sometimes i personify my eczema

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When I haven’t had a real flare in a while (flare in my case depicted by aggressive heating up randomly due to pressure or any prolonged skin contact, or when my skin develops a hot red undertone color), its timely arrival always knocks me down a few notches. Sometimes I liken my eczema to being some kind of monster that continues to hunt me movie after movie sequel, or I hear its irritating voice cutting through a crowd. This most recent flare comes across like a socially unaware drunk, and I like to lighten my mood by pretending it would act like Sheldon from The Big Bang Theory:

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Ugh. At any rate, I’m taking it day by day, and the good news is when I do fall asleep (and Fiona doesn’t wake me up) I can really sleep, thankfully. It’s strange, I don’t really remember what it’s like to naturally wake up anymore. In the immortal words of country singer Thomas Rhett, “ain’t it funny how life changes”.

But, when I am first in bed, sandwiched between the time before I can succumb to the depths of the dream world and the time before Fi wakes me up again, my head is filled with thoughts that I have to process.

It’s during this time that I find that I tend to blame myself for my flares. I’ll think back to things I ate and worriedly wonder if it was sunflower oil in the crackers causing me to develop a sensitivity to my moisturizers that have sunflower in them. Or I’ll berade myself because I had the fruit covered in dark chocolate. I’ll panic that I’m secretly allergic (but not anaphylaxically) to almonds and just never knew, or that it’s because I had too many calories and ate too many legumes and so I slugged my digestive system down and now I am paying the price. Or maybe I had a Polar Seltzer and who knows what those natural flavors are made of! Or I had a probiotic drink and maybe it was the wrong kind of probiotics. What if it was the coconut!? At any rate, the result is always the same, fearing food and feeling blue about myself.

This type of stress gets compounded by my clingy eczema, as it lingers over me constantly reminding me that there is a cause to each flare-up, so what was it this time? I also find that I scratch my hands a lot more at night from a combination of the heating up moments laying under the blankets along with the constant drying out (and literally nothing keeps the moisture in at this stage!).

What I’ve learned is that when I get super tired in the middle of the night, as I’m pawing away at my paws, I tend to have thoughts zoom around my head that make no sense but seem so logical in the moment. If I just scratch here then you know that assignment will get done. And random nonsensical thoughts like that. I honestly have no idea what I’m talking about when I wake up in the morning and looking at my picked scabs and scratch marks.

When I do have some skin healing downtime, I like to map out how I’ll treat myself later. I know it’s a pretty divisive option, but I love tattoos. I think there is something about knowing my skin gets all wrinkly and cracked and flaky that makes me not have those “well imagine how bad it will look when you are old and wrinkly” thoughts. I’m already wrinkly, and age has nothing to do with it. Me and this cat are basically identical:

giphy

At any rate, I like to find cleared spots and think about what kind of tattoo I would get there. Lately I’ve been thinking about lotuses. They have a lot of symbolism for women’s health which I really like. That and I really want to get a tattoo of a open book at some point. Generally I like dreaming this up a lot more than I actually execute action, but who knows what will happen after this flare passes.

 

 

do you detox? (or fast? or supplement?)

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“Hello darkness my old friend”… today’s post was started during the witching hours of the night, not because of insomnia (yay, progress!) but because of Fi-somnia… aka my 4.5 month old baby, Fiona. She’s a much cuter reason to have a disturbed REM cycle.

Anyway let’s talk about the health elephant in the room: detoxing. I have heard more and more talk about various detoxification methods and I am just not sure what it all means, so today’s post is about clearing my system (pun intended) of these questions.

First off, what are the theories around detoxification? One theory I have heard for those who have eczema goes as followed: our organs (specifically the liver and kidneys) become over-taxed by our modern diets and exposure to heavy metals and other toxins, and at some point it becomes all too much and our bodies cannot flush-out said toxins, so instead, the build-up of toxins show off their toxic love by wrecking our skin.

Now going by that theory, let’s quickly delve into the soup to nuts details of how detoxification works in the body in general by addressing (very quickly) specific organs.

  • Liver: works by changing toxins into less harmful substances and/or helping the body flush out toxins
  • Kidneys: remove waste and acid build-ups from blood into our urine to be flushed out of the body
  • Intestines: helps to remove toxins via waste or vomit
  • Lymph system: transports its white blood cells throughout the body
  • Respiratory tract: the lungs remove gases from our bodies
  • Skin: (when intact) prevents some toxins from penetrating into the body

So from there, let’s address some specific detox methods I’ve heard about including the watermelon detox, the lemon detox, etc. My internet researching first led me to a review done in 2014, which reported that there wasn’t much evidence to show that detox diets actually work. It indicated that studies that said otherwise usually had flaws in their methods or too few people tested (aka small sample sizes, which is a problem because then you can’t reasonably assume the results will work for a much larger group).

