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.
The rebound often starts on the chest, back or lower belly and looks like this. 
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.
Summary
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.
Our Eczema Story 
I’m starting to wonder if the Lipikar Baum and Avene Xeracalm Balm sold in the UK is different from those sold in the US. I can’t find a mention of any probiotic bacteria on any of the US sites for these creams… We’re a week in using AO+ Mist from AOBiome, but I was hoping to add to my daughters skin biodiversity.
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The bacteria in Lipikar is marketed under the name Aqua Posae Filiformis. It does not appear in the ingredients list but does appear in the description. This may be because the bacteria is in the water which is listed in the ingredients list. Make sure you buy the AP+ though as the AP does not contain it.
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I figured that out and couldn’t find it AP+ on any Of the US sites that old those brands. I was able to get it off of eBay from a taiwanese seller. Just got it the other day, we’ll see how it goes!
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How is the AO Biome mist doing?
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I never did try the AO Biome but would love to hear from anyone who has.
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How did you get on with the Lipikar cream Lauren?
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Sorry it’s taken me so long to get back! I have to get the Lipikar through eBay (at least I’m buying it through a Greek seller, my little bailout help) as they don’t sell the AP+ here in the US, only the AP (I think it’s a patent issue or something). It took a little while getting gradually better – maybe a month of using the AO Biome AO+ spray (now Mother Dirt) and the Lipikar AP+ (I maybe went through a 200ml tube before it really started to work for me) but now, several months later my daughter doesn’t have any eczema at all. One day not too long ago, she came home from her grandparents with some eczema spots on her legs. I may or may not have given her a bath (I probably did, but we are in the process of moving and it’s been crazy) but I put some steroid cream on the spots, moisturized/sprayed and by morning it was all gone.
On a side note, I’ve been told as an adult that a spot I had on my hip was eczema (once I got rid of it). My parents don’t remember me having skin issues (though I do). When I was in elementary school, however, I figured out that if I rolled in the grass at school I would get welts on my skin and get sent home for the day, which I thought was awesome since, though the welts were itchy, I could rinse my arms off and they’d go away. Unfortunately the school figured that out pretty quickly too. I feel like that’s where we’ve gotten with my daughter’s eczema, it shows up and we can get rid of it.
I’m relieved since it appears that maybe the skin irritation from eczema causes allergies and not allergies cause eczema, and both her father and I have allergies, but she doesn’t appear to so far (crossing my fingers).
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Can you elaborate on the progression/improvement with the Lipikar AP+? Should the skin improve continuously? I tried the AP+ once and didn’t make it past day 3, since it seemed like it was making my skin worse. Thinking about giving it another shot. Thanks!
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The improvement happened suddenly after ten days but bare in mind that I was using steroids also. The steroids would always clear the skin but 3 days later rebound would happen. On the tenth days rebound did not happen in the areas where I was using the Lipikar AP+ but it did occur in the areas where I was using another cream. If the eczema is severe and you are not using steroids I doubt that the Lipikar alone will stop it.It is the combination of the two that brought the success. Most people just end up stuck on steroids though because they have no way of stopping the rebound other than applying more steroids.
The skin did improve continously. We still had minor outbreaks but with the Lipikar they got less and less over the next month. We still get ocassional minor outbreaks now 7 months later but the eczema goes down very quickly and never spreads. Her hands are still a challenge though.
Having her skin clear has also enabled us to work out what her triggers are. They are cats and grass.(probably pollen).
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Hi Martin,
Thanks for your post. I found it really informative.
I have some questions for you though.
Are you able to go through your regime of using steroids together with the lipikar ap+?
My 5 month old has eczema and flares up just like Millie on his front and back when I stop using steroids. I’ve been using the Avene xeracalm on him for 2 days (no steroid) and its really not helping much. Which is why i want to know…did you use the steroids together with the lipikar? Maybe that’s what I’m getting wrong? If so, how often did you use both? As in, was the lipikar used as a moisturizer?
Sorry for the questions. I’m just a desperate mum trying to help my son and stop him from suffering.
Any help will be appreciated.
Kind regards
Carol
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Hi Carol
Yes I combined the steroid with the Lipikar. I have a seperate blog that will tell you exactly how I did this. Click on the blue link.
Please don’t apologise for asking questions. Eczema is an awful condition and I know how you feel watching your child suffer so I am happy to help.If you ever want a chat I can be contacted through the facebook group that I help run
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Thank you Michael!
