the eczema body, treatments

let’s get receptive: the relationship between pain and itching

black and brown coat animal on brown trunk
Photo by Flickr on Pexels.com

When I was still in my physical therapy graduate program, we had a lecture on pain and neural pathways, and I stayed after class to ask the professor about the relationship between pain and itching because I noticed my itches sometimes felt like they traveled along a nerve (such a perk of being a PT student, you’ve got to know your nerve branchings!).

I’m reading this book now called Living with Itch by doctors Gil Yosipovitch and Shawn G. Kwatra. This book first got on my radar when I was reading a National Eczema Association post called “Itching for Answers”, and it mentioned Dr. Yosipovitch and talked about how cytokines (one of the molecules secreted by the body’s immune cells that we usually blame for our overactive immune responses), are also located in the nerve cells. The thought is that some of the nerves may have “faulty wiring” and so they are constantly firing and sending up itch signals when there is low to no itchy stimuli.

Anyway, the book goes into detail about various chronic itch-related disorders/diseases as well as the anatomy behind the itch, and it depicts the relationship of pain and itching to be almost inverse. As the book explains, we have a bunch of different sensory receptors on our external body to send information from what we encounter in our environment to our brain. One such receptor type, located in the epidermis layer (the shallow most skin layer) is the C nerve fiber, which relays information about, you got it, pain and itching. These C nerve fibers send the sensation information to a structure called the dorsal root ganglion, and then the info crosses the spinal cord and goes up the opposite side of the lateral spinothalamic tract to get to the thalamus in the brain. There the thalamus sends info about the itch sensation to other parts of the body that link it to our physical, cognitive, and emotional responses. The lateral spinothalamic tract also relays information about pain and temperature, which is important and I’ll get to in a minute.

So what do we know about pain and itching? We know our bodies’ physical response to pain versus itch is very different. With pain, we withdrawal the part of the body that comes in contact with the painful stimuli; step on a nail, you immediately try to pull your foot away. But with an itch, we immediately go to a scratch reflex. The book goes into more detail about why that is, saying that the scratch reflex causes a sort of pain, which effectively masks the itch, and we now know that is precisely because the two stimuli types do share that same lateral spinothalamic tract. And because temperature also can share that tract, this is why using cold on inflamed skin, or taking a hot bath can also mute the itch.

Lastly, the book goes into why chronic pain and chronic itch can be similar. The biggest commonality is that both involve the nerve fibers being overactive, so we perceive the pain/itch to be even more intense (this is called hyper sensitization). And yes, when the sensations are that heightened, like say you are always itchy due to eczema or another condition, something that should be painful like an electric shock, or pouring rubbing alcohol on your scratch wounds (the latter which I’ve done…) might just make you itch more!

The most recent medications/treatments on the market are called biologics (and include names such as Dupixent), and they target the cytokines that give us so much grief. For eczema, those cytokines include interleukins 4 and 13 (IL-4 and IL-13) so far, and they are working to make treatments that target more ILs in the future.

One other takeaway from the book that I thought was relevant is that the epidermis layer, when sufficiently compromised (like after it’s been scratched a lot), can have more sensitive nerve fibers because they are more exposed by the broken skin barrier. So one important treatment in managing eczema is helping to try to repair and protect the skin barrier to subsequently protect the nerve fibers. The book mentions two ways of going about this:

  1. using moisturizers with ceramide in them to help coat the skin barrier as the skin barrier lacks the protein filaggrin*
  2. using moisturizers and cleansers that are more acidic so that they help get the skin back to its normal pH range of about 4-6 (with 1-6 being acidic, 7 being neutral, and 8-14 being alkaline). Note that most soap bars are alkaline.

*A cool way to know if you genetically are lacking filaggrin is to look at your palms. People with crazy amounts of lines are generally lacking filaggrin. I’ll be talking more about filaggrin in a post later this week. Meanwhile look at my lack of filaggrin below!

2018-10-26 13.12.40.jpg

What I am curious about is why then, is it advised by so many dermatologists to take bleach baths? I understand that when diluted, bleach can still help kill a lot of germs on the skin, but if bleach is a pH level around 12 (so pretty basic/alkaline and maybe gets diluted to around 9 when in a bath), it is very far from the desired pH of our skin. If we are adding an element that further changes our skin pH, how does that help our healing? Though I guess if the pH of our skin is higher than 9, bringing it down to 9 with bleach baths would be beneficial then too.

I haven’t searched super thoroughly yet, but the most recent study I found so far indicated that bleach baths with a course of topical steroids was no more effective than just doing the course of topical steroids alone. A review tested a treatment group using bleach baths and mupirocin (a topical antibiotic) versus a control group using normal baths and petroleum jelly and found that the former was more effective, at one month at reducing Staphylococcus aureus (the bad Staph we all know), but again this is not comparing bleach baths in isolation (and the study went on to say that at 3 months there was unchanged frequency of Staph in the treatment group meaning it was still as widespread on the body, though they didn’t test the concentration to see if the quantity of Staph had changed).

Yet another study supported that the topical antibiotics with diluted bleach baths were most efficient at killing Staph, yet also noted all groups (no bleach, bleach with topical antibiotics, etc) had reoccurrence rates of Staph after 4 months. A different review on using diluted bleach talked about how bleach is awesome because it’s a ubiquitous cheap house product that kills bacteria, viruses, and fungi alike and doesn’t cause bacteria to become resistant. However, then it also talks about why the studies using it for infected eczema are lacking, and includes reasons that one might one to avoid using it such as:

  • the amount in a cleaner can vary
  • its strength can degrade over time
  • it can make dermatitis worse
  • it often contains fragrances
  • the studies done didn’t have enough people in them, and
  • there is no consensus on the optimal amount of bleach to use or how frequently use it to effectively stave off future Staph infections.

