all posts, eczema hacks, the eczema body, women's health

will my baby have eczema?

smiling baby lying on white mat
Photo by Victoria Borodinova on Pexels.com

A while back I wrote a post about what it’s like to have eczema and be pregnant, followed by another post after my little one was born all about living life with eczema and a baby. But today’s topic isn’t about the mom, but rather, about the baby and the baby’s risk of inheriting eczema from his/her parents.

The inspiration for this post comes from the eczema community on instagram. Many ladies have been asking about this topic, so I figured I would try to search for an answer. I apologize if it isn’t the clearest of posts. It’s a culmination of a bunch of witching hour moments over a few days, when Fiona decided that midnight, 1am, 2am, 3am, etc are equally important times to wake up each day.

Most of us know that there is a genetic component to eczema but what does that actually mean? There are a few different ideas being studied about where genes come into play with this condition that are lumped under the “outside-inside model” which look at skin barrier dysfunction (as opposed to the “inside-outside model”, which is about the gut health). Some examples of the outside-inside model, which I’ll go over individually, include:

  • FLG (a gene, that makes the protein filaggrin). I mentioned this protein in an older post, talking about how there were treatments for eczema being developed that made use of it. The gist was that a loss-of-function in the specific gene results in less filaggrin being made, and filaggrin is an essential player in keeping the skin barrier intact.
  • Tmem79/Matt (colloquially known the Matted mutant gene, so named because in mice it results in their fur having a matted look). Researchers found that mice that had this mutant MATT gene also had skin barrier issues and dermatitis issues, and that humans had a similar gene, with a common single nucleotide polymorphisms (or SNP). When there is a misstep (or a mistake) in humans’ SNP, there are significant atopic dermatitis associations.
  • Th2 (a cytokine, or a protein that impacts cell signaling). Th stands for T helper cells, and they help with host defense, but also impact inflammation. Some, like Th2 are know for being (pro)inflammatory, while Th1 is known to be anti-inflammatory. I mentioned this a little when talking about pregnancy and eczema. Research from 2015 showed there are many different Th types, that all may have their own impact on inflammation.
  • interleukin-1 (a protein from a family of inflammatory and regulatory cytokines). Many studies are still showing that breastfeeding reduces your child’s risk of eczema, because of some components (interleukin-beta specifically) in the breast milk that the child consumes. One such study went so far as to say that breastfeeding halves the risk for children between 0 and 3 years of age (and no you don’t have to breastfeed for 3 years for that to be the case!). The way interleukins work is that they are released when there is bacteria or immunological disturbances. The interleukins show up and affect cells like capillary endothelial ones, making them release chemicals and attract monocytes (large white blood cells that help kill bacteria). The problem with these is that certain types can be associated with Th2 (like IL-22 which is made by Th-22), or they can be known to be associated with inflammatory diseases like IL-17.

Then there has been a lot of research investigating if and how probiotics can help prevent eczema for babies too (even Gerber makes probiotic-included products now). In particular, Lactobacillus rhamnosus was seen to have mixed results, with some studies showing it reduced genetic susceptibility to eczema (meaning it somehow calms the baby’s risk of having eczema) for children with thirty-three eczema susceptibility SNPs. On the flip side, other studies said Lactobacillus rhamnosus had no effect on reducing the child’s risk of eczema.

To be honest, I am still a bit skeptical of the studies done that show no effect because, from what I can tell, they have the parents give the babies probiotics for say 6 months, and then continue to see if there is a benefit at some later date like 2 years of age. If a modern western diet (high carb, especially in refined sugars) can alter an adult’s gut microbiome fairly rapidly, why would the probiotics a baby takes at 6 months still be helping the gut at 2 years (the biome diversity would have changed due to diet by then, and the gut must stay healthy for it to help the skin)? Wouldn’t one expect the gut microbiome diversity to change and said “good” gut bacteria to not be able to survive the environment anymore?

