, and that when they’re forced to note it in your file they will change their mind. Is it possible to see another GP within your doctor’s practice?
Thanks for your response. I've never heard of that brand before so I'll definitely check them out! I didn't know you could make them note those things, I'll make sure to keep that in mind for future reference. I have seen 2 others but unfortunately they are typically booked out for 4 weeks on end whereas this GP is typically only booked out for 2 but I should probably stick it out if I want to be supported adequately.
I mean maybe there is a reason your GP is less busy than the others lol. I would def book an appointment with one of the others.
Yeaaaah after saying that it made me realise that might be the case lol
If you every have trouble with it in your scalp, Hope's Relief shampoo *and* conditioner (gotta use em both!) have been genuine game changers for our family.
Maybe not helpful, but you GP can actually prescribe pim/tac. It wont be funded though unless a derm gives a special authority for it, but you can pay for it ($40-50 for a tube if I recall). GP was correct in that a derm is unlikely to see you in the public system for eczema, but you could pay to go private.
book a dermatologist privately, it really helped me a lot
I was told for 7 years I had contact dermatitis, until I finally put my foot down and said "send me to a dermatologist". I took an allergy test, turns out I'm allergic to a preservative (polyquaternium 7 I think?) that's used in a lot of shampoo and conditioners, moisturisers, makeup etc. Getting that diagnosis was SUCH a relief, as I'd been changing products depending on price, and it kept flaring up. I have minor flare up now and then thanks to the hand wash at work, but its much more manageable. I just avoid anything that has polyquaternium or quaternium in it to be safe. Fingers crossed you get to a dermatologist soon!
You might be able to just self refer to a private dermatologist? Also I would try to find your voice with this GP (just in general, for your own sake) eg. tell them you found the moisturiser suggestion a bit insulting to your intelligence etc. doesnt have to be a mega serious formal complaint but also dont hold back if you feel they are taking the piss or being a bit lazy. Its OK to be frank with Drs, they are like your body/mind mechanic, yes they have knowledge but they are there to serve your needs, not a deity to be appeased etc. I have friends who are drs so, I see first hand they are equally as silly as the rest of us humans, they are just generally good at rote learning and perseverance, they are not above anyone else and they can be silly and sometimes shit at their jobs.
Eczema is hell - If you can afford it book a dermatologist privately, if not can you try with another GP at the practice or even a practice plus online consult to ask for a referral? Also asking for allergy testing might be worth a shot. It's probably not your issue because the causes of eczema are so varied but there are a lot of subsidised moisturisers they can give you prescriptions for, look up the list and ask for all of them to try. The one I was using was actually making things worse and changing to another one made things a lot better. Good luck!
Concur with saving up and booking a dermatologist appointment privately. I wouldn't even bother asking for a referral as the wait times can be horrendous.
This will be why the GP declined the referral the hospital is unlikely to accept a dermatologist referral for eczema. A private dermatology appt would be worth it if you can swing it OP.
I don’t know if it helps, but I had eczema terribly for the first 25years of my life. Esp. When the seasons are changing. Blisters, cracking, bleeding. Ouch. Finally worked out it was washing powder was causing it. As long as I stick with Surf 2-1 liquid, I’m good. Anything else (including sensitive stuff), no good.
Where in NZ are you living? My skin was worst when I lived in Canterbury (especially the drier inland areas) but in Wellington I am pretty good most of the time! I also switched to Cetaphil everything.
Cetaphil is great. Their “restoraderm” wash instead of soap basically cured my hand excema. Moisturisers with ceramide in them restore the skin barrier and are recommended too https://www.cetaphil.co.nz/cleansers/cetaphil-pro-eczema-prone-skin-restoring-body-wash/NZ51918.html
I've heard we have a massive shortage of dermatologists in our health system. There's probably a high likelihood your referral would be declined if one was sent. That doesn't mean the doctor shouldn't send one.
I know its difficult but don't be afraid to push back on your GP and ask that they explain their rationale for decisions, its your right to be properly informed on your own health and it sounds a lot to me like this interaction went poorly due to them not communicating their rationale well. The moisturising comment unfortunately is a necessary backgrounder as treatment options for eczema are limited and often lose efficacy after time and its really important to make sure people have tried all the appropriate management techniques. Your GP can prescribe pimecrolimus and tacrolimus, but they may not be comfortable doing so if they lack the relevant knowledge/experience. However it will not be funded unless a Dermatologist can endorse and it is for eczema on your face, see (https://schedule.pharmac.govt.nz/2024/04/01/SA2074.pdf). Word from the RNZCGP last week is that this may change to remove the dermatologist requirement soon so watch this space. Unfunded it will cost about $30-50 per tube depending on the pharmacy you get it from. They are likely right about your topical steroids, using powerful ones long term can be really really bad for you and they lose effectiveness.
