Nikki's baby had a common rash. But treatment withdrawal was worse
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A Melbourne mother-of-two says her six-month-old daughter is suffering from cracked, crusting and bleeding skin due to withdrawal from topical steroids prescribed to treat eczema.

Nikki Estrada took her baby daughter, Xenrea, then four months old, to hospital after she became dehydrated due to low milk supply.

While they were there, doctors noticed a red patch on Xenrea’s cheek and prescribed five days of antibiotics and 14 days of topical steroid cream as well as bleach baths as a “precaution” in case the skin had become infected.

Baby Xenrea pictured when doctors first diagnosed her eczema (left) and after ceasing topical steroid treatment after 14 days (right). (Supplied)

“I thought it was a normal baby skin rash, I didn’t suspect it was eczema,” Estrada said.

“My gut instinct was like, this is wrong, she doesn’t need it… but you just think, I’m gonna listen to the doctors.

“And it worked, the little patch on her cheek, it was gone.”

But two days after finishing the prescribed topical steroid cream treatment, she said her daughter’s symptoms worsened.

“As soon as I stopped, it just came back with a vengeance,” Estrada said.

“It’s broken, it’s open, it’s weeping, she doesn’t sleep.

“I can’t sleep because I need to hold her so she doesn’t scratch.

“Her mouth cracks and bleeds from trying to eat.”

Desperate and distressed, Estrada took Xenrea to the GP and a paediatrician, who both recommended she resume the topical steroids until the symptoms cleared.

By that time, she had begun researching topical steroid withdrawal (TSW) online and had found similar cases in online support groups.

Xenrea’s symptoms dramatically worsened after completing the prescribed 14 days of topical steroid creams. (Supplied)

TSW is characterised by red, burning and itchy skin, that sometimes presents after ceasing prolonged or high-potency steroid treatment.

“Speaking to other mothers, it sounded like she was going through a withdrawal, because, you know, I only applied (steroid cream) to her face, but it was everywhere on her body, which was identical to other parents and their kids,” she said.

“First, it becomes really, really red and hot and burning, and then the body will ooze, the skin barrier breaks, and then it scabs, and because it’s so dry it bleeds and it’s prone to infection, and it’s just a cycle until the new skin comes back up.”

Estrada is now seeing a naturopath and says her daughter’s skin is slowly improving with the use of natural creams, and prebiotic and probiotics for her gut health.

“It’s just been so heartbreaking seeing my daughter in so much pain and she’s only six months old,” she said.

“I feel like I’ve still got months until her skin’s gonna go back to how it was.”

According to Professor Deshan Sebaratnam, a dermatologist at The Skin Hospital in Sydney, side effects from the use of steroid creams are rare.

“When used for skin conditions which come and go like eczema, where you are only applying them for a few days then taking a break, side effects are vanishingly rare,” Sebaratnam said.

“When patients stop using their steroids, their underlying skin disease can flare back up, and sometimes this can be confused by people as dependency or addiction – which it isn’t.

“Patients need to also consider the effects of not controlling their eczema – itch, pain, increased risk of infection, sleep disturbance, cost, the impact on the whole family et cetera.”

Professor Deshan Sebaratnam said topical steroid creams are safe when used under the direction of a doctor, and side effects are rare. (Supplied)

Eczema is often worse in winter, due to low humidity, long hot showers, and irritation caused by people wearing extra layers, heating and electric blankets.

Melody Livingstone, CEO of Australian skincare company MooGoo, said sales of their eczema and psoriasis creams had doubled this winter, compared to last year.

“Australia has one of the highest incidences of eczema in the world, and it is only getting worse – 50 years ago, only one in 10 Australian children suffered from it,” she said.

Eczema, also known as atopic dermatitis, is a chronic, debilitating disease that affects 2.8 million Australians, including one in three Aussie kids under the age of six.

Management includes keeping the skin moisturised and avoiding triggers such as soap, fragranced washing detergents, prickly fabrics, and heat.

Topical steroid creams, when used under the supervision of a doctor, are widely considered by doctors and specialists to be a safe treatment for flare-ups.

Please note the information in this story is general in nature. Please always consult your GP or health professional for advice that is tailored to your specific health concerns.

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