Phone Visit
Narrative: SPRUCE MESSAGE VISIT Date: 2026-04-24 Encounter: Spruce text message with photo review (rash images sent by parent; product links reviewed by Dr. Hobbs) CC: Stubborn, itchy eczema flare-up in an infant. HPI: Daisy is a breastfed infant who is currently cutting her first tooth and drooling. Parent reports recurrent eczema with stubborn patches and a current flare-up that appears particularly itchy. Parent suspects a dietary/gut-related trigger but has been unable to identify a specific cause. Products currently in use include Aquaphor, Coterie baby balm, fragrance-free lotion, and Active Skin Repair baby spray. Photos of the rash were shared with Dr. Hobbs. Assessment: Dr. Hobbs reviewed photos and identified moderate eczema. He noted that eczema is largely a predisposition influenced by environmental factors, with fair-skinned individuals being more prone, rather than being primarily gut-driven. Plan: Advised to discontinue Coterie baby balm and Active Skin Repair baby spray. Recommended Cetaphil or CeraVe wash and moisturizing ointment, plus 0.5% hydrocortisone applied to the reddest and roughest areas. Instructed to avoid organic or scented products. Medications: - Hydrocortisone 0.5% 0.5% topical, applied to reddest and roughest areas (new) Key clinical quotes: "thanks for the pics - I do see some moderate eczema there" "generally a good plan is cetaphil or cerave wash and moisturizing ointment in combination with 0.5% hydrocortisone to the reddest and roughest parts" "most people with it are predisposed to it, then their environment aggravates it" Source: Spruce conversation t_2MBH50I4LS000