And again, I’m not sure what the role of a diluted bleach bath would be for those of us avoiding topical steroids/going through withdrawal and not currently on antibiotics.
However, given the pH of bleach alone, and then adding the fact that so many studies mentioned the frequency of Staph reoccurrence, as my skin is going okay right now, I’ll personally be using apple cider vinegar baths more frequently instead.

Amended: This does not mean I no longer take bleach baths, because I still do. I just treat them as a more aggressive maintenance treatment for the management of my skin, and subsequently take them sparingly, but as needed.

 

REFERENCES

Barnes TM, Greive KA. Use of bleach baths for the treatment of infected atopic eczema. Australasian Journal of Dermatology. 2013 Nov; 54(4): 251-258.

Chang MW, Hirschmann JV. Bleach Baths for Atopic Dermatitis. NEJM Journal Watch Dermatology. 2009 Jun 5;(nd).

Crane, Margaret. “Itching for Answers.” National Eczema Association, https://nationaleczema.org/itching-for-answers/. Accessed 23 Oct 2018.

Fritz SA, Camins BC, Eisenstein KA, Fritz JM, Epplin EK, Burnham C Dukes J, Storch GA. Effectiveness of Measures to Eradicate Staphylococcus aureus Carriage in Patients with Community-Associated Skin and Soft Tissue Infections: A Randomized Trial. Infect Control Hosp Epidemiol. 2011 Sep; 32(9): 872-880.

Gonzalez ME, Schaffer JV, Orlow SJ, Gao Z, Li H, Alekseyenko AV, Blaser MJ. Cutaneous microbiome effets of fluticasone proprionate cream and adjunctive bleach baths in childhood atopic dermatitis. J Am Acad Dermatol. 2016 Sep; 75(3): 481-493.e8.

Panther DJ, Jacob SE. The Importance of Acidifucation on Atopic Eczema: An Underexplored Avenue for Treatment. J Clin Med. 2015 May; 4(4):970-978.

all posts, miscellaneous, nutrition, treatments

waiting on time is so friggin’ stressful!

adult alone autumn brick
Photo by Pixabay on Pexels.com

Today’s post starts off as a bit of a downer. I have been feeling a bit trapped lately.

First off (and I’ll need to go back and do some searching because I’m genuinely curious), of all the people out there going steroid-free/not on biologics who have eczema covering over 50% of their body (and all the concurrent fun symptoms that entails), did this degree of eczema impede or otherwise alter your life plans (specifically career goals and things of that nature)?

I ask because lately I have fallen into a rut where I feel like I am failing. I left a planned career behind because a continuously flare was deteriorating my lifestyle and because of the nagging fear that my flares would always be there holding me back, making me miserable in my field of choice (physical therapy at the time). So there I was, feeling grumpy, and wondering  how others with severe eczema who work in health professions do it. But then I talked to my husband about my frustrations, which, to be fair were compounded by the worries and stress I’ve had with breastfeeding.

So let me foray into that realm now. In a nutshell, the current issue is that Fi sometimes has blood in her stool (poop) and most doctors tell me to use formula, in lieu of focused elimination diets. This stresses me the f*ck out because one, the pediatricians have been inconsistent in their reasoning. When Fi was less than 2 weeks old I was told to use formula because Fi wasn’t gaining “enough” weight (which is pretty subjective especially since their measurements haven’t been the most accurate… but that’s a rant for another time). Instead of teaching me about different ways to entice a baby to eat more or about potential reasons why she might not be eating, I was told to try pumping once to see how much I make in a sitting, and then supplement with formula with however much I pumped to make 3 ounces. The logic was clearly my body was failing to produce enough milk. So I pumped and only made about half and ounce and I diligently tried to feed her 2.5 ounces formula. You know what happened? She only drank half an ounce of formula and then didn’t want to eat anymore. The second reason I get stressed by this push towards formula now is that initially when Fi wasn’t eating I was told to eliminate dairy and soy from my diet. When I asked three doctors about how to reconcile the fact that formula (including the hypoallergenic ones) have dairy derivatives and soy I was told 3 different things:

  • Doctor 1. The hypoallergenic formula doesn’t have dairy or soy. But it does.
  • Doctor 2. It (this was around day 10) is more important for Fi to gain weight than whether or not the formula has allergens. That’s great and all, but Fi wouldn’t take more than an ounce of formula or breast milk at a time.
  • Doctor 4: This particular other hypoallergenic formula (being prescribed at around 3.5 months due to the blood in Fi’s stool) has hydrolyzed milk protein (basically pre-digested milk proteins, in that they are broken down so supposedly easier for the baby’s digestive system to handle), while the brand prescribed to me at 10 days was partially hydrolyzed. Okay sure, but then there was no mention of the fact that the third ingredient in said formula is still soy oil.

My complaint with this process is that the pediatricians have no advice about nutritional or dietary changes. Doctor 1 told me to give up dairy and soy, and then try gluten and eggs too if that didn’t work, but openly admitted to not knowing much about how diet affects breast milk or if foremilk/hindmilk imbalances have an effect. The same doctor told me that we had to keep getting diapers tested for occult blood (invisible blood in the stool). Doctor 2 was more like “look she’s a baby. These things happen. She’s gaining weight now so we are good.” And doctor 4 was like “occult blood doesn’t matter, we only care about visible blood”. I have a hard time trusting my baby’s doctors if they are all giving wildly different advice. Oh, and another point I have to make. I didn’t seek out 4 different doctors. The practice Fi goes to usually just sticks us with whoever is available so we have seen 5 different doctors/nurses there and gotten wildly different advice from each one. Doctor 4 I mentioned was a GI specialist, which we went to see as per doctor 1’s advice.