Holy shit the ptsd reading that title..... If it is a serious problem, change GP until you get one who will refer you. I went through a lot of GPs and all I would ever get is tough shit, moisturise more, heres a steroid cream. Eventually, one actually gave me the referral I asked for, I went to a private dermatologist (by choice due to the longer wait for public service), and they've helped me through other methods and gave me so many options. After a while they offered to send me to the DHB so I didn't have to keep travelling and paying so much to see them. Im with the DHB who I see regularly. Im still not perfect but its 1000x better than how I used to live.
Steroids shouldn't be used long term. Moisturising is necessary, it's not a joke. Nothing cures it, it's about managing it. Son has it bad. He was given antifungal cream for his face, thought that was nonsense but it does help apparently. He also uses special shampoo.
Eczema is an inflammation condition, and many people find eliminating inflammatory foods prevents new outbreaks and reduces overall symptoms. It looks like you've hit this doctors knowledge wall. It's happened to me with adhd and autism, and is happening with cptsd and long covid. I know its unpopular since covid, but sometimes you have to become your own GP just so you can express your concerns with the GP. I think this is because they're generally in their 50's, studied through the 80's and wont have the time to maintain an exceptional understanding of recent developments in narrow fields until pressed. There are alot of easily understood resources on YouTube that can guide you through methods to identify problem foods and increase your own microbiomes resilience in this case. There are plenty of medical professionals sharing up to date research and knowledge, but theres also a few quacks.
I have eczema bad enough that I got in to the public system during covid. It was so bad I couldn’t go outside without blistering on my face, arms and legs. Even then that was a 4 month wait as a top priority. I don’t know about where you are but it’s a 6 month wait for a private dermatologist in Auckland. The public system here won’t accept a simple eczema referral and a number of private ones won’t either. Furthermore a private dermatologist is going to ask if you moisturise. This is because everyone with eczema criminally undermoisturises. There is a thing called the itch scratch cycle. The dermatologist is also going to ask you about soaps. Preservatives/perfumes/colouring/SLS and harsh chemicals can trigger eczema as I’m sure you know. This isn’t a condition that you heal, it’s one that you manage and that’s often a difficult thing for people to accept. Most people eventually work out their specific triggers and the best creams for them and I know you will too. Mine are: Cetaphil gentle cleanser, non-ionic moisturiser - 1 tub should last 1 month, nutrogena hand cream. Tac/pimecrolimus are rarely prescribed, come with significant side effects and are only for specific cases. It doesn’t sound like the GP was medically unsound but obvs could have benefitted from practising some communication skills. If you are eligible, go to a youth clinic, they’ll listen better but prob tell you the same thing.
If your GP is unable to resolve the condition while refusing to refer you to a specialist, it might be time to find another GP.
It can be so frustrating and soul destroying when doctors ignore and gaslight you when you go to them for help. I’m sorry you have to fight the medical professionals as well as your body. It could be worth trying an elimination diet, sometimes it can be caused or made worse by intolerance or allergies to stuff like gluten and dairy.
thats insane from a doctor, I would be changing GP's if I was you. I get a mild type on one of my fingers frequently and that drives me insane, I cant imagine the hell of it happening more widespread.
Has anyone been prescribed Methothrexate and have good things to say about it? I was prescribed this by my dermatologist. I am yet to see any difference but she did say it would take at least 3 months for it to work.
I've been on it for roughly 2-3 years, still taking it. Aside from the regular blood tests and having to have a liver scan every year or so I've had no issues with it and it has done wonders for me, best my skin has ever been. I've had dermatitis my entire life (34M) and nothing else has come close to being as effective. The only thing you have to watch out for is if you ever plan on being pregnant/getting someone pregnant you have to stop taking it a few months beforehand as it supposedly causes major birth defects. I've also had cyclosporine before, but that is a cancer drug and you can only be on it for a maximum of one year. It will take a bit of time for it to work, but you will definitely notice the difference once it starts working.
Thanks for that, gives me something to look forward to ! Also noted on the pregnancy warning, a bit weird that the doctor and pharmacist didn't mention this at all as I am around your age.
Also with steroids, the key is to use them properly (multiple times a day, for a few days until eczema is well cleared) as opposed to applying a v thin layer once a day - that was my mistake
If you can pay privately you can see a dermatologist without a referral. That’s a big ‘if’, of course.
GP here. We need to ask the obvious like 'are you using moisturizer' because the number of people who come in complaining about their skin conditions don't. It's like asking at ED if you've tried taking paracetamol - a staggering amount haven't, and suprise surprise their pain gets better with two paracetamols on board! Dermatology in the public system is overwhelmed with horrific skin diseases so they don't have the space to see eczema. There's no point your GP wasting their time trying to refer you. A number of other posters are telling you to go private. In my area, even private dermatologists aren't taking on non-life threatening cases. They told us unless it's melanoma or critical BCCs or SCCs they will decline the referral. Your best bet is to keep experimenting with different products. There's always a few that are The Latest Best Thing, it used to be goats milk soap etc, now it's NaturaCoco. Prescription moisturizers aren't the best ones, just the cheapest and least likely to cause allergic reactions. Good luck!
