Wednesday, 21 September 2016

National Eczema Week 2016: Tips For Living with Eczema

Since it's National Eczema Week I thought I would share my experience and tips to help raise awareness. First of all eczema is a dry and inflammatory skin condition (also known as dermatitis.) Atopic eczema has a genetic basis and is often found in families or people with asthma and hayfever. For people with atopic eczema, "the function of their skin as a barrier to the outside world does not work well, so that irritant and allergy-inducing substances can enter their skin, and may cause dryness and inflammation." Atopic eczema can occur anywhere on the body including the face but it is most common on the creases of the skin, so back of the knees, inner arm, ankles, wrist and neck. It can also appear as coin sized areas of inflammation or small bumps near the hair folicles. Skin will be very itchy, red and dry, and scratch marks (and bleeding) are common which can sometimes lead to infection. It is not contagious at all.

Atopic eczema is common in babies and children, most who grow out of it although some still experience it as adults.  In the UK, 1 in 5 children and 1 in 12 adults have eczema. For some people their eczema is worse in the winter with dry, cracked, sore skin while others find that the hot, sweaty conditions of summer irritates their skin.

My eczema is on my legs, mainly my ankles and knees. When I have flare ups (usually in the summer) my thighs and inner arms get eczema too. I usually use a moisturising/emollient cream prescribed by GP and then use steroids/ hydrocortizone during bad flare ups or if the skin becomes infected. These should only be used occasionally since they are known to thin the skin. I've also tried complimentary therapies, specifically homeopathy and Chinese herbal medicine. However my general advice is to get diagnosed by a doctor first.

Common Triggers 

The most common are dust and dust mites. Mattresses, duvets and pillows should be enclosed in non-allergenic covers. Vacuum rooms often to limit exposure to dust mites and clean surfaces with a damp cloth. Wash soft toys at high temperatures or freeze them for 24 hours to eliminate any dust mites.  Avoid hoarding and declutter! The more things you have in your room/house the more things you have that get dusty, attracting dust mites and requiring regular cleaning.

Animal dander (particles of old skin shed by animals.) Keep pets out of the bedroom, don't let them sleep on the bed because dogs and cat dander can make eczema worse. Vacuum the house regularly.

Heat Wipe sweat away with a cloth/soft towel. Wear loose clothing. Sleep in a cool room. Having a bath or shower everyday can actually be bad for eczema so spot clean with a flannel face, hands, armpits and private parts.

Cold dry air Buy a dehumidifier and try to keep the humidity above 40%, if possible.

Foods In 10% of cases eczema is triggered by foods such as milk, eggs, citrus fruit, chocolate, peanuts and colouring. While avoiding a certain food it is important maintain a balanced diet with fibre, vitamins, proteins and carbohydrates.

Reacting to stress by habit scratching. Break the Itch scratch cycle (scratching that makes itching worse, which makes you want to scratch more.) Try as much as possible not to scratch eczema. To relieve itching place a metal object against the skin (such as a spoon, drinks can, metal camping mug ) this will cool the skin. You could also wear cotton gloves at night if you tend to scratch in your sleep and use anti-scratch mittens for babies. Keep nails short to minimise the impact of scratching. Find ways to relax such as meditation, yoga and exercise to combat stress.

Tips for managing eczema 
  • Moisturise frequently with an alcohol free and unscented cream. I use Unguentum M twice a day (morning and evening) but have also used Diprobase (good) and E45 (ok) in the past. Other brands I have not used but may help include Aveeno Eczema Therapy, Cetaphil and Oilatum. Most creams can be prescribed by a GP and put on a repeat prescription form which is often much cheaper in the long run and available in bigger sized containers.
  • Wear cotton clothes instead of polyester, nylon, spandex. Cotton will let the skin breathe and absorb sweat.
  • Chuck out old clothing that is pilling (bobbly) if it's in direct contact with the skin. The surface isn't smooth and soft anymore and can lead to itching. If it can't be saved by combs or tools that remove pilling ditch it. 
  • Wash clothes in Non Biological washing powder and avoid fabric conditioner. (I use Persil Non Bio or Ecover.) 
  • Bathe in warm but not hot water.
  • Avoid bubble baths, bath bombs and shower gels. This is why there is a conspicuous absence of these on my blog. Perhaps it's not as fun but it means more money to spend on makeup!  Stick to unscented soaps and shampoo. Personally I just use Dove soap but this may not suit everyone. Doctors or a pharmacist will usually suggest a bath oil to clean and moisturise the skin, I use Oilatum bath oil . Be careful when using it to prevent slip ups in the bath. I also use Oilatum to shave my legs when I don't have flare ups. 
  • Some people swear by coffee scrubs. (I think this helps the kind of eczema that gets worse in winter.) Brands include Frank, Grounded and Bean Body.
  • Salt is a natural antiseptic (and cheap!) so adding a handful to a bath or cupful of salt if you have flare ups, is good for the skin. Adding colloidal oatmeal to your bath or applying it to the skin directly in the form of a paste also helps relieve itching.
  • After swimming in a swimming pool, rinse off any chlorine from the pool, as this can irritate the skin.
  • Apply moisturiser at least 20 minutes before bedtime to allow it to soak in.
  • Keep the bedroom cool and use cotton sheets or a light, natural-fibre duvet. If you have the money choose Egyptian cotton bed sheets in a high thread count. 
  • Wear silk Pyjamas. They are more expensive but they keep the skin cool and feel smooth and soft against the skin. It is one of the main things that really helped me. I got mine from Patra. Otherwise choose cotton pyjamas and nightwear and avoid synthetic fabrics like nylon.  
  • When you can't sleep because of itchy skin then consider taking antihistamines or at a last resort sleeping pills. These will knock you out and save your skin from hours of scratching and bleeding, sore skin. 
For more information contact the National Eczema Society,  The British Skin Foundation and Allergy UK.

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