I then looked more for studies, but before I talk about them, let’s backtrack and talk about studies that investigated how detoxification naturally works in the human body (and/or animal bodies). First I wanted to figure out what organs have been studied to hold toxins. A study done in 2007 on African catfish showed how the livers, kidneys, and hearts of the fish ended up storing high concentrations of heavy metals (zinc, lead, arsenite, cadmium, and copper) presumably from pollution entering the water nearby. I’m not sure if the same organs are seen to hold toxins in the case with humans, but given how often we hear livers talked about in the same sentence as detox diets, I’d venture to say yes. I then actually looked up via the CDC, about organs and toxic exposures for humans, and apparently all organs can be affected. Well then, how do our bodies avoid full spectrum toxicity?

Well, bodies have some ability to create compounds out of heavy metals, to bind them chemically to make them less dangerous to the body (which is the function of the liver, remember?), as was supported in a study in 2004 on seals, porpoises, and albatross. Generally heavy metals can end up in cells in the body: in the cell’s fluid, mitochondria, nucleus, etc (in the case of the study, they were talking about liver cells). But how specifically do bodies deal with heavy metals; or in other words, what gets the liver to start neutralizing these toxins? A study done in 2004 on mice looked at something called the metal responsive transcription factor 1 (or MTF-1)Side note: a transcription factor is a protein that helps turn on/off genes. The study’s results showed that a developing fetus that lacks Mtf1 (the gene that MTF-1 can turn on/off) will die because its liver won’t be able to form properly, but an adult that lacks Mtf1 will have difficulty handling heavy metals and will have low lymphocytes (the cells that help clear bad germs and materials out of our blood). This MTF-1 also is used to deal with when the body has hypoxia (not enough oxygen) or oxidative stress (too many free radicals in the body). What this all means is that our liver is able to function properly because it has this protein that turns on whatever genes are needed to get the liver to deal with toxins (metals and free radicals).

Now let me also quickly talk about oxidative stress, which is important to note because heavy metals can cause oxidative stress. That may be why and where the idea of some detox diets came from: if you want to detox from free radicals in the body, doesn’t it seem logical to consume antioxidant-rich foods and nothing else for a few days to cleanse? And what foods are known to have good supplies of antioxidants? Watermelons, lemons, and many fruits and vegetables that we see juiced into detox juices. So using that line of thinking I now move on to trying to better understand the support behind specific cleanses.

First I searched for the lemon detox. There’s a study that was done in 2015 on overweight Korean women that tested the lemon detox drink (a lemon, maple syrup, and palm syrup combo) versus a placebo drink versus a normal diet for 7 days followed by 4 days of food transition. According to the abstract of the study (which was all I could access freely) both the placebo and lemon drink resulted in improved BMI, body weight and body fat, as a well as improved serum insulin levels and insulin resistance scores. Hemoglobin and hematocrit levels were unchanged for those on the lemon diet, while a protein called serum high-sensitive C-reactive protein (hs-CRP) was reduced. What I am unsure of, is if the hematocrit and hemoglobin levels were within a normal range to start for the participants (which is important to know because too low indicates issues like anemia/low iron in the blood; too high can be a signal of dehydration among other things). The researchers concluded that going on a lemon drink detox for 7 days improves body fat and insulin resistance. The reasoning behind why however, they said was because the lemon detox drink is low-calorie, so essentially you are just burdening your digestive system less. So it’s more likely the fasting component that helps rather than the lemon drink having a cleansing effect.

What about watermelon? A study done on rats in 2015 indicated that a diet of watermelon helped reduce the effects of laboratory-induced type 1 diabetes. The procedure involved the rats fasting for 24 hours before being injected with a solution (alloxan) to induce diabetes, and then being fed watermelon extracts for a week. The rats given the watermelon extract had improved weights and reduced blood glucose concentrations, among others changes that caused the watermelon-fed rats to more closely resemble the control (healthy) rats, than the diabetic rats.

Thus my overall concluding thoughts on detoxing so far, are that:

  1. If you are consuming fewer calories, innately you are taxing your digestive system less so you’ll have a natural “detox” effect,
  2. With fewer things in your digestive system, the effects of consuming foods that are rich in antioxidants probably does help remove free radicals. It also probably therefore lets your liver bind toxins and your kidneys remove waste more effectively, and
  3. If detoxing is therefore being used synonymously with fasting, then there is a lot of evidence that it works. Fasting has been studied to, when done safely, be beneficial for everything from diabetes and obesity to other autoimmune disorders.

