Those who follow my blog will know that I’m always searching for something that will improve my daughters eczema. You will also know of my recent interest in probiotic creams. The theory behind using probiotics on the skin rather than in the gut is that they can improve the balance of good and bad bacteria on the skin. They may reduce the levels of staphylococcus aureous which exacerbates eczema by producing a toxin that irritates the skin. But there are question marks over whether probiotic bacteria can survive in creams or on the skin. (For more info see my blog ‘Are topical probiotics the future for eczema treatment’) So I decided to put three to the test.
My main objective was to stop the 3 day steroid rebound that we get. (She flares all over 3 days after covering her in Betnovate and then we have to cover her again). I was particularly concerned about the systematic effects of covering her whole body in a strong steroid every 3 days. The NHS were supposed to provide a pediatrician to monitor this but 6 months and numerous requests later we have still not seen the pediatrician.
If not treated with steroids this is what can happen to Millies skin.
I tested 3 creams containing probiotic bacteria. La Roche Posay Lipikar Baume AP+, Avene Xeracalm Balm and Epesencial Baby Time. The first two were used for at least 30 days. The third trial was abandoned early on.
La Roche Posay Lipikar Baum AP+ Results
The clear winner of the 3 creams was La Roche Posay Lipikar Baume AP+. This contains a bacteria called Vitreoscilla Filliformis which lives in Thermal springs. Tubingen University did some trials on this bacteria which had good results for eczema.
In the first week we had to use steroids as per usual but we persevered with it. After about 10 days we saw a change in her skin. The usual places that we saw rebound did not show any sign of it. This pattern continued and we have not had to use steroids on her body for 50 days which is amazing.
Before we used the Lipikar we would see eczema appear on her lower back and top of chest after 3 days without steroids. If steroids were not applied, her whole back and front would be covered in eczema within 24-48 hours.
Her back and front are now clear most of the time. She has had a few patches appear on her neck and shoulder but these go down in a day or two without having to use steroids. Her legs have also been very good and no longer require steroids. We used to have terrible trouble with her feet and only Fucibet (strong steroid and antibiotic) would previously give any relief. Her feet are now clear most of them time.
Prior to the using the Lipikar we frequently had to use Eumovate or Hydrocortisone on her face. Now it is completely clear.
The only place that we still struggle with are her wrists. We still have to use steroids in small patches about once a week.
Thanks to the Lipikar, overall we have reduced our steroid use around 98% which is such a relief to us. The only negative side to this cream is that it initially stung her and she hated having it applied. It particularly stung red areas but as the eczema cleared she seemed to complain a lot less. Now that the skin is clear she doesn’t seem to complain any more. If you are thinking of buying this cream make sure you buy the AP+ version. The plus indicates the addition of the probiotic bacteria.
Avene Xeracalm Balm
This also contains a thermal spring bacteria called Aquaphilus Dolomiae. Unlike the La Roche Posay Lipikar Baum this did not sting my daughters skin even when it was red. I tried this on her arms and legs only. After 11 days we started to see an improvement but as time went on we saw more and more flares. Initially each one went back down in two days without using steroids. However 19 days in Millie had a very severe outbreak on her arms that would not go down. We succumbed to using steroids to prevent it getting infected. She had managed to go 13 days without steroids which was an improvement on the previous 3 day record. However thereafter it was a constant battle against flare ups and although we were using less steroids than previously it was still a significant amount. So I believe that this cream did help but was not nearly as effective as the Lipikar.
Epesencial Baby Time Results
This tube was just too small for a 2 year old with eczema all over and the cream does not moisturise. It also contains some sort of grit which I assume is an exfolliant. After a few days I gave up with this which is not long enough for a trial. This may suit someone who has just small patches of eczema.
Millies eczema is certainly not cured but I believe we have won the battle against staph. This means that we now only have to deal with mild eczema instead of severe eczema. Skin dysbiosis (bacteria imbalance) is rarely talked about in eczema circles and the mainstream approach to deal with staphloccocus aureous is through steroid, antiseptics and occasionally antibiotics. Unfortunately these just temporarily reduce all bacteria levels and do not restore the skin to a healthy bacterial balance. I believe topical probiotics are a more natural way to restore the balance and this trial (albeit unscientific with a sample size of only 1) shows that they can work.
Through the eczema forums I have spoken to other parents who have had good results with the Lipikar and the Xeracalm. I also heard of a dermatologist in Australia recommending the Lipikar after good results with her patients.
If you want to try a probiotic cream it is important to use it correctly as other creams, lotions, antiseptics etc can kill the beneficial bacteria. Therefore I have written down the protocol that I used for my daughter in another blog.
Update: 20/6/15. I wrote this blog 5 months ago. Millies skin is still completely clear and soft other than her hands and wrists which occasionally need steroid cream. If she accidentally induces one of her food allergy triggers see still scratches and we see some redness on her skin but this goes back down within one day. The Lipikar AP+ cream has transformed her life and I am so glad that I did this trial.