So essentially I am still thinking, as the studies show no negative effects of taking probiotics, after talking with your baby’s pediatrician of course, what would be the harm in giving your baby probiotics? That and making sure to keep your baby on a diet that creates a gut environment more conducive to good bacteria flourishing.

Also note, I wasn’t able to access the whole study so I’m not sure how the probiotics were administered unfortunately. On a tangent, that’s always a frustrating point to me. I don’t think studies should cost the public to access because we should want to encourage people furthering their health in any way possible. I understand scientists need go make money too but I do wish there was another way besides charging subscriptions to databases of research. 

But I digress. So what is the takeaway for all those future mamas worrying about passing eczema on to their children? Do they have cause for concern? Perhaps. The way I see it (noting I could be interpreting this incorrectly) is for:

  • filaggrin: If the loss of function filaggrin gene is passed on, the child would probably have an increased risk.
  • Th2: the Th1/Th2 dominance seems to be more dependent on estrogen than genetics (though I could be wrong) so my guess would be that having a girl would make her more susceptible in that case (again I definitely could be wrong).
  • MATT gene: The atopic dermatitis shows up is because of that misstep (mistake) in the common SNP of the gene. As a result I think the answer is yes, it probably is a risk for one’s children, because missteps (I believe) would be passed down since they are mutations.
  • interleukins: I believe the pro-inflammatory ones that are problematic are a product more so of consistent stressors on the body (both from invaders like bacteria, and from literal stress). If the baby/child is relatively healthy and isn’t too stressed out, in tandem maybe with the mom breastfeeding her baby (so long as she is able to, aka isn’t on chemotherapy or radiation or something), then I do think the risk of eczema from this perspective, is decreased.

But the real question now is how do all these components balance out in an individual, in a baby? Does having a loss of function filaggrin gene guarantee a lifetime of eczema? Or does it just make you more susceptible but you are fine if you don’t have the MATT gene’s SNP misstep (or one of the other 33 SNPs mentioned that are related to eczema susceptibility)? It would be interesting to see a study done that investigates all these components together, so we could know which are still present when you have people with severe eczema, topical steroid withdrawal systems, etc. As for the initial question, sure, there are genetic components that you pass down to your baby, but it seems like not all the heavy hitters are genetic so your baby may still be fine.

One more thing to leave you with: the American Academy of Dermatology made a post a while back saying a few ways to reduce your baby’s chance of eczema (minus genetics naturally), which included:

  • having a dog at home before the child’s 1st birthday
  • moisturizing a newborn’s skin
  • not eliminating a bunch of things in your diet
  • eating a health diet while pregnant, and
  • breastfeeding (and having a healthy diet during it too)

All in all, know this: if you do have a baby and he/she has eczema, the research body is growing in the field and more understanding of what causes eczema are coming to light, which means better ways to treat it will follow.

REFERENCES

Bauer SM. Atopic Eczema: Genetic Associations and Potential Links to Development Exposures. International Journal of Toxicology. 2017 Mar 30: 36(3): 187-198.

Cabana MD, McKean M, Caughey AB, Fong L, Lynch S, Wong A, Leong R, Boushey HA, Hilton JF. Early Probiotic Supplementation for Eczema and Asthma Prevention: A Randomized Controlled Trial. Pediatrics. 2017 Sep; 140(3).

“Can anything prevent my child from getting eczema?” America Academy of Dermatology, https://www.aad.org/public/diseases/eczema/prevent-my-child-from-getting-eczema. Accessed 9 Jan 2019.

Hofmann A, Kiecker F, Zuberbier T. A systematic review of the role of interleukin-17 and the interleukin-20 family in inflammatory allergic skin diseases. Current Opinion in Allergy and Clinical Immunology. 2016 Oct; 16(5): 451-457.

“Interleukin 1.” R&D Systems 1999, https://www.rndsystems.com/resources/articles/interleukin-1. Accessed 18 Dec 2018.