The reason I brought up point number 3 is because there are studies done on lemon juice and other popular detox foods that don’t include fasting, but rather just adding said food to a person’s existing diet. One such study done in 2016 tried such an experiment, by adding lemon juice and garlic to participants diets, and their results included decreased cholesterol, reduced blood pressure, and reduced BMI. In Jason Fung’s book Obesity Code, he mentions how drinking two tablespoons of apple cider vinegar in water before bed helps lower your blood sugar levels while you sleep. So then one can beg the question of, are we seeing improvements to health more so because fasting allows our bodies to “catch up” and get rid of toxins, or because we are lacking nutrients and so when we supplement them we see positive outcomes to our health?

Backtracking for one last comment on juicing and raw vegetable/fruit detoxing. A study done in 2017 looked at the effects of a raw juice diet of 6 drinks a day for 3 days, varying the juices throughout, and saw a lot of positive results in changes to the gut microbiota, increasing microbiome species correlated with weight loss and other aspects. The issue still stands of whether or not it’s the food types themselves that are included in the juices, or the fasting aspect (as one consumes a lot fewer calories when juicing), that provokes said positive results.

Honestly, in my humble opinion, it doesn’t actually matter which answer is correct because if you are safely fasting on occasion (and/or reducing calories), and consuming healthy options with lots of vitamins and minerals while doing so, does it really matter which aspect is to praise for the good results?

Ending note: I hope this was apparent, but, the intention of this post isn’t to target people who do or don’t do detoxing juice diets but merely to satisfy my curiosity. I had heard a lot of anecdotal experiences on the matter and so I was curious to hear about the results from more formal studies as well. Whether or not you choose to juice is your own prerogative.

 

REFERENCES

Aslani N, Entezari MH, Askari G, Maghsoudi Z, Maracy MR. Effect of Garlic and Lemon Juice Mixture on Lipid Profile and Some Cardiovascular Risk Factors in People 30-60 Years Old with Moderate Hyperlipidaemia: A Randomized Clinical Trial. Int J Prev Med. 2016; 7: 95.

“Detoxification.” Partnership for Environmental Education and Rural Health, https://peer.tamu.edu/curriculum_modules/OrganSystems/Module_3/index.htm. Accessed 7 Nov 2018.

Farombi EO, Adelowo OA, Ajimoko YR. Biomarkers of Oxidative Stress and Heavy Metal Levels as Indicators of Environmental Pollution in African Cat Fish (Claris gariepinus) from Nigeria Ogun River. Int J Environ Res Public Health. 2007; 4(2): 158-165.

Henning, SM, Yan J, Shao P, Lee R, Huang J, Ly A, Hsu M, Lu Q, Thames G, Heber D, Li Z. Health benefit of vegetable/fruit juice-based diet: Role of microbiome. Scientific Reports. 2017 May 19; 7.

“How does the liver work?” Informed health Online, Institute for Quality and Efficiency in Health Care, https://www.ncbi.nlm.nih.gov/books/NBK279393/. Accessed 6 Nov 2018.

Ikemoto T, Kunito T, Tanaka H, Baba N, Miyazaki N, Tanabe S. Detoxification Mechanism of Heavy Metals in Marine Mammals and Seabirds: Interaction of Selenium with Mercury, Silver, Copper, Zinc, and Cadmium in Liver. Archives of Environmental Contamination and Toxicology. 2004 Sep; 47(3): 402-413.

Kim MJ, Hwang JH, Ko, HJ, Na, HB, Kim JH. Lemon detox diet reduced body fat, insulin resistance, and serum hs-CRP level without hematological changes in overweight Korean women. Nutrition Research. 2015 May; 35(5): 409-420.

Klein AV, Kiat H. Detox diets for toxin elimination and weight management: a critical review of the evidence. Journal of Human Nutrition and Dietetics. 2015 Dec; 28(6): 675-686.

Oseni OA, Odesanmi OE, Oladele FC. Antioxidative and antidiabetic activities of watermelon (Citrullus lanatus) juice on oxidative stress in alloxan-induced diabetic male Wistar albino rats. Niger Med J. 2015 Jul-Aug; 56(4): 272-277.