As for Fi’s inability to gain weight fast enough from day 10? She started gaining weight (still exclusively breastfed) after we had her treated for reflux, (which I had noticed because she made gagging faces whenever she ate, and doctor 3 confirmed my suspicions go be correct). After a few weeks, the reflux abated and she was fine on that front.

My problem with this process is it feels extremely similar to how doctors treat things they can’t solve, such as with eczema. I’ve gone to state-of-the-art facilities, told a dermatologist my background including about having horrible topical steroid withdrawal symptoms, and been either convinced or scared into using steroids again (the scaring came from being told my organs would all be inflamed if I didn’t use steroids). None of them addressed diet, none of them offered any alternatives to steroids, though one did say if steroids didn’t work we would move to cyclosporin (an immunosuppressant drug used for people who get organ transplants so that their body can’t reject the new organ). That option was on the table so long as I was ready to get frequent check-ups for my kidney* to make sure it was functioning well, and so long as I knew I would be at risk for getting sick more easily. It felt like an extreme option to say the least.

*(I previously wrote liver but meant to write kidney!)

This constant push towards formula without trying less invasive means first, disturbs me. Formula and breast milk are very different. Breast milk gives Fi a better chance of not getting eczema (which she sorely needs given that both Jake and I have it) as well as helps her fight off colds by producing antibodies when either one of us is getting sick. Breastfeeding also releases oxytocin and other calming hormones to make us both happy mellow and sometimes sleepy lovelies when I nurse her (a nice boon!).

This is not to say I wouldn’t use formula if I knew it would solve her problems. But so far the evidence indicates that it may not. Her weight gain issue resolved without formula, despite it being implied over and over that my body was to blame for the issue in the first place. She could only be having weight gain trouble if I was underfeeding her, because my supply was too low, right? Imagine if I hadn’t thought to inquire about her reflex symptoms.

And if doctor 2 is right and this is stool issue just part of her developing digestive system, then we have cut her off breast milk for no reason. Plus the formula doctor 4 prescribed? It’s so expensive that there’s a black market demand for it, despite it being pretty much identical to the formula doctor 1 prescribed. What?

So anyway I have this constant lingering fear that my body is poisonous and killing my baby, so therefore I’m failing being a mother, and I can’t work first because of skin and now also because of my tenure as a failing mother, so I’mm failing as a working adult, hence the added stress of being a useless human.

I should probably qualify to say that despite Fi’ s ever fluctuating stool contents, she is quite a happy baby, still slowing gaining weight, and hitting milestones as she goes. She is  also a crazily active baby, which may be the reason she gains weight slowly as she does spend cumulatively hours a day flail kicking whatever comes her way and smiling about it.

I don’t know. I guess the problem is that I straddle unknowns so often that they are starting to get to me. It just sucks to feel like my body is constantly to blame. It feels like my skin is a fluctuating erratic b*tch and now my breast milk is too?

Another qualifier I have to add. After all these diet changes I’ve been doing, I have noticed that my skin is much less terrible this cold season than previous ones. So clearly something I’m doing is helping a little. And the same can be said about Fi. The blood on her stool has lessened so much from when we saw doctor 4 and I just started avoiding rice (which I ate all the time) and oatmeal (which I realized I wasn’t eating notably gluten-free ones (oats are commonly contaminated with wheat during processing)) and cocoa/chocolate (which has caffeine and historically I’d eat a lot of it at one time). But the other problem is all these factors take time. There’s always potentially a quick fix medication to mask the symptoms, but to actually suss out what works and prevent it from happening again takes time. And what’s more nerve-wracking then sitting around waiting to see if your changes help or hurt your baby?

And then I’ll think, well maybe it’s not my diet at all, but the fact that I have so much systemic inflammation living with eczema, and that’s affecting Fi (despite not being able to find scientific proof or any doctor that believes that that happens). I don’t know. There’s no worse feeling than the lingering doubt and insecurity that you are f*cking up your baby.

Anyway that’s the basic hum of stress I have undertoning my life lately.

To combat that hum, I have been trying to augment lived with things I know have always made me happy and continue to do so: books, and more specifically, library books. I am forever taking out book after book on all manner of subjects, to consume like it’s my calling, like ants to sugar. To this day I know I would love working in a public library; I have so many ideas swirling in my head about improvements to various existing ones to help further user accessibility and build community. I just love libraries and books. So much information right there, and for free! You don’t need WiFi or a smart phone or anything. It’s a relic of a bygone era that I think is so important for today, as it provides so many underappreciated values. You can go to most libraries, in most towns, without being a patron, and sit down and enjoy their services including free internet. Lots of libraries have free events from book clubs to baby hangouts to beer nights. Every library has its own history and is usually shaped by its community, so you can get a glimpse of what a town is like by just walking through its library doors. Plus most libraries have interlibrary loan systems where they are partnered with other libraries to make sure they can continue to supply their community with a wide array of materials. There are also some funky libraries out there including Bookmobiles or libraries with novel services like American Girl doll rentals or art and tech supplies (like with Maker spaces). Libraries are actually one of the coolest inventions mankind has created. I just can’t get over a system that lets me borrow so many stories (I think I currently have 11 out, 7 on their way through the ILL system, and 21 more on my radar to take out once I make a bit more headway with my current batch).

I frequently find myself singing to Fi (completely randomly as I haven’t seen this show in years), “Butterfly in the sky. I can fly twice as high. Take a look, it’s in a book. Reading rainbow. Reading rainbow!”

nutrition, treatments

“and now for something completely different”

mountains nature arrow guide
Photo by Jens Johnsson on Pexels.com

Remember how I did a post yesterday about my skin care regime? Yeah ignore that. Much like how lives change, the way I take care of my skin is almost as fluid as my skin itself. Let me explain.