Jepsen AA, Chawes BL, Carson CG, Schoos A-MM, Thysen AH, Waage J, Brix S, Bisgaard H. High breast milk IL-beta level is associated with reduced risk of childhood eczema. Clinical & Experimental Allergy. 2016 Jun 2; 46(10): 1344-1354.

McLean WHI. Filaggrin failure – from ichthyosis vulgaris to atopic eczema and beyond. Britist Journal of Dermatology. 2016 Sept 26; 175(52): 4-7.

Morgan AR, Han DY, Wickens K, Barthow C, Mitchell EA, Stanley TV, Dekker J, Crane J, Ferguson LR. Differential modification of genetic susceptibility to childhood eczema by two probiotics. 2014 Aug 21; 44(10): 1255-1265.

Raphael I, Nalawade S, Eagar TN, Forsthuber TG. T cell subsets and their signature cytokines in autoimmune and inflammatory diseases. Cytokine. 2015 July; 74(1): 5-17.

Saunders SP, Goh CSM, Brown SJ, Palmer CNA, Porter RM, Cole C, Campbell LE, Gierlinski M, Barton GJ, Schneider G, Balmain A, Prescott AR, Weidinger S, Baurecht H, Kabesch M, Gieger C, Lee Y, Tavendale R, Mukhopadhyay S, Turner SW, Madhok VB, Sullivan FM, Relton C, Burn J, Meggitt S, Smith CH, Allen MA, Barker JNWN, Reynolds NJ, Cordell HJ, Irvine AD, McLean WHI, Sandilands A, Fallon PG. Tmem79/Matt is the matted mouse gene and is a predisposing gene for atopic dermatitis in huma subjects. J Allergy Clin Immunol. 2013 Nov; 132 (5): 1121-1129.

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

how my skin made me take the road less traveled

gray pathway surrounded by green tress
Photo by Skitterphoto on Pexels.com

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.
all posts, the eczema body, treatments

where’s my glow? (pregnancy with eczema)

pexels-photo-132730.jpeg

Today I decided to dig a bit more into the world of eczema for us pregnant folk.

I started by watching a podcast done by Abby Lai (of Prime Physique Nutrition) in which she talked with Dr. Peter Lio (he’s done a few National Eczema Association webinars). Link to Abby’s podcast is here.

The major points were:

  • It’s not really understood why but about 1/2 of pregnant women have worsened symptoms and 1/2 have bettered symptoms. Dr. Lio likened it to how some women get nausea during pregnancy.
  • You can have a flare in one pregnancy, but not in the next. Also you can have changes in skin between trimesters.
  • Dr. Lio mentioned a few itching conditions that can occur during pregnancy such as cholestasis (when liver and gall bladder slow down their bile flow which causes a terrible itch), atopic eruption of pregnancy, PUPPP (or pruritic urticarial papules and plaques of pregnancy which usually occurs during the 3rd trimester).

He and Abby then talked about treatments used during pregnancy including such as:

  • how topical steroids are okay but not most potent ones. The goal is to keep body surface area that you apply the topical steroids to relatively low (so not WHOLE body), because topical steroids go in blood if they are used long enough or over large surface areas.
  • light/phototherapy
  • Benadryl and other anti-histamines
  • wet wraps, icing, moisturizers (see my post on products I’ve tried here)
  • anti-itch creams in small amounts (such as camphor and menthol)
  • natural oils like coconut and sunflower seed oil (if not allergic)
  • dilute bleach baths (he also mentioned a recent paper shows it’s anti-inflammatory and anti-itch directly, as well as being antibacterial)
  • topical vitamin B 12 (water soluble) – pink magic

The takeaway advice he gave was don’t be afraid to use medicine so long as you have a doctor helping you.

