The Management of Severe Eczema
If your child's eczema keeps coming back, if nights are broken by scratching, and if you've been told to keep using the same creams that haven't worked, there is another approach worth knowing about.
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What parents usually tell us
Most families arrive having already tried a great deal:
Emollients applied several times a day, with little lasting effect
Courses of topical steroids that work briefly, then the eczema returns within days
Repeated courses of antibiotics for infected skin
Months on a waiting list for a dermatology appointment
Being told the child will probably grow out of it
Meanwhile the child is scratching until they bleed, sleeping badly, missing school, and self-conscious about how their skin looks.
If that's familiar, the problem usually isn't that you're doing it wrong. It's that inflammation is being treated on its own, while two other things driving the eczema are left untreated.
The approach
Severe eczema in children generally involves three problems at once: inflammation, a damaged skin barrier, and bacterial overgrowth on the skin, usually Staphylococcus aureus.
The Aron Regimen treats all three together, using a single compounded preparation combining a dilute topical steroid, a topical antibiotic and a large quantity of emollient, applied frequently and adjusted at review.
Read more about how the Aron Regimen works
"But I don't want my child on steroids"
This is the first thing most parents say, and it's a reasonable worry.
The steroid in the compound is heavily diluted — considerably weaker than a typical prescribed tube — and mixed into a large volume of emollient. Strength and frequency are stepped down as the skin improves, so most children are using markedly less within a few weeks.
Babies and very young children are treated with the most dilute preparations.
Steroid strength is reviewed at two weeks, four weeks and annually, precisely so that no child stays on more than they need. If you have concerns, bring them to the consultation. They should be answered properly, not brushed aside.
Can babies be treated?
Yes. Infants, can be treated using appropriately dilute preparations. Children and babies make up a large share of this practice.
What is prescribed depends on the child's age, weight and the severity and location of the eczema, which is what the consultation establishes.
How it works
The consultation. £180, by video, from home. No travelling with a distressed child, no waiting room. Bring photographs of the skin at its worst — eczema has a habit of looking better on the day of the appointment.
The prescription. If the regimen is appropriate, a preparation is made up specifically for your child by a compounding pharmacy. Medication is paid for separately.
The reviews. Two weeks and four weeks, £100 each, then annually. This is where the treatment is adjusted to your child, and it's the part that makes the difference.
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Who we can help
Children and babies with:
Moderate to severe atopic eczema
Eczema returning quickly after steroid creams are stopped
Repeated skin infections
Broken sleep from itching and scratching
Eczema affecting school, confidence or daily life
You don't need a GP referral, and you can book from anywhere in the UK.
Questions parents ask
How quickly will we see a difference? Many children improve within the first two weeks, some sooner. A short period of worsening at the start isn't unusual as heavily colonised skin settles.
Do we have to stop what we're using now? That's discussed at the consultation. Bring a list of everything currently being used.
Can we stay under our NHS dermatologist or paediatrician? Yes, and many families do. Tell them what your child is using so everyone has the full picture.
How much will it cost altogether? £180 for the first consultation, £100 for each review, plus medication from the pharmacy. Most families pay for the consultation, two reviews and medication over the first two months.
What if it doesn't suit my child? By the four-week review it's usually clear. If it isn't working, that's said plainly and other options discussed.
Do you need to see my child in person? No. The consultation is by video, and photographs are used alongside it.