I realized you had a protocol once I had already sent in the message! Silly me!
And I’ve followed it to a t and it’s day 1 today so keeping a close eye on his skin! Fingers crossed it works. I really like the sound of this regime.
Oh and just sent a request to join the FB group!
Thanks so much for your help and your blog!
Hope Millie is doing well! 🙂
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Forgot to tick the notify me of comments box!
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I am so so glad that I bumped into this blog. Thank you Martin for capturing the details on Probiotic use for eczema and I am so happy to hear of your daughters response to it. That gives me great hope for mine.
I have 2 kids suffering eczema, and it has gotten worse for the last 10 months. Similar to other parents, we have tried everything possible – homeopathy, naturopathy, steroids, diets, supplements, etc. One my child was also hospitalized for staph infection and that started antiseptics, bleach baths, antibiotics. I have tried several products in the market – nothing has helped so far.
Reading your blog, I immediately ordered the AP+ Balm, and am really praying that this does it for my kids. Keeping fingers crossed.
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Thanks Farah. Good luck with the cream. Make sure you follow the protocol as it stings like hell otherwise,
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Thank you so much for this post! My local pharmacy gave me some 15ml sample tubes but I was hesitant to try because I couldn’t imagine how I can cover my child head to toe in it all the time as it is just so expensive especially when I am not sure if it really works, but you answered my question. Can you tell me how many times you apply it on your daughter per day? I normally moisturise my bub head to toe every 2-4 hours because he just dries out so fast. That will be a lot of this stuff if I do it the same way. much appreciate your comments.
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Initially we used our prescription moisturiser twice a day and the Lipikar twice a day. Now we use it just once a day because her skin is so good. Do not use the Lipikar on inflamed skin though. Use the protocol that I wrote. So many parents give up with it because it stings on red skin. It is essential to clear the skin with steroids before introducing the Lipikar.
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Thank you again. I will be sure to update you here on how we go. I have read over your protocols a number of times today and I read your blog in entirety today. You gave me so much hope.
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Hello Martin. It has been 4 months since I found what you wrote and I have been going around telling anyone who would listen that it has been a miracle. My son’s skin is pretty much perfect baby skin. Ocassionally he will have the tiniest of flare ups on his legs that are almost not noticeable except we are use to inspecting him all over and we see it. Nothing ever required more than an extra moisturising session on the problem spot with the Lipikar or the mildest steroid cream to take care of it. A friend of mine who’s daughter has been suffering bad eczema for over three years has recently bit the bullet and tried it out. Two months later she told me her daughter’s skin is now beautiful. Amazing. I continue to mention it when people talk about their battles. Thank you again.
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Im so pleased that it has worked for your son and your friends daughter. I spoke to a couple of people before I used the cream and they had had great results also. But not everyone I have spoken to has had great results. Unfortunately many people cannot get passed the sting so give up early on. I wish La Roche Posay would modify their ingredients taking out whatever causes the sting. I have tried talking to them but it was a waste of time.
My daughter continues to be largely eczema free. I sometimes wonder if it was just luck that the eczema suddenly disappeared when it did but your story confirms that it was the cream and protocol that worked. So thank you for the update. Has anyone else got an update? Good or bad?
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From what I have been hearing, the eczema doesn’t just disappear without some sort of help. I am pretty certain it is the Lipikar. I have no evidence to back that up aside from our own experience and hearing the stories of the other successes. Although I have shared my story, I haven’t had that many others come back and report on if they have tried it and the results. If I do, I will be sure to update you.
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I’m so glad I found this post. I’ve ordered some of the AP+ Baume from eBay and hope it will help with my eczema.
I’m on a steroid rebound after a 2 week intensive treatment with antibiotics and topical steroids. I am trying the Mother Dirt AO+ spray but my skin is way too dry currently without lotion. I’m hoping the Baume will solve this problem. Thanks for the post and I hope to update you with good news.
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Hi. Since reading this post I have ordered the lipikar and I am impatiently waiting for it to arrive in the mail. I’ve suffered from dyshidrotic eczema on the bottom of my right foot for a couple of years now. I’ve tried everything, and I mean everything. I’m really hoping this lotion will finally help! There have been times I can’t even put shoes on, which is a ridiculous idea when you live in Minnesota! Thank you so much! Once I receive the cream I will try and remember to come back with my results.