Yesterday I was talking about how I was using two products (Eczema Honey Co.’s Nut-Free Natural Healing Cream and Chuckling Goat’s Calm Down Kefir Lotion), and talked a little about them both. Well last night, Fi was fighting the sleep hard and I couldn’t get her down until around 11pm (after trying for 3 hours!), which meant that I didn’t get to catch up on the massive sleep deprivation from the night before. While I was trying to get her to calm down and sleep through various means, I was using the Chuckling Goat lotion on some dry areas (hands, feet, knees) to help work through some light itching. Finally, the little piglet stayed asleep when I put her down and I thankfully succumbed to my own exhaustion, only to be woken up around midnight by myself scratching the sh*t out of my hands, arms, and feet. It was so bad I could feel my skin starting to weep. Here’s a picture of the aftermath on my hand:

2018-10-17 20.21.01.jpg

When I woke up enough to realize what I was doing, I took some Benadryl and waited for it to kick in and knock me out. But then I had to wake up at around 3am because Fi has been big into not sleeping through more than 4 hours at a time lately, which was rough (I don’t know if you’ve ever tried to cut your sleep short when taking Benadryl, but it is hard to mentally function afterwards).

Today I started the day off (once the Fi routine was completed) with another bleach bath to help level out my skin, followed by rinsing off using the Chuckling Goat Calm Down soap bar, and then using the Eczema Honey Co cream again. I am still very much enjoying it, in fact, it’s time for a mini review!

Eczema Honey Co is a company where the founders live with eczema themselves (always a plus because you know they are actually experiencing the condition they are treating). They currently have 4 products: their original cream, their nut-free (no almond oil) version, an oatmeal scrub, and cotton gloves, and the cool thing about their line is that they have a monthly subscription, which is lovely because when you have eczema all over your body, you know that you’ll need a lot of product. The one I am using is there nut-free cream and so far I love it. It’s only got a few ingredients (Organic Pure Honey, Grapeseed Oil, Organic Grated Beeswax, Organic Sunflower Oil, Colloidal Oatmeal, Pure Spring Water, and Optiphen), which makes it easier to understand what I’m putting on my body (aka looking up the studies on how specific ingredients affect skin). This is an important factor to consider because our skin is quite absorbent and things we put on it can end up in our hypodermis and/or our blood stream (and this is even more true for people with compromised skin like those of us with eczema). Of note: optiphen is a chemical made of Phenoxyethanol, Caprylyl Glycol, and Sorbic Acid, and the biggest concern with it seems to be that it can be a skin irritant according to EWG Skin Deep Cosmetics Database. My opinion on the product overall is that it seems to be the best thing I have tried up to now. I put it on after baths or showers and it tends to hold in the moisture best like I mentioned in my post yesterday, and it smells nice and seems to be helping reduce the major TSW signs: the redness, the dryness, etc. Jury’s still out as to whether it is helping with the itch (currently it seems my itching is worst 11pm-4am and nothing can fix that minus taking Benadryl to knock me out). All in all I think for now, especially given that I have only used it for a few days now, this is the product I am going to stick with and see where it takes me and my skin. The only less than positive comment I have is that it is a bit sticky, but it’s mostly made of honey, so that’s expected. All in all I’m giving it two thumbs up so far.

Now why do I think I am enjoying this Eczema Honey Co product? It may jusr be because their first ingredient is honey, and honey historically has been used topically to treat wounds. The evidence is still a bit iffy on how effective honey really is on wounds other than partial thickness burns, with some studies toting the antibacterial properties when used for wounds (studied on the wound of a stumptail macaque), and other saying that honey can slow healing (of venous ulcers in particular). But all in all, as with most things, I think it comes down to using what you feel is comfortable (and consulting an open-minded medical professional who you can discuss your concerns and questions) to determine what you want to use for your care.

Speaking of skin (which I almost always am), I am currently reading The Little Book of Skin Care: Korean Beauty Secrets for Healthy, Glowing Skin by Charlotte Cho. So far I’m enjoying it immensely, as it goes into detail about how the Korean skincare regiment works in a nutshell, as well as how the mentality of it differs (Cho says that Koreans enjoy their skin care and don’t think of it as a chore). I am trying to think about how those of us living with eczema/TSW could learn to love our skincare regimes. It feels like such a foreign concept, but I can see how it would be an immensely helpful part of healing. So, I am thinking about how to apply what I’m reading in the book to myself and if it works, subsequently to the eczema/TSW community. Keep your eyes posted for that in a bit!

I also wondered if there are estheticians that specialize in eczema/TSW, because that would be awesome. Another idea I had was that if in some world I could learn Korean, it would be awesome to go to South Korea (with my sister who has been studying Korean for years) and experience their skin care ways for myself. But that’s a pipe dream.

On a complete and utter tangent, all I dream about lately is eating That’s It Bites, the blueberry ones in particular. But actually. I go to sleep wanting them, I wake up wanting them, and then when I am sitting around during the day, especially if I get a little bit hungry, I crave them so badly. I think I’ve latched onto them because:

  1. That’s It bars are so good
  2. blueberries are some of my favorite berries
  3. the chocolate truffle version is delicious, particularly the blueberry one
  4. they don’t have any other ingredients in them besides blueberries, apples, and dark chocolate (cocoa, cane sugar  and cocoa butter), and I’m not eating sweets with ingredients I can’t track

So basically if you are ever feeling like you want to send me something nice… send me those – insert winking face here – !