“Taking an Exposure History: Which Organ Systems Are Affected By Toxic Exposure(s)?” Agency for Toxic Substances & Disease Registry: Environmental Health and Medicine Education, https://www.atsdr.cdc.gov/csem/csem.asp?csem=33&po=6. Accessed 6 Nov 2018.

“Transcription factors.” Khan Academy, https://www.khanacademy.org/science/biology/gene-regulation/gene-regulation-in-eukaryotes/a/eukaryotic-transcription-factors. Accessed 7 Nov 2018.

Wang Y, Wimmer U, Lichtlen P, Inderbitzin D, Stieger B, Meier PJ, Hunziker L, Stallmach T, Forrer R, Rülicke T. Metal-responsive transcription factor-1 (MTF-1) is essential for embryonic liver development and heavy metal detoxification in the adult liver. The FASEB Journal. 2004 Jul 1; 18(10). 

“Your Kidneys & How They Work.” National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/kidney-disease/kidneys-how-they-work. Accessed 6 Nov 2018.

my new(est) regimen

agriculture basket beets bokeh
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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.

how to “solve” eczema

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Over the years I have gotten so much advice from well wishers about how to cure my eczema/topical steroid withdrawal (because in my case, the condition that changed my life was TSW, which was caused by the treatment of eczema). While some of the suggestions may be useful, more often than not they aren’t, and it may not be because the advice is something I’ve already tried or something outlandish. It may be more so because advice about a single aspect in my life to change doesn’t do anything impactful, because eczema’s root cause can be anything but singular.

I know some people are lucky: they remove the allergen (mold, gluten, soy, eggs, nightshades, dairy, dust), they decrease their stress, they exercise more, they find a supplement that really works, and bam, no more eczema. Unfortunately, I am not one of those people.

My root cause seems to be tied to many different aspects, from overuse of topical steroids, to unresolved emotional issues after familial deaths, to increasing sensitivity to foods (on top of food allergies I was born with), to increasing discomfort with specific exercises and a sensitivity to heat and sweating, to insomnia and other sleep issues, etc. So being given a new product to try doesn’t really solve the other issues preventing me from quickly recovering from each flare.

What I do find interesting, is people that have learned to live with eczema (and/or topical steroid withdrawal) and the various lifestyle changes they have done to help keep their flares under control. I came across a post a while back called The Metaphysical Meaning of Eczema – Do People Get Under Your Skin, which I thought would just be talking about how my emotions cause my eczema, but I was pleasantly surprised to read the author’s inclusion of a whole host of other things she does in her life to help. Because yes, I am sensitive, both skin-wise and emotion-wise (I can now flare-up from heightened nervousness from public speaking, or due to misunderstanding over trivialities at the store) but, and I am indignant about this, my sensitivity didn’t cause my eczema, and it definitely didn’t cause my topical steroid withdrawal. It probably is the reason it takes me so long to heal (on top of the constant flow of changes in my life… e.g. getting married, moving 4 times, leaving my graduate program, buying a house, having a baby- all within the last 3 years). I have learned to be zen about skin-related sleep deprivation, about hives from foods I normally can consume, over having to adjust all forms of activity I enjoy, over forgiving myself for making “mistakes” that then provoked a flare, etc. I know I still have a ways to go to consistently help my emotions flow naturally and not build up stress, but I have made immense progress and my skin doesn’t always reflect that. Hence why I get up in arms when people try to reduce my condition down to me “just not doing x”.

Woof, okay so now that I’m done that rant, back to my initial idea around today’s topic. The point is, eczema can be a multifaceted b*tch of a condition, with varying twists and turns that dictate how it goes for different people. If you don’t believe me, try reading the experience of Daniel Boey in his book Behind Every Itch is a Back Story: The Struggles of Growing Up with Rash, or peruse any number of personal blogs out there these days about someone going through TSW.

My point is that while I am happy for people who find ways to rid themselves of eczema flares through a singular method, I find it frustrating when we see the gimmicks of “anyone can cure their eczema if they just do x!” and find it somewhat damaging to reduce all people with eczema into the same world because said singular solutions don’t work for everyone. I appreciate people that talk about the myriad of changes they have had to do, because it shows that the cause of eczema, as it is still unknown for the most part, requires different management for different people, hence why it is so hard to “solve”.

how my skin made me take the road less traveled

gray pathway surrounded by green tress
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Today’s post is all about trying to convey what life with eczema is like for me. The first thing I need to stress is that my condition was not always this severe. I can remember a “before”, as my condition didn’t start affecting my skin globally until I was 21 or 22.

So how has eczema affected me?

