It will come as a shock to absolutely no one that Bubba just tested positive for basically everything outdoors. Environmental allergies are even more common than food allergies, they tend to run in families (like ours), and are commonly seen in kids with eczema. Until recently I didn’t see the point in testing Bubba for seasonal or environmental allergies because there weren’t any pressing symptoms that I felt needed treating. She’s not an especially sneezy kid – no constant runny nose or cough either. She had been getting along just fine. That is, until this summer. I swear her skin has been in some sort of flare up or hive outbreak for the past two months. We’ve treated her eczema with steroids and lotions and her hives with a variety of antihistamines but we never seemed to be able to get things under control for more than a day or two. Of course chlorine, heat, and sunscreen wreak havoc on these poor eczema kids, but it seemed like there was something else going on. Bubba started spitting all the time which seemed to be the result of a post-nasal drip. Our pediatrician advised trying a daily antihistamine for a week or so to see if that helped. That was appropriate advice, but I wanted an actual diagnosis before we entered a continuous medication plan of action.
Skin testing went well (Bubba is a champ) and we got the answers and advice I was seeking. Bubba is allergic to grasses, trees, weeds including ragweed, cats, and dogs. Her largest wheal was for grasses. This explains her terrible skin in June when grass pollen counts are highest. Environmental allergies can begin at any age, but my layperson’s impression is that many kids seem to avoid them for the first few years of life. Once they begin, they largely mimic allergies in adults with the same symptoms and treatments. Children as young as five can receive allergy shots, a form of immunotherapy. They can also benefit from pollen and dander reduction through cleaning and air filtration. We have been using a HEPA air filter for years in Bubba’s room and have never allowed our dog in bedrooms or carpeted areas of our home like the playroom or basement. Our allergist recommended giving Bubba Zyrtec daily for the next few weeks and, if effective, using it during peak pollen seasons.
We developed a plan to help manage Bubba’s skin better and to control her itching: (1) Wet wrap therapy at least twice a week. Wet wrap therapy is extremely useful in increasing skin moisture, decreasing itchiness, and upping the efficacy of topical steroids. You can use wraps, specialized dressings, or regular clothing like we do. After a bath we apply a moisturizer (Aquaphor during a flare, Vanicream other times), then a steroid cream, and then put her in wet pajamas. After 45 minutes, we remove the PJs, dry her off, and put her in dry PJs. (2) We’re also going to add two new creams to our repertoire. Our allergist recommended starting her on Bactroban as a topical antibiotic cream. Staph is a common problem for those with eczema. In fact, more than “90% of people with moderate-to-severe eczema are colonized with staph.” This can be addressed with bleach baths but we found them to be too drying for Bubba’s skin. Triamcinolone was recommended as a more powerful cream to address eczema flares.
I continue to be impressed with my tough as nails, roll with the punches kiddo. She helps me to do the same.