I was having trouble finding full access studies but I did stumble across a PDF from the National Eczema Association about getting pregnancy, skin tips during pregnancy, and after pregnancy advice. It also talked about the likelihood of the baby getting eczema and things to hopefully prevent it. The same PDF also mentioned that avoiding soap can also help decrease the disruption to the skin barrier, and it even goes as far as talking about when the mothers are postpartum, such as how there can be challenges with breastfeeding if the mother develops eczema around the area. In that case, the study said low to moderate potency topical steroids can be used so long as they are washed off before the next breastfeeding.

Updated: The National Eczema Association posted a new article May 2018 called Oh baby! Eczema from pregnancy to menopause that goes into more detail about why women may experience more incidences of eczema during pregnancy. It mentions how a researcher at the University of California-San Francisco (Dr. Jenny Murase) found that when a woman is pregnant, her body shifts from Th1-dominant to Th2-dominant immunity in order to protect the fetus (because Th1 attacks foreign material that get into our cells, aka it would attack the fetus since they have half of the father’s cells). Th2-dominant immunity means the mom’s body attacks allergens and whatnot that are flowing around outside her cells, protecting the fetus, but not helping when it comes to eczema. The blog post said that the shift from Th1 to Th2 is driven by the surge of estrogen. Perhaps that is also why women generally have higher rates of eczema than men? Unfortunately I couldn’t find the study that the NEA article cited so I can’t follow up with more, though I did find an abstract from Dr. Murase et al, that mentioned how psoriasis tends to improve during pregnancy correlating with those higher estrogen levels… so maybe one of the immunity-linked causes of eczema and psoriasis are opposite in origin?

My personal experience with being pregnant while having eczema has been that I have to be more mindful about how I treat my eczema relative to general lifestyle changes too. For example, no longer can I go and drink tons of kombucha (due to varying alcohol content and the light risk of bacteria), enjoy whatever random herbs I feel will help me heal, go jump into a hot yoga class unprepared (because getting dizzy affects another being besides myself), eat whatever fish I want whenever (I am a tuna fan and enjoy sushi when not pregnant), run and jump into a hot springs all willy nilly, etc. I have to be more mindful about sharing my body and not just jumping into whatever new protocol or thing I want to try out to help my skin. I can’t decide to just go on a particularly aggressive dietary change that involves caloric restrictions or drastic nutritional adjustments.

That being said, being pregnant has also had a lot of changes that might be helping my skin. In my first trimester I was very sugar and meat adverse, so I ended up eating a lot more veggies. Now in my third trimester I tend to crave veggies as a way to keep my guts feeling good, and to keep indigestion at bay. I also eat smaller meals more frequently, and don’t really accidentally binge eat big meals mindlessly, which is great because it means my body isn’t overtaxed in digestion (more time to heal the skin!). Pregnancy has me feeling a bit more tired (and much like with a flare, also avoiding high intensity activities), so I tend to stick to lower impact, longer duration activities like going for walks for miles or remembering to get in 100 modified push-ups a day.

Anyway, I’ll stop there and leave you with a current photo of me. I’m about 31 weeks pregnant now and you can see my arms and hands in particular are especially topically-challenged.

Screen Shot 2018-04-23 at 11.11.01 AM.png

 

REFERENCES

Crane, Margaret W. Oh, baby! Eczema from pregnancy to menopause. National Eczema Association, https://nationaleczema.org/oh-baby-eczema/. Accessed 30 Apr 2018.

Lawton, Sandra. “Pregnancy and eczema”. Exchange, https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=20&ved=0ahUKEwj3hO2D-9jaAhWmc98KHRNhAusQFgjGATAT&url=http%3A%2F%2Fwww.eczema.org%2Fdocuments%2F711&usg=AOvVaw2fS6lrX7fvyosOV1imHE4p. Accessed 30 Apr 2018.

Murase JE, Chan KK, Garite TJ, Cooper DM, Weinstein GD. Hormonal effect on psoriasis in pregnancy and post partum. Arch Dermatol. 2015 May;141(5):601-606.

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