  • insomnia – Some nights I was unable to sleep until 6am. More recently off and on I have difficulty sleeping from midnight to about 6am.
  • food paranoia – Given that I have legitimate food allergies to peanuts, pistachios and cashews, I know how to deal with food allergies that cause anaphylaxis. What I don’t know how to deal with is the thought that some common food might have developed into being the cause for the severity of my skin issues. Also sometimes I’ll eat something that is usually fine for consumption, and I’ll break out in hives in my mouth inexplicably and the next time I consume said food, it won’t happen.
  • many different diets – I have tried the gambit of elimination diets, auto-immune diets, vegetarianism, paleo diets, sugar-free diets, low-carb diets, detox diets, etc).
  • food-related social repercussion – You have no idea how frustrating it is to have people think I am “just being picky” when I am avoiding certain foods or diets. It’s usually when I’m avoiding gluten, dairy, or soy or other common American-diet staples. What I don’t understand is why people think I enjoy avoiding these foods… do they not know my undying love for pizza and ice cream?
  • intimacy issues – picture not being able to cuddle on the couch while watching a scary movie without covering myself in a blanket to make sure my skin doesn’t touch my husbands. Long drawn out hugs? Nope.
  • skin-to-skin with baby issues – I have adapted to the lifestyle of needing to put a barrier between me and my baby’s skin. When I feed her, I throw a cloth on or wear long sleeves before I put her head on my arms. When I have her in a carrier, I try to put a layer between her face and my chest, or else I know I’ll have to take her out earlier as my chest will start turning red, flushing, and itching.
  • exercise limitations – Up until my junior year of college I was doing many different sports and activities including soccer, track and field, long runs on my own, ultimate frisbee, generically running around like an idiot, etc. Post-eczema life, unless I can get a flare to calm down for months, cardio is a nightmare. Hell, at this point in time, just going for a long walk in the summer induces itching everywhere that takes at least 10 minutes in an air-conditioned building to relieve.
  • summer nightmare – See what I mentioned about walking above and now just add that to general life in the summer. I do well if I don’t move, and if I avoid direct sunlight. Though I also need sunlight for vitamin D (and in my previous life I loved the sun) so I’ll pop outside for a few minutes to bask in the sun’s warm embrace and then I’ll overheat and have to come inside. At least the itching only starts if I sweat.
  • pain (cracked skin) – During certain stages of a flare I dry out (especially at night or after washing my hands or other random times) and my skin will crack. The worst areas are my hands (which will fissure all over) and my ears, as well as sometimes under my eyes.
  • obsession – I spend so much time thinking about my skin and worrying over if I am doing something to make it worse, or not doing enough. It gets exhausting really.
  • career switching – I dropped out of my physical therapy doctorate program because I just couldn’t deal with my skin. I wasn’t sleeping, I was uncomfortable sitting (more on that in a bit), and I couldn’t stand being in an air-conditioned room (see below), or being touched or coming in contact with another’s skin, which made it incredibly difficult to practice the hands on aspects of PT. I am now still in a stage of making my own career, which while exciting, is stressful when I have to talk about it because it’s not a clear cut “oh, yeah, I do X” anymore.
  • fear of infections – As my skin barrier is compromised so often, the risk of infections, primarily Staph, is high. I spend a lot of time wondering if I am infected and worrying when I catch a cold or something that I have contracted Staph (again).
  • hand washing (pain/itching) – Imagine how many times you have to wash your hands or use hand sani when you are a PT student working in a clinic. Doing dishes is irritating enough. Sometimes even just taking a shower will irritate my skin.
  • cleaning frequency – Given that I shed skin faster than the average human, I spend a lot of time cleaning to try to not live in my own skin dust filth.
  • social situation aversion – When I am flaring, I have no desire to go out, not only because I worry about the stares I get for physical appearances, but also because it takes so much energy to deal with varying temperatures, varying foods, varying stressors, usually a lot of sitting, the inability to play/dance without itching, etc.
  • general discomfort (pain, itch, smell) – Eczema this severe is uncomfortable. The obvious is that it itches, and not like a “I have a random little itch” but more on the level of if a swam of mosquitoes bite you all over your body but instead of having angry welt-y bite marks externally, they are all inside your body and not visible to anyone. The pain comes from the cracking I mentioned above, as well as the pain of the self-inflicted wounds from scratching too hard. When I have a bad flare, I develop this scent that I call the burning rubber skin that I loathe.
  • depression and anxiety – It’s no surprise that aggressive and long lasting flares take an emotional toll. As I spend time in pain, itching, paranoid about foods I eat, avoiding people, and unable to exercise and play as I normally would, sometimes my moods take a nose dive.
  • money spent – From skin care lotions and moisturizers, general soaps, bath products (bleach, epsom salt, apple cider vinegar), natural house cleaning products, dry brushes, the rebounder, to the doctors’ visits, etc, this condition isn’t cheap.
  • doctor visits (dermatologists, endocrinologists, neurologists) – There is something very frustrating about seeing many doctors and still getting no relief. I have moved a few times in the last past 4 years and as a result have an even larger number of individual doctor visits under my belt. The general consensus? I am fine (as in no underlying crazy cause of my skin issues like cancer), but I have eczema. Oh and have I tried using steroids creams? -.-
  • hormone imbalances – Since I spent so much time inflamed, I usually have a highly elevated level of immune stuff, like my white blood cell count. When my skin first started going haywire, I also have high cortisol level, which made doctors think I had a hormonal imbalance and first order an MRI of my brain.
  • forever fielding questions – “Have you tried X??” “What’s wrong with your skin?” “Do you use lotion?”
  • excoriation disorder (dermatillomania) – Due to very often having flaky skin, I have developed a picking disorder where I spend inordinate amounts of time trying to remove dead skin from my body. It’s become partially therapeutic and partially me trying to exert control over my uncontrollable presentation.
  • scratching OCD – I scratch all the time. In my sleep, when I’m stressed, when I’m relaxing. I don’t even notice I’m doing it sometimes.
  • scarring – Go figure from all that scratching I’d have scars.
  • ring wearing/jewelry/piercings – I no longer wear my wedding band on my left hand because the ring finger on that side is usually swollen. I wear it on my right now. I also had to take out my belly button piercing, my nose piercing, and all ear piercings except tragus one because the skin started itching so badly around them all.
  • hot inflamed skin with cold chills/shivering – One of the worst stages of a flare is when my skin is constantly wet and weeping and heated, but I’m losing so much heat that I am internal freezing and will shiver uncontrollably.
  • winter is bad – It’s hard enough to regulate my body temperature without the weather outside being frigid.
  • sensitivity to pressure contact (sitting/laying down) – This made PT school very trying. Hell, going to a doctors office and laying on the table, or sitting on a chair for too long made my skin feel terrible and heat up and start itching. This is even through wearing long sleeves and pants.
  • nervousness = flares – Some nervousness is good for keeping our brains alert. Unfortunately, any little bit of social nervousness (like before a practical or talking to new people) would cause me to start to flare and itch.
  • wrinkly, swollen skin – Still not sure why this happens (maybe it’s a product of topical steroid withdrawal) but the skin around my joints especially, on the extensor side, starts to look like that of an elephant.
  • discoloration – From redness to drying out gray/white, I am a veritable human mood ring.