Anyway, in regards to the title of today’s post, what I meant by taking a new direction is that I am trying to figure out what my focus, both hobby and career-wise, will be. I am accepting that my skin is going to be the limiting factor for a while to come and in that interim I am trying to figure out what I can do, not just in the meantime, but potentially forever. I want to be able to start to commit to things again and know that I’ll still be able to do them even with the worst of flares. I know I’ve dabbled with writing for a while, but now I am thinking of taking it seriously (Glob help me!). If you know of any opportunities, let me know (this is my desperate reach out to the universe)!

Tangential parting thoughts: Did anyome know the reference I made with the post’s title? I credit my dad for why things like that are still stuck in my head today.

 

REFERENCES

Jull AB, Cullum N, Dumville JC, Westby MJ, Deshpande S, Walker N. Honey as a topical treatment for acute and chronic wounds. Cochrane Database of Systematic Reviews. 2015 Mar 6;(3):CD005083.

Jull AM, Walker N, Deshpande S. Honey as a topical treatment for wounds. Cochrane Database Syst Rev. 2013 Feb 28;(2):CD005083.

“Optiphen.” EWS Skin Deep Cosmetics Database, https://www.ewg.org/skindeep/ingredient/732140/OPTIPHEN/. Accessed 17 Oct 2018.

Staunton CJ, Halliday LC, Garcia KD. The use of honey as a topical dressing to treat a large, devitalized wound in a stumptail macaque (Macaca arctoides). Contemp Top Lab Anim Sci. 2005 Jul;44(4):43-45.

all posts, nutrition, treatments

my new(est) regimen

agriculture basket beets bokeh
Photo by Pixabay on Pexels.com

I successfully (so far at least) staved off a flare! Generally as the seasons change towards their colder demeanor, my skin freaks out. As I have gone through topical steroid withdrawal for about 4 of the last 5 winters, I’ve learned that this time of year includes symptoms such as:

  • a baseline of my skin getting redder,
  • little pimple-looking marks on my arms and legs especially,
  • thermoregulation issues at night especially, which start with what I liken to non-menopausal hot flashes of the skin while my core feels freezing,
  • a thickened and discolored layer of skin developing all over, and
  • an insatiable itch thats origin is probably more related to the inflamed nerves as the itch can travel.

On worser years there was also skin weeping and other gross exudate but luckily this time around, as I haven’t used steroids in about 11 months (and when I was using them they were not a strong), this flare’s symptoms seemed to be more benign. That being said, I also am a seasoned TSW sufferer now so I know more or less how to handle the onset of a flare.

Firstly, diet. I luckily am in the midst of multiple dietary changes for the sake of Fi and her developing digestive system, and so I have already been avoiding dairy, soy, gluten, and eggs (all as per suggestion of the pediatrician), and coconut and corn for good measure.  Then I recently eliminated rice and oats, which apparently are other common allergens a breastfeeding baby can have (which I learned by word of mouth from a physicians assistant’s coworker). I’m at the stage where everyone, especially pediatricians, joke about how I have nothing left to eat but air, and it’s getting old. Essentially my diet just means I have to (aka Jake has to) cook all my food at home. My meals have become neither meat- or carb-based, which completely confuses the majority of people I meet. Here’s an example of what I ate yesterday. I had 6 separate food dishes that I rotated around to make 3 meals. They were as followed:

  • a cold salad of chickpeas, cucumbers, red cabbage, vinegar, and some peppers
  • a pulled chicken with a graoefruit sauce in lieu of BBQ, cooked with onions, kale and other spices
  • a quinoa dish with poblanos, dried apricots, and spices
  • braised rosemary potatoes
  • baked and salted chickpeas
  • chorizo, “riced” cauliflower,  pinto beans, onions, garlic, kale and other spices, and
  • a warmed apple with cinnamon for a sweet treat

So clearly I still have plenty I can eat. But I digress! My point is, my diet is currently avoiding a number of inflammatory and common eczema-inducing foods.

So now that we’ve gotten past food, the next factor in my skincare during a flare (that rhymes!) is figuring out the topical stuff. First, I end up taking much more frequent baths. The pimple looking stage is what triggers me to take a bleach bath, the redness drives me towards Epsom salt baths, and the residual heat or skin discomfort and dryness warrants apple cider vinegar baths. Epsom baths tend to dry me out so I use them after bleach baths when I know the bacterial overload has been decreased and now I need something to dry out the dead crusty exudate layer.

Then comes the moisturizing stage. Lately I have been using two products. Eczema Honey Company’s product Eczema Honey Original Natural Healing Cream, and Chuckling Goat’s kefir lotions (first the rosemary, now the lavender one). I think the Eczema Honey Co works a bit better. It tends to provide a better barrier and seal in moisture better, plus the honey works as a light and natural antiseptic. It’s downside is that it separates from the oil in the mixture pretty quickly so I have to stir it a bit before use, and that it is so sticky! The Chuckling Goat lotions are better for the inflamed days as it seems to help dry out the excess heat and redness.

Lastly, there is the stress factor. I have gotten pretty good at distraction (as mentioned in one of my previous posts), which truly does help keep my flares under control. I just don’t let them get to me for very long. It’s really a godsend right now because I haven’t been sleeping so well (partially because I’ve been under the weather, partially because my skin heats up like crazy when I’m under a blanket, and partially because a few days ago Fi started randomly waking me up every 2 hours to feed. Apparently it’s possible that I was producing less milk while sick and so she needed more feeds in to get the same amount as usual. Anyway, the point is that my sleep has been compromised.

Instead other things I’ve done to try to help my skin include drinking a lot more water (something I am historically terrible at), and taking probiotics and the daily prenatal. I have also been making sure to do some kind of physical activity, usually the True Blood Fitness Game (see the post here), but also yoga when my insomnia gets bad, and generally just passing around the house holding Fi for “cardio”.

It’s slow going, but I seemed to have been able to skip over most of the worst of the inflammation phase, save for a few elephant skin wrinkles and the telltale cuts in my hands as they dry out. I’m hoping the difficulty with sleep (and the whole aggressive skin heating up in bed) dissipates. Work in progress with that.

Ugh. Overall my feelings (mostly formed based on how my skin reacts) are that I am not a fan of when the cold seeps in and it feels like nothing can stay warm. Until I can consume copious amounts of hot tasty beverages and treats for fall and live dressed in a thick comfy blanket, this time of year is bleh! Sometimes I think I was meant to be a bear because hibernating through the cold months seems ideal.

all posts, the eczema body, treatments

there are germs on my skin! part 2

selective focus photography of person wearing three bangles
Photo by Godisable Jacob on Pexels.com

It’s my favorite time of year and I just received my Chuckling Goat package (but more on that in a bit).

2018-10-02 13.40.38

A few months back I wrote a post about the skin biome and how I was excited by the small movement of companies creating products geared towards helping it. Since then there have been developments about different companies creating products to help either work with the natural skin biome or to help reintroduce micro-diversity to create an appropriate balance for healthy skin.

I didn’t know it previously, but Johnson and Johnson had a movement a while back to create products that didn’t mess up the skin microbiome of babies’ skin. Such products, like Aveeno Eczema Therapy Moisturizing Cream have a trial indicating that they actually help to increase the microbiome diversity of the skin with use over time.

The company has become skin microbiome-focused in a multitude of ways, including offering use of their JLINX incubator under the JLABS. S-Biomedic has joined JLINX and is working to create products that remove the bad bacteria and replace it with good ones to balance out the diversity of the skin back to a healthy level. This idea of balance is becoming more and more accepted as it is found that overuse of antibiotics is causing more harm than good for conditions like eczema. Studies are showing that balanced diversity is what we need for our skin biome, rather than sterility (noting that antibiotics still have their place, including when surgery or infection is involved). Microbiome transplants are now no longer a thing of the future but are instead potentially the next big medical treatment protocol!

More recently, I read a book called The Good Skin Solution by Shann Nix Jones, that talked about the gut and skin microbiome and Jones’ personal experience as to how she came to develop a treatment to help manage her young son’s eczema. The goal was to help increase the diversity of both microbiome using the probiotics in kefir made from their goats’ milk. When it was a success with their son, her and her husband decided to sell their products and hence the Chuckling Goat business was born.

Jones reintroduced me the theory that you need to fix your gut microbiome to have any really lasting effect on your skin, but she added the idea that it’s best to treat both at the same time, (hence her her program that includes probiotics for both the skin and the gut). Needless to say I was intrigued so I looked into her products and went on to order some (but unfortunately I can’t get the kefir drinks because I live in the states and they don’t ship that outside of the UK).

Today the soaps and lotions arrived and I am beyond excited to receive them (happy as a clam… or a ceramic jack-o-lantern!). See my spoils below:

2018-10-02 13.40.42

I’ll have to figure out what to do to increase my gut flora diversity in lieu of kefir, as I was advised to avoid dairy while breastfeeding to see if that helped with Fi’s digestive woes. I’m not sure if goat milk would be okay since it is supposed to have less allergenic components than milk. I may just wait until Fi is done breastfeeding.

 

REFERENCES

Capone K, Klein SL, Kirchner F, Tierney N. “Effects of Topical Lotions on the Atopic Dermatitis Skin Microbiome and Associations with Itch and Skin Barrier Function.” 76th Annual Society for Investigatiev Dermatology (SID) Meeting, Portland, OR. 26-29 Apr, 2017. Poster presentation.

Myles IA, Earland, NJ, Anderson ED, Moore IN, Kieh MD, Williams KW, Saleem A, Fontecilla NM, Welch PA, Darnell DA, Barnhart LA, Sun AA, Uzel G, Datta SK. First-in-human topical microbiome transplantation with Roseomonas mucosa for atopic dermatitis. JCI Insight. 2018 May 3;3(9):e120608.

Parikh-Das A, Ganopolsky I, Nunez C, Moreira L. A clinical trial to evaluate the efficacy of a OTC colloidal oatmeal skin protectant cream in the management of mild to moderate atopic dermatitis in infants and toddlers. JAAD. 2017 Jun 76(6);AB10.

Puniewska, Madgalena. “How the Microbiome Could Transform Your Skin in Surprising Ways.” Johnson&Johnson Innovation, 12 Oct. 2017, https://www.jnj.com/innovation/how-the-microbiome-could-transform-your-skin-in-surprising-ways.

 

all posts, the eczema body, treatments

using boob milk for more than the baby

agriculture animal blue sky breakfast
Photo by Pixabay on Pexels.com

As some of you may know I am currently nursing my 3 month old baby girl, and in doing so as she is my first, I’ve learned that leaking is a thing (sometimes it occurs when she’s nursing on one side- the other side will start to drip milk, and other times they seem to leak for no apparently reason at all). As I wear nursing pads in my shirts during the day, the problem begins at night when I’m in bed trying to sleep. The leakage then can be really annoying. So my most recent solution has been spreading the milk on my skin, because why not- it’s already leaking all over it anyway.