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I know I’m one of the only ones commenting who does not have a child with eczema but I believe this protocol could help many adults suffering from different kinds of eczema as well. Mine has always been only on one sole of my right foot and is called, dyshidrotic eczema. The worst part is the cycle of tiny blisters reappearing soon after getting rid of them. Painful, itchy, burning skin, similar to other forms of eczema. I’m hoping, if the Lipikar cream works, to let you know here, so others suffering from dyshidrosis can find something that might help them. Thank you again for your exhaustive research and information! It is so appreciated!
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I just want to say thanks so much for this post. My 3 year old daughter suffers from asthma, allergic rhinitis and eczema. As at the start of this year we had the first two under control (thanks to asthma medication, giving up dairy, probiotics and rehoming our dogs etc) but I could not bring the eczema on her face under control. It was particularly bad around her mouth. Cortisone cream barely worked. I found this post and we started with the Lipikar. We persevered past the stinging phase and her skin became less red and inflamed after a few weeks. After about 2 months her skin is vastly improved … almost normal. I would urge anyone battling eczema to give Lipikar a try.
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Im really pleased to hear that it worked for your daughter. It is such a relief when you finally get it under control. Eczema dominated our daughters life (and ours) for the first 3 years but now we hardly ever mention it.
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Hi..thank you for sharing about this probiotic cream. So i have given this lipikar for my 3years old daughter who’s got eczema since baby.. she’s been using steroid cream also for years and we’ve been trying to wean her off for steroid but that aint easy. So i have read many successfull story about this cream and i have a high hope too. It seems like this cream making her skin dry faster and flaky. That peeling skin result in clearer skin though, but still it feels like it dries so fast we have to put the cream in the next half hour. My question is how is the cream works? Is it peeling all the infected skin and restore them with new one? Or that means the cream doesnt work for her. Thankyou.
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Hi Anita
The cream works just like any other emolient. It should not cause the skin to dry faster. It is possible that your daughter is allergic to something in the cream so if you have any doubts I would stop using it.
However the only time I have seen skin need remoisturising every half hour was when Millies eczema was very severe and infected with Staphococcus.
If the eczema is staph infected no amount of any emolient will help. When she was infected it felt like Millie was a big sponge that was able to absorb huge amounts of emolient. We went weeks without sleep because we would moisturise her 24 hours a day every half hour.
Eventually she was given antibiotics to fight the infection and a 3 month tapered steroid regime which allowed her skin to recover. It was at that point that we introduced the Lipikar. I think if we had introduced it earlier it would not have worked. It is important to get the skin in good condition first.
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Thank you for your kind response. The flaky and drying skin actually started before we use the lipikar. That was started right after we tapper down the steroid. And happen until now on her hands. And actually the lipikar also peel off the dead bad skin from the scratching that resulting in new good skin-that happen on her back and bottom and neck, theyre looking good until now. And i also feel theres a stronger skin barries on that are because they’re not easily crack and red anymore. but on her hand thats kinda different , it keeps on peeling since she keeps on scratching them. I dont know whether we need more time for the hands or we need to put on steroid back or do some allergy test. Yes theres a lot to do knowing that this year she will start school.
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Finding allergies is the most important thing for beating eczema. If the eczema comes back as soon as you stop the steroid it suggests she is being exposed to the allergen every day so it may be in the home or in food. Common childhood allergies are milk, eggs, nuts, animals and dust. RAST tests are the most reliable for finding allergies. If she is about to start school she is old enough for a RAST test. (It is not so accurate on younger children).
Until you find the cause I would keep using the steroid cream as directed by your doctor/dermatologist. Steroids will stop the staph getting out of control.
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Hi Martin, I just stumbled across your blog and will be purchasing the Lipikar in the hope that it helps to reduce our steroid use. I just wanted to ask what laundry powder / gel you use? My daughter is often triggered by laundry powder. We have not had much luck finding one which does not affect her skin. Thanks
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We use Fairy Sensitive or Almat (from Aldis) and we do not use any fabric conditioner.
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Interesting you use Fairy. After my hands were cured thanks to you, I had the time to think and research and came to the conclusion that Fairy dishwashing soap was the culprit in every single outbreak I had. I got rid of that, plus the Lipikar has kept me clear for over 2 years now. Everyone is different.
Still happy….
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Hi Martin, i just found out about your blog several weeks ago. I’m happy for you because your daughter is no longer suffer for eczema.