And since people love me and will forever want to help, here is a list of what I have already tried:

  • topical steroids (for a good 20 years as this was the main accepted solution to eczema for decades)
  • topical medicines that are not steroids (Elidel/protopic, etc)
  • oral steroids
  • lotions/moisturizers (cetaphil, cera ve, aquaphor, dove eczema line, exederm, burt’s bees, obscurely-named-other-ones, etc)
  • going moisturizer free (actually does help with the red/weeping stage)
  • ocean water
  • chlorinated pools
  • naturopathy
  • acupuncture (including herbs, cupping, and massage)
  • diet (gluten free, soy free, dairy free, vegetarian, sugar free)
  • phototherapy (clinically done in light boxes, and just being in the sun)
  • antihistamines
  • sleep aid pills
  • yoga, meditation, and deep breathing
  • coconut and sunflower oil
  • bleach, epsom, and apple cider vinegar baths
  • antibiotics
  • collagen powder (edible)
  • collagen cream
  • wound care
  • probiotics

Update: I have not tried any biologics because I have been pregnant and am now nursing.

Despite all the shit that comes with eczema, there have been some silver linings in my experience including:

  • Having to deal with eczema year round has made me live much more seasonally. In the warmer months I try to take advantage of being able to walk outside for hours and garden to get vitamin D and get exposed to bacteria in the soil (and as stress relievers). In the colder months I turn to herbal teas and nourishing soups, and bundle up well to go on walks to get fresh air. I pay a lot more attention to what can grow when, and try to eat accordingly (like lighter foods in the summertime).
  • Having dealt with the difficulties of eczema for so long, in juxtaposition pregnancy wasn’t half bad (though to be fair my belly was small and I didn’t have morning sickness… but discomfort with sleeping? Aversions to certain foods? Tired randomly? Feeling generally uncomfortable? Yep, I was used to that all already).
  • In effort to control my flares, I am constantly open to trying new things (though my wallet isn’t!).
  • When I first came up to visit Jake, before we were dating, we had an honest conversation about eczema and I told him how bad it gets for me, and he still wanted to be with me. To this day, I’ve never had insecurity about my skin around him.
  • I have learned to really appreciate the good days. As a result, I’m generally even happier of a person.