My less impulsive logic for trying this experiment came from some research I had been doing a few weeks ago about breastmilk and its health benefits for the baby. Fi got sick and I wanted to know how her immature immune system could handle sickness when she only intakes breastmilk as her food source. This search led me to an internet viral photo showing how a mom’s breast milk changed when her infant got sick. The 2013 study mentioned in that post talks about breast milk’s immunological function and explains how when the mom or baby get sick, the number of leukocytes (aka white blood cells) in the breast milk drastically increases to help protect them, because leukocytes help fight disease (which I found to be such a cool example of symbiosis. I personally have also noticed that breastfeeding seems to keep both me and the baby from getting too severe of sicknesses. In fact, my mom, mother-in-law, and husband each got sick after the baby was born yet Fi and I were fine!).

I also read an article by NPR addressing the breastfeeding versus formula debate for poor countries.  A point it stated made me more curious about breast milk; it said formula can cause increased risks of diarrhea and respiratory infections. I assumed this is so because it requires using water to make (and clean sources are not always available in impoverished countries) but maybe it’s also because formula doesn’t have the same chemical and bacterial composition to allow it to be readily accepted by the baby’s developing digestive and immune systems? By extension I supposed that breast milk had to have some component in it that generally allows it to not irritate the digestive and immune systems*… which is my big sign to think “MICROBIOME” (* this of course is excluding when the baby has allergies or sensitivities to something the mom is eating that is going into her breast milk). The article also talked about how it’s weird that we are constantly trying to research the benefits of breastfeeding when it’s as natural as “breathing, chewing, hearing, passing stool”. But we live in a society where we need evidence and so I decided to play the game of informal (and badly controlled) science to see if I could test my own theory, that breast milk may help with (eczema) healing.

I did not participate in the rigors of the scientific process because I am lazy and I doubt Fi would be content amusing herself long enough for me to do it, but instead I just dabbed some breast milk on my shallow cuts every now and then instead of using neosporin or leaving the cut alone. My observations: it would seem as though breast milk can help with reducing the pain of shallow cuts (I tried it on the cracks on my knuckles and outer ears, cuts on my ankles and hands), and helps to speed up the healing of said cuts. It does not moisturize (the spots I put it on tended to be drier the next day… though that could be because when cuts heal on me, they start skin flaking…) but overall, the spots I put it on did seem to heal up and achieve a cleaner scab and softer skin around it.

Apparent cons of this experiment? The milk can sometimes burn (but again, everything burns when it touches my inflamed skin spots… even water) and it’s also a little sticky but it dries sticky-free. Fun fact, I have a pet peeve about being sticky. I hate it. So much.

After this self experiment, I was more curious to support why I might be seeing the results I saw so I did some low level cursory research. Also speaking of research, I received my diploma the other day. I officially have a Master of Science in Health Sciences from MGH Institute of Health Professions. I am now a MASTER of science. The academic title of master seems somewhat archaic; I envision myself similar in status to an entry-level alchemist or and mage, as I have established myself in a trade, but it will still take years to perfect my craft. Anyway…

There’s not a lot of recent research being done (or at least it’s not readily available yet) but I did come across two recent ones. This first paper, of which I could only access the abstract, tested wound healing of the cornea (yes, of the eye) in mice using human breast milk, milk from mice, artificial tears, and the control group. The results were that the human breast milk caused the fastest healing, followed by the mouse milk. The other two groups (artifucial tears and the control) were still not healed by the end of day two. The other study I found was published in 2015 in Nature, and it was titled, “Human milk proresolving mediators stimulate resolution of accuse inflammation”. It came to the conclusion that the lipid mediator-specializing proresolving mediator profile (a ratio of sorts between lipid mediators and specialized proresolving mediators) in human milk helped the macrophages (or cells that engulf bad bacteria) to contain pathogens and remove dead cells (in a process called efferocytosis- my word of the day). It is important to note that this was seen in vivo (in mice), and that breast milk was not applied topically to the skin. If the results are applicable to humans, I see this study as being useful because people with eczema suffer high levels of inflammation internally not just on their skin, and because turning off the inflammatory phase is also important in wound healing (more on this in a later post).

After that article I backtracked and wanted to know more about what breast milk is, which led me to this document that included the various components of breast milk (though I can not find the professor or the molecular virology lab anywhere else on the web…). Also note that the tables say the various factors are tested “in vitro” meaning not in the organism (for example, secretory IgA from breast milk was probably removed from breast milk and tested in a petri dish against E. coli). Even so, the breadth of potential abilities of breast milk, due to its staggering list of factors alone was interesting in its own right.

In conclusion, though I don’t think breast milk applied externally heals the mother’s eczema or TSW, I do think it can help me with superficial wounds, especially when it’s the middle of the night and I am otherwise unmotivated to leave the bed even if I’ve been scratching.

 

REFERENCES

Arnardottir H, Orr SK, Dalli J, Serhan CN. Human milk proresolving mediators stimulate resolution of acute inflammation. Mucosal Immunology. 2016, May 9;9(3):757-766.

Asena L, Suveren EH, Karabay G, Durson Altinors D. Human Breast Milk Drops Promote Coreanl Epithelial Wound Healing. Curr Eye Res. 2017 Apr;43(4):506-512.

Brink, Susan. “Why The Breastfeeding Vs. Formula Debate Is Especially Critical In Poor Countries.” Goats and Soda, https://www.npr.org/sections/goatsandsoda/2018/07/13/628105632/is-infant-formula-ever-a-good-option-in-poor-countries?utm_source=npr_newsletter&utm_medium=email&utm_content=20180719&utm_campaign=goatsandsoda&utm_term=nprnews. Accessed 1 Oct 2018.

all posts, community, miscellaneous, treatments

girl power! on collectives and community (and witches!)

photo of multicolored abstract painting
Photo by Free Creative Stuff on Pexels.com

Eczema is a devilish disease that is best thwarted mentally (in my case) by keeping myself busy reading, researching, and daydreaming. The strongest distraction as of late has been collectives. I have always had an affinity for all sorts of collectives because I think that when the project comes together from all that cooperation, it showcases the greatness of an amalgam of multiple minds. As such I have become more aware of collective collaborations over the years, especially when it comes to the arts. As I am often entangled in women’s health, below are a few of the more recent finds that are all women/all girl collective efforts.

The Secret Love of Geek Girls is an anthology created by Hope Nicholson and other artists, of prose and comic forms, which encompasses various topics such as divorce, coming out, asexuality, young love, and other aspects all from the lenses of women who identify and/or embody the idea of a geek. I absolutely loved it. It’s an anthology I have purchased to randomly flip open pages to read when I’m feeling a certain kind of way. Also I think it would be an awesome idea to create an eczema anthology one day, to share the experiences and feelings and worlds of those afflicted.

Girls Drawin’ Girls Tarot Deck  is a beautiful tarot deck done by the Girls Drawin’ Girls, a group formed by Melody Simpsons (who worked on the Simpsons). The group was formed to allow women a space to compete in a traditionally male-dominated industry. Speaking of tarot, I’ve gotten very interested in it lately. Not only does it gave a strong history of feminine mysticism but some people in the medical and health professional fields have been starting to use it as a therapeutic device. Jessica Dore uses tarot in her clinical work as she becomes a social worker, and Dr. Art Rosengarten, a clinical therapist, uses tarot for psychotherapy. There are a few older studies (like this one from the 90s) about tarot used for therapy, and the general impression I got is that due to the symbolism, tarot helps to give the clients a more visual way to process out their thoughts and bring forth aspects that are on their subconscious. In my head, if nothing else I see it as being a therapeutic tool, much like the Rorschach (ink blot) test but more multifaceted, and I would love to see more studies done on it. I personally want to learn how to do tarot readings for the storytelling aspect, but if it makes me subsequently be more in the moment, reflexive, or mindful (or if nothing else, distracted from my itches), I’m not complaining.

And since we’ve delved into tarot, and are thus already over the line and into mysticism, we must then talk about witches. The history of witches in America (as I understand it to be from listening to the tours in Salem and from this Smithsonian article), is mostly a tale of fear mongering. It started in Salem, Massachusetts (at the time the town of Danvers was also a part of Salem). A young girl and her cousin (Elizabeth and Abigail), whose slave (Tituba) used to tell them stories to amuse her and her friends, supposedly faked going into a possessed fits, their friends followed, and then religious men got involved who started calling out all witches to be persecuted (usually with the sentence of being jailed forever). A witch ended up encompassing any wayward woman (or sometimes man), such as one who didn’t behave as expected, who was promiscuous, who spoke her mind with the candor of a man,  who dabbled in the art of herbal healing, etc, and evidence for arrest included visions for a time. The tension was ramped up because of various families in towns competing for resources and believing the high tensions to be the result of devilry (witches were thought to commune with the devil). I’ve heard it thought that there may have also been competition for tourism and so slandering the other parts of Salem (e.g. Salem Village versus Salem Town) with the threat of witchcraft was a surefire way to insure more money into your own town (but I’m not sure this is true- I just heard it by word of mouth). The culmination of events led to the infamous Salem Witch Trials, with 200 accused, and the death of 20 people (not including those who died in jail).

Today there is more of a new era of witch culture in America. Well there are two blurred and overlapping lines of “witches”. There are the herbalists and healers who had had a bad rap in the past for practicing medicine and healing outside of the realm of religion/formal hospital training, and then there are the new age witches (which can also include herbalists and healers). As I live very close to Salem today and Vermont/Maine, I do get glimpses of both, but only limitedly. A lot of Salem is rampant tourism like the Harry Potter store Wynott’s Wands (though their wares are beautiful and I found out that their wands sell well as batons for conductors, which is really cool).

One example of the new age of witches is HausWitch, the store creation of Erica Feldmann who describes it as “a modern metaphysical lifestyle brand and shop” where they sell “witchy” wares made by independent makers, including a lot of self care body products, journals, courses (like tarot readings and seasonally-focused events), etc. The most interesting aspect of HausWitch and stores like it are the modernization of witchcraft as an inclusive movement. HausWitch for example, works to create community and thus holds many different events and healing practices and activism discussion among other activities to foster connections. Traditionally, a bunch of witches together in a group was called a coven, and was seen and portrayed as a dangerously bad thing, but in seeing covens today, they are essentially just another form of community with the commonality, instead of being location, sparking the starting connection.

Personally, as a person who is always trying to find ways to foster community wherever I go, I think the whole new resurgence of witchcraft is pretty cool, and I’m excited to learn more about it and see where else in the country it’s happening. I am particularly biased because I have always loved herbalism and since my eczema has gotten crazy, self care, and so any movements that entails taking care of yourself and immersing yourself in a community that is seasonally-inclined, is my cup of tea.

 

REFERENCES

Blumberg, Jess. “A Brief History of the Salem Witch Trials: One town’s strange journey from paranoia to pardon.” Smithsonian.com, https://www.smithsonianmag.com/history/a-brief-history-of-the-salem-witch-trials-175162489/. Accessed 17 Sept 2018.

Dore, Jessica. “Tarot + Psychology: An Interview with Dr. Art Rosengarten.” Jessica Dore, https://www.jessicadore.com/tarot-psychology-interview-dr-art-rosengarten/. Accessed 17 Sept 2018.

Heaney, Katie. “Does Your Therapy Need More Tarot?” The Cut, https://www.thecut.com/2018/07/does-your-therapy-need-more-tarot.html. Accessed 17 Sept 2018.

Semetsky, Inna. Integrating Tarot readings into counselling and psychology. Spirtuality and Health International. 2005;6(2).