I had a 4 y.o daughter who suffered eczema for about a year now. I have been prescribed steroid cream all the time, and i just found out that the steroid is not for long term use.
So now i want to try this Lipikar cream, just got it a week ago and I read the protocol that you wrote about how you used emollient, Lipikar cream and the steroid. I used lipikar cream (but not the emollient) on my daughter for about 3 days now and she said it’s getting more itchi when the cream is applied, so she’s reluctant to use it.
Can you still remember what kind of emollient you used? I think if i used the emollient i can help reduce the itchiness.
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Hi Melanie.
Its so long ago I can’t remember the name of the emolient we used but as time went on we just used the Lipikar and the steroid. Then later just the lipikar and finally no creams at all. (not used any for years now). I think any emolient will do in the early stages.
Has the steroid got the skin in good condition before you apply the lipikar. If the skin is still red when you put the lipikar on then it may sting or itch. Steroid should get the skin completely clear. If it is not, then the steroid is not strong enough. We had to used a medium strength steroid as the mild ones made little difference. I know people are reluctant to use stronger steroids but using the right strength in the short terms should mean less steroids in the long term.
Also keep looking for the allergen that is triggering the eczema. It can be really hard to work out and doctors put little focus on it but it is important. Eczema is an allergic response. When the lipikar/steroid combination got the skin in good condition it was much easier to spot what was triggering the eczema. Millie had already tested positive for eggs and milk but after the lipikar trial we discovered that pets were a huge trigger. As long as we keep her away from animals she is completely clear now and has been for years.
If you have pets you may want to read my blog on pets and eczema https://oureczemastory.wordpress.com/2017/12/23/pets-the-eczema-trigger-that-we-miss/
I hope this helps and hope your daughter gets better. I know how awful it is seeing them suffer.
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Hi Martin, I have a question regarding to “La Roche Posay Lipikar Baum AP+”. The product has an how-to-apply instruction and it says to use it once a day. Do you know why it states so? Any issues to use it more than once per day?
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Sorry but I don’t know why it is once a day. Unfortunately its so long ago now I can’t remember how many times a day we applied it but it was probably one or two max. Its probably best to follow the manufacturers guidelines as there are all sorts of things in many creams that are probably not good in large doses but sometimes we have no choice. If you have a regular emollient that can be used multiple times a day then you could do one application of Lipikar and then a few applications of the regular emollient. I think we may have done this.
We found that as her skin improved we needed less and less emollient (or Lipikar). Now 4 years on we never use any cream on her and I can’t remember the last time we did. This is partly due to the success with the Lipikar and partly due to working out and eliminating all her triggers (an exercise that is much easier when you get the skin back in good condition )
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Thanks Martin for your kind reply!
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I used it about 10 times a day in the beginning and at night slathered it on thickly and put on gloves. I’ve been cured for 2 years now and don’t use it anymore.
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A lot of creams contain all sorts of chemicals which to some extent get absorbed into the body so its best to follow the instructions to limit them. However each individual has to decide between the benefits and risks. We did use it more than the recommended amount but thankfully we don’t have to use any cream of any type anymore as Millie has been largely eczema free for a long time now.
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I had painful eczema on my hands for two years and went to countless doctors who all prescribed steroids. They worked as long as I was using them. When I stopped, the eczema returned after 3 days, often with a vengeance. And then I read your blog about using Lipikar. I used it about 10 times a day at the beginning and at night wearing gloves. My hands got worse but I was bound and determined to stop using steroids. And then, they started getting better and today are completely clear have been for over a year. It took about 8 months. I don’t expect it to come back. I wanted to let you know that this cream did indeed work for me, but like you said, everyone is different. I do think that everyone should give it a try at least. It’s a nice cream on its own and lasts a long time so it’s not really as expensive as it seems. It’s worth every penny. I would post pictures as I kept an extensive journal but I don’t know how to.
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Hi Mary
Im glad that it helped. Well done for persevering. Many people are looking for a quick fix but there isn’t one with eczema. When you have had severe eczema the skin gets quite thin and it can take some time to build the layers back up and get the skin in good condition again. When its in better condition I think its more resilient to allergens.
That being said, 8 months is a long time. Its worth checking if anything else has contributed to the improvement. Were there any changes to your environment in that period. e.g. change of job, home, death of pet,change in diet etc.
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