the magic of medicinal ideologies

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Something that has always fascinated me has been the underlying ideologies behind medicine of different regions/cultures, be it modern western science, naturopathic medicine (which can blend a lot of the holistic and western medicine practices), traditional Chinese medicine, Ayurveda, or yoga.

As western medicine is the most familiar, I will talk about that briefly at the end.

The other day I went to a Qi Gong and Tai Chi school where I talked with one of the instructors about the concepts behind medical Qi Gong. We talked a little bit about my skin and the instructor mentioned how the skin and the liver are connected in the Chinese ideology and so if the skin is showing lots of signs of disease, there may be an issue with the liver’s digestion. She also mentioned that I would be a person expected to have an imbalance of yang over yin. Yin and yang are seen as complimentary energies that keep the body in balance, with yin being the cooler, more feminine energy, and yang being a hotter, more masculine one.

In regards to nutrition, when I was seeing an acupuncturist a few years ago, she also talked about the dietary components that might be causing my skin issues. She also believed that I had an imbalance of yin and yang, (in that again I had more yang), hence the inflammation. Her advice to me was to eat less spicy food, avoid sugars, and have more bitter herbs in my diet, as well as continuing the treatments I was getting from her in acupuncture, cupping, and massage.

The National Eczema Associate interviewed Dr. Xiu-Min Li (a Professor of Pediatrics in the Division of Pediatric Allergy and Immunology at the Icahn School of Medicine at Mount Sinai) who studies asthma and allergies (including AD) and went on to explain about traditional Chinese medicine and how it fits into the treatment of eczema. The article provides more insight into how TCM is starting to be incorporating into mainstream western medicine, with the goal of having an alternative to use before topical steroids. It would seem that many people currently turn to try traditional Chinese medicine when standard western medicine practices of topical/oral steroids and other topical medications don’t do the trick.

When I was doing my yoga teacher training a while back they talked about chakras. Chakras are energetic points of the subtle body and there are 7 of them that line the spinal column, and they each are meant to represent a basic level of human consciousness. According to what I learned during the training, when the third chakra (Manipura) is unbalanced, one can expect to see eczema and other stress-related skin conditions. This may be because the third chakra is connected to the detox related organs (like the liver) as well as the abdominals, obliques, etc.

Nutrition based in the Ayurvedic ideology talks about balancing the Pitta dosa (doshas are energies that control how we act, think, move, etc), and to do that they advise avoiding eggs, wheat, milk, nightshades, spicy foods, corn, shellfish, and overly sugary foods. Eczema is seen to be more of an excess of Pitta dosha, or more fire, hence trying to eliminate inflammatory foods.

Here’s an anecdotal story published by the National Eczema Association a while back about a family that turned to Ayurveda when the western medicine wasn’t helping their daughter’s eczema.

In regards to modern western medicine practices, a few comparison points are developing that reflect the more holistic ideals in the ideologies mentioned above. For example, added sugar is more or less nationally seen as being inflammatory, and many doctors will caution against having a diet that includes too much of it. There are also more practices such as taking bleach baths to help reduce infection risk and other treatments that can be done at home without a prescription that a western doctor will recommend now. And the recommendations around lotions and moisturizers (over the counter) are more prevalent, though the brands which are suggested still vary. Light therapy/phototherapy is also recommended to help increase vitamin D exposure, and more and more doctors are also advising getting moving more to help with healing, as well as different solutions to try at night to help with sleep- from stress relieving techniques like meditation or taking a bath at night, to antihistamines.

I personally however, have not yet had a doctor who engaged me in a conversation that got more specifically into nutrition (minus not eating a lot of sugar or junk food). I am not sure if it is out of their scope of practice, but it has not come up in 26 years of seeing doctors, which surprises me. Many doctors, as far as I can tell, still think eczema is not really related to food, but as I do have food allergies I was born with, I would probably be a prime candidate to test for new allergies. The rub there is that generally doctors will prescribe getting a patch test done- but you have to have cleared up skin for the test results to be more or less accurate, and you can’t be on steroids at the time (and I haven’t had clear enough skin in about 3 years).

There is also the holistic medicine movement we see that is not specifically tied to any of the above ideologies. It includes more of western herbalism, often crossed with different nutrition changes and protocols, like the autoimmune protocol, or the elimination diet, or other variations to help with what is called the “leaky gut” syndrome. There are tons of resources from bloggers, nutritionists, doctors, etc about how to go about a nutritional change to heal whatever ailments you are undergoing with food, and I’ve also noticed a lot of sufferers of eczema have gone into nutrition after having success controlling their conditions with their dietary changes (one example being Prime Physique Nutrition). There are also movements to changing the whole lifestyle to be more holistic (like making your own cleaning products as well as skin creams, moisturizers, body wash products. A lot of this new movement is grounded in taking control of your health, often after having tried working with doctors in modern western practices for long periods of time unsuccessfully.

A health resurgence in America has been in herbalism. Some famous members of the community include Rosemary Gladstar (author of Herbal Healing for Women), Susan Weed (author of Wise Woman Herbal for the Childbearing Year), Aviva Romm, Mark Blumenthal (founder of the American Botanical Council), Christopher Hobbs, and many, many others. Of note, I am usually deep into researching about women’s health, hence the references above. Gladstar does have a book on men’s health called Herbal Healing for Men.

From Gladstar’s book Herbal Recipes for Vibrant Health (which I own) she briefly talks about her general advice as an herbalist for how women can keep balance in the bodies by doing “good living practices”, which she notes as having proper nutrition, ample enough rest, joyful exercise, self connection, and tonic herbs. Delving deeper into nutrition she says to eat foods close to their natural states (which also means eat what grows seasonally), pay attention to how you feel while eating and afterwards, eat organic when you can, and eat  alkalizing foods. She notes about the latter that a lot of the disorders women have thrive in acidic conditions (aka when we eat too many sweets and carbs).

Personally, I have found relief from the most extreme symptoms by modifying my diet (I usually avoid eating wheat products and sugar because I tend to over consume foods containing them), and by using products approved by the NEA that avoid parabens, alcohol, and other chemicals that can be irritants for people with eczema. Acupuncture did seem to help- though I can’t say it was in isolation, since I did get massaged each time (which is also known for helping eczema). I tend to only bathe in a diluted bleach bath when I feel like my skin is getting close to infection (not sure how to explain how I know when that point is), otherwise this winter I did take a lot of baths with either apple cider vinegar (works similarly to bleach) or epsom salt (tends to calm me down and works well for helping me get through the dry out phase of TSW faster). I generally avoid using topical steroids when I can because I have gone through withdrawals before, and because I don’t like the reliance on something that doesn’t fix my issue (usually starting on steroids means I have to stay on them because I flare back up as soon as I start a taper).

All in all it does feel like there are more overlaps occurring over time in these differing ideologies, and we are seeing them sort of blend together in effort to figure out how to deal with chronic non-fatal diseases such as eczema. Whether or not they work still mostly seems to comes down to a person-by-person basis.

 

REFERENCES

“Ayurvedic Medicine and Eczema.” National Eczema Association, https://nationaleczema.org/ayurvedic-medicine-eczema/. Accessed 14 May 2018.

Berzin, Robin. “The Simple Elimination Diet that Could Change Your Life Forever.” Mind Body Green, https://www.mindbodygreen.com/0-12540/the-simple-elimination-diet-that-could-change-your-life-forever.html. Accessed 14 May 2018.

“The Effects of Traditional Chinese Medicine on Eczema.” Pacific College of Oriental Medicine, https://www.pacificcollege.edu/news/blog/2016/08/19/effects-traditional-chinese-medicine-eczema. Accessed 14 May 2018.

Ehrlich, Henry. “Traditional Chinese Medicine and Eczema: An Interview with Xiu-Min Li, M.D.” National Eczema Association, https://nationaleczema.org/traditional-chinese-medicine-and-eczema/. Accessed 14 May 2018.

Gottfried, Sara “Is the Autoimmune Protocol Necessary?” Sara Gottfried MD, https://www.saragottfriedmd.com/is-the-autoimmune-protocol-necessary/. Accessed 14 May 2018.

“The Three Doshas: The Keys to Your Individual Nature.” Eat Taste Heal, http://www.eattasteheal.com/ayurveda101/eth_bodytypes.htm. Accessed 14 May 2018.

“Yoga for Skin Diseases”, Yoga India, http://yoga-india.net/wp-content/uploads/2014/04/Yoga-for-Skin-Diseases-Anna-Mayer.pdf. Accessed 14 May 2018.