A D.C. dermatologist has tips on how to help your skin combat the cold, dry air of winter and avoid flare-ups of conditions like eczema.
WTOP’s Alan Etter on how to winterize your skin in dry weather.
The cold, dry air of winter can make your skin drier than usual and make skin conditions like eczema harder to keep under control.
But there are strategies to help winterize your skin and combat the weather changes.
Dr. Adam Friedman, professor and chair of dermatology at George Washington University School Medicine and Health Sciences, said there are certain things you can be doing to keep your skin hydrated.
“Your moisturizer needs a winter upgrade,” Friedman said. “Lotions will not cut it this time of year. I recommend creams and ointments to actually trap and hold moisture in the skin, giving the skin a time to repair and actually stay calm.”
So what should you be looking for on the bottles and tubes?
“Products that say ‘for eczema,’ as this is an FDA regulated term requiring a barrier protectant called colloidal oatmeal, which has decades of supporting data,” he said.
And if your skin is really thick and flakey, he said to look for exfoliating products.
“Keratolytics like urea, mandelic acid … ammonium lactate, these can safely exfoliate that thick skin and help pull water in,” he said.
He said the simpler the better, when it comes to what is in the products. You want to limit how often you’re cleansing and avoid lengthy showers.
“We want mild cleansers, because bathing, how one bathes, can play a very big role in how dry one’s skin is during the wintertime,” he said. “We want to keep showers short, not scalding hot, lukewarm. The most important thing is using a mild cleanser, and honestly, not to the whole body.”
He said not every body part needs to be cleaned everyday. So what should you be doing?
“The only areas that need soap every day are the underarms, face and groin,” Friedman said. “We can skip a day here and there, because soap is very drying. But then even more importantly is applying that cream or ointment based moisturizer to damp skin, usually within 30 seconds after getting out of the shower.”
And when it comes to which brands to buy?
“If a claim sounds too good to be true, it probably is,” he said. “My advice is, go for the bigger name brands that have the resources and take the time to actually evaluate their products with clinical studies.”
WTOP’s Mike Murillo contributed to this report.
Get breaking news and daily headlines delivered to your email inbox by signing up here.
In late October, SheKnows hosted a panel on living with eczema called Empowered With The Skin You’re In: Navigating Eczema & Sharing Moment Of Clarity. The panel was moderated by Nitika Chopra, founder and CEO of Chronicon, with speakers Dr. Sandra Lee (aka “Dr. Pimple Popper”); Kristin Belleson, CEO and president of the National Eczema Association; and comedian Heather McMahan. The panel covered everything from the challenges of living with eczema to real-world advice on how to get relief when flares strike.
Dr. Lee, who is a board-certified dermatologist, opened up about living with mild-to-moderate eczema, noting that she’s had it ever since she was a baby. But Dr. Lee shared that she struggled with bad flares during medical school and beyond. “I had one of the worst flares during medical school. I was studying for an exam, and it was cold, so I decided to use this dusty old space heater a lot,” she said. “Big mistake, because it triggered a flare, and I just immediately could feel that heat and that dust on my face, working with my skin to cause it to get really tingly. I remember turning that thing off as soon as I started feeling those symptoms, and just slathering myself with moisturizer to try to slow this down, because I knew that this was potentially going to be bad.”
Now, Dr. Lee said she tries to avoid her triggers, like wool, on a daily basis—and especially when she’s going to be on camera. “Eczema can affect my day, any day, and it’s no different when I’m on set or not,” she said. Dr. Lee revealed that she uses OPZELURA when she experiences an eczema flare. “It works pretty quickly,” she says. “When I had an itch and used OPZELURA for a few days, I really noticed an improvement in my itch and a clearing in my flare within a few weeks.”
But Dr. Lee wasn’t the only speaker to share her story with eczema. “When I’m on the road, I’m not sleeping well, there’s a million other things that are going on, and I can just feel it like when I am run down, when I am stressed, when I’m under those hot lights and I’m sweating under makeup, I can just feel like a flare up coming,” shared McMahan. She said she’s learned to be “proactive and not reactive,” noting that she picked up a lot of eczema hacks from other people on TikTok. She also said that OPZELURA has been “helpful” for her, personally.
But McMahan, Dr. Lee, and Belleson also spoke about the importance of community and sharing what they’ve learned to help other people with eczema. Here’s the knowledge they want others to know:
(L-R) Nitika Chopra, Dr. Sandra Lee (aka “Dr. Pimple Popper”), comedian Heather McMahan, and Kristin Belleson
Don’t leave home without moisturizer
Dr. Lee noted that having moisturizer on-hand is “the most important thing” to her eczema management. “I don’t care about my lipstick, but if I forget my moisturizer when I go on a trip, I will look like a lizard,” Dr. Lee said. So, she carries her moisturizer with her everywhere. “If you don’t have those things, one little thing will put you over the edge, and then it’s over,” she said.
Try not to scratch
It’s easier said than done, but Dr. Lee and McMahan issued a warning: Scