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-   Help and Resources for Hemangiomas (http://birthmark.org/board/forumdisplay.php?f=9)
-   -   Diaper Area Hemangioma (http://birthmark.org/board/showthread.php?t=2898)

mspittsburgh 05-27-2008 07:52 PM

Diaper Area Hemangioma
 
Hi all. I am very new here and I need help. My daughter is currently being treated for a diaper area H. She is seeming to respond well, but still screams when she goes the bathroom (#2). It has only been a week, but I am concerned. Does anyone have any advice? How do I know it is going away or getting better?

missy 05-27-2008 09:13 PM

Other parents will chime in soon. I have no experience with that, but I wanted to say welcome!

It will help, too, if you let us know what course of treatment she is receiving, if you are using any over the counter products, or if you have noticed any changes at all yet.

Take care,


Missy

mspittsburgh 05-28-2008 02:45 PM

Thanks for responding :) She is currently taking Amoxicillin & Bactroban cream. It is helping :)

nickbar 05-28-2008 09:04 PM

This area is prone to ulcerations. Please email me and I can connect you with another mother with extensive experience with diaper area h's.

Corinne

beano 05-28-2008 09:57 PM

hi, just to say, it is very worrying , not knowing what the direction the H will take, I am one of the lucky parents the Sara H started to Involute at four months... but if it is causing distress to your baby, do all you can.... keep posting .. thinking of you beano

Caitlin's Mum 06-17-2008 02:04 AM

Hi,

Speaking from recent experience it is heart breaking to watch your baby suffer. We're thankfully are on the other side now... I don't know if you saw some info that I posted here last month, but I swear by Secura Protective Cream! Within a day Caitlin stopped crying when she wet or dirtied her nappy, she was a different girl! Even if you were to use the cream on its own without the other bits I mentioned it could make a difference.

Within three weeks of using this cream (and the cleanser and spray) we went from approximately 2 by 1 inch ulcer to completely healed skin. The H has started to involute but it is very, very slow. A word of warning - we've just survived a week with a stomach bug and the constant dirty nappies started a few new bleeds. Luckily we kept using the secura cream and they didn't come to much, no new ulcers like we would have expected before. So we're stocking up on new supplies just in case. At the very least its great protection against nappy rash.

Best wishes to you and your family

threeunderthree 05-08-2010 12:17 AM

I am going through this right now with my three month old twin daughter. She is on propanelol and it is not working as hoped. Our next course of treatment is steroids, and I have great concerns about this. We are using all types of topical meds to heal the ulcerations, but it is very slow healing. She cries and screams when she goes to the bathroom. I would love any input or suggestions for help.

missy 05-08-2010 12:32 PM

If you haven't already, write to Dr. Serena (wound care expert) through
http://birthmark.org/experts.php and he can give you some ideas on caring for the ulceration.

And, welcome!!

Missy

Kirstyloo 05-17-2010 10:13 PM

I know how hard this is! We were you about 3 weeks ago, but the good news is that my daughter's spot appears to be healing. Here is our story and what we found worked for us.

My 9 mo daughter has a half dollar sized hemangioma on her right buttocks. Luckly, it is not on the anus or in the mucosal area. This hemangioma like the other 3 on her body had started to regress. As commonly happens it became ulcerated during the regression. Despite seeing her ped and getting an antiobiotic cream, it became bigger. One week after it opened up, we had an appointment with a plastic surgeon who used laser treatment on it. A week later, it was even deeper and more painful. At its worst, the ulcer was larger than a quarter and about centimeter deep. It didn’t seem as though anything that we did helped, and it was horribly painful for my daughter.

We were frustrated because the doctors didn’t give us a wound management plan. We took what little advice we got from our Ped and the Plastic surgeon and here is what we came up with:
1. We changed her diaper every 2 hours religiously while she was awake. We didn't care if she didn't seem wet. We also changed her diaper ASAP after stool. She is 9 months old so we could let her sleep on her stomach during the night so the pee would drain forward. If she were younger, we might not have made that choice because of the potential of SIDS.
2. We also changed our diaper wipes. We found some without alcohol to use for general diaper cleaning. We’ve also been using a wet wash cloth to clean the wound. We send a pack of 4-5 wet wash cloths to daycare in a ziplock with the instruction to dab/pat her ulcer at each diaper change. They use the wipes for all other areas.
3. Our plastic surgeon gave us a prescription for Lidocaine jelly (the jelly lasts longer on the skin than the cream or solution). We apply a very thin amount of Lidocaine 2% to the sore after diaper changes. Within 2-5 minutes, it appears to dramatically decrease her pain; however, you need to be very careful not use too much as it can cause respiratory and cardiac problems. Our plastic surgeon didn’t mention this when it was prescribed. Only when I called back a week later and talked to his nurse was I informed of the drugs serious risks. She seemed a bit shook up as to how we were using it originally.
4. We applied a prescription antibiotic cream 3x day and after stool. From what I’ve read, antibiotic cream can irritate the sore so we've tried to limit its use.
5. Our Ped indicated that we should apply Aquafor to the site to provide a water barrier; however, cream didn’t stay there well enough between diaper changes. When I asked the Plastic Surgeon what to do, he recommended using a nonstick pad without tape to cover the site, but he didn't mention Aquafor. Each in isolation wasn’t working as they didn’t last or stay stuck. So we combined the advice. We put a heavy layer of Aquafor on the pad before applying it. If it is changed every 2 hours while the child is awake, it appears to provide a pretty good barrier. It seems to protect about 90% of the time.
6. We then applied a diaper ointment with zinc oxide to the rest of the traditional diaper area. I realized that she was developing some irritation in other areas. I think that this was because we weren't able to clean her off quite as well as usual because of how traumatized she was during diaper changes. Some websites recommended zinc oxide for ulcerated lesions so we applied it liberally every where else except for the ulcerated area.
7. We had her sit/play in a warm bath for 5-10 minutes each day and then we gently patted the area with a dry towel. Do no rub as it can pull off the new skin.
8. We had her “air dry” bottom up for 10-40 minutes each day on dry towels. Personally, I found this to be a really great mommy and baby time.

I think that the key for us was the Aquafor and the pad. It did a pretty good job of keeping stool and urine off of her sore. Even without the tape, the Aquafor did a pretty good job of holding the pad in place and urine and poop away.

I’m so happy to say that my daughter’s ulcer is only about 1/3 of the size it was 10 days ago, and it is much shallower. She hasn’t cried because of it for about 4 days. I know that we aren't out of the woods, but I do think that we're moving the right direction.

Best of luck! I really do know how hard it is when your child is in so much pain, and you can’t stop it.

PS - If you do get laser treatment for your child, make sure that they put a pain killer on it while you are in the office! The surgeon gave us a prescription for the numbing med, but the first pharmacy I went to didn't have it. She screamed herself to sleep as we drove frantically around. I do wish the doc had simply pulled out a tube and used it. I can't imagine that he doesn't have tube of it somewhere in his office for use before or after a procedure. We will have a discussion about this during our followup appointment along with him not warning us about the dangers of the drug.

lizzyh 05-18-2010 04:24 PM

I feel your pain!! Maybe try mepilex borders (see response to Kirstyloo). Would laser treatment of the ulceration be an option?


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