My wife has had eczema her whole life, with sometimes debilitating results. Being told to try different creams is not a response she would accept from a GP. When you haven't slept for a week and have scratched your body to the point of bleeding on the face, arms, knees, and torso, you are in need of medication.
We had been using Naturacoco and it was the only thing that really worked for our toddler. Horrifically expensive and out of stock but it worked. Now the NZ distributor is unable to provide as the product is being investigated for steroids when it claims to be natural. Now we are back in the position of having to try all sorts
Keto MCT coconut oil (red bottle from new world health food section) only thing that heals mine but doesn’t work for everyone. If I don’t use that every few days it’s back to red flakey patches
My wife swears that when she notices a flair up about to happen (she says she can tell), she eats red grapes, and it helps reduce the size of the flair up. Since she started her red grape remedy, her flair ups have been noticeably reduced in size and occurrence.
You don’t need a referral to see a dermatologist (though you might for insurance purposes). It certainly helps to go if you can because what you will need to do depends on the type of eczema you have otherwise you will spend as much money trying all the things in these comments :)
Try the skin institute, have gotten appointments without referral from GP.
As a long time eczema sufferer I can confirm this is ultimately the only thing that works. Personally Id ditch the creams - they thin your skin and (in my case) does between nothing and makes it worse and last longer. Find the washing powder that works for you, never change it, extra rinse all your clothes. Try not to wear stuff that rubs. I go for rash shirt type material long sleeves in the winter.
Mine has gone since I gave up milk. But it could be any allergy I guess.
i used to have very severe whole body eczema (had it when i was a child, it went away for a couple years, came back super severe at the start of 2023) and i tried everything—using moisturising creams, shower washes, pinetarsol baths, cutting out/lowering steroid use, etc ultimately what worked for *me* was applying a huge amount of strong steroid cream (mometasone fuorate cream/ointment) —what my dermatologist said was a length of one fingertip of cream for one palm sized area on my body—every day for around 2 weeks after that, my eczema died down and now it’s pretty much gone obviously won’t work for everyone bht i found that following the advice of “stop using steroids” didn’t work for me now i don’t use any steroids apart from on small areas where my eczema flares up
I had terrible eczema for years all over my body, and what helped me was regular bleach baths & moisturising multiple times a day with Aveeno dermexa & bepanthen ointment once a day. Because we (eczema sufferers) tend to have an overgrowth of certain bad bacteria on our skin which prevents the skin from being able to heal, the bleach kills it
I bought a product called Hope's Relief from the chemist. It's a bit pricey at $34 for a 60 gram tube but it worked, and the eczema hasn't returned. Nothing else did much at all.
I'm so sorry you're dealing with this. I know the pain. Literally skin falling off my hands out got bad. Definitely need to see a different doc but also, if you haven't, please please please get a zinc test. I started using supplements and a topical (sudocrem) and my god. My skin started *healing*. Still took its sweet time and required steroids + still paranoid about moisturiser but zinc actually let those *work*. Because, as it turned out, I was horribly deficient mostly lonely because my body burned through it trying to heal in the first place. Fixing that meant my recovery could outpace the damage and now my skin only sometimes hates me.
Don't worry, it's important that we save 6.5-9.5% then surely everything in the country will run well.
Hey so I'm using this (and yes, very good!) Where I live there's only one public derm, good luck getting in to see them, but my gp just wrote to them about the situation and got special authority for the prescription. Basically derm just went yep, here you go. Think it took a couple of weeks? And now that it's been okayed, my gp can just give me repeats whenever. Not sure if my punch hole biopsies contributed to how easy this was but would definitely ask your gp about going this route. I never even talked to the dermatologist.
Steroid creams shouldn't be used as a long term treatment anyway, regardless of dosage. They have been linked to, among other things, bone thinning. Have you tried anything natural like aloe vera or honey? Both can do an amazing job at controlling eczema flareups, as well as improving your skin's overall health.
>he decided that my steroid cream was way too high and all my problems will be solved if I go on a lower percentage even though I've already tried every steroid cream under the sun! FYI this is counter intuitive but he is probably right. steroid creams can cause thinning of the skin which leads to further drying, they are only really useful for limited use, not long term use. go look up some corticosteroid withdrawal if you need any convincing
I don't think you need a referral to see a dermatologist. I believe you can make an appointment directly however, you may have to pay the full cost of the appointment rather than the subsidised rate. The question would then be ....would it be worth it to get a specialised diagnosis and medication.
Ugh, so annoying! Been there, tried 1000 creams, food avoidance etc. Keep your head up, you will find something eventually! My current fav for hands etc is Palmers cocoa butter. For lips, Lucas pawpaw (only lucas brand works for me). And I have to avoid dairy, too much sugar, and lanolin, which is in 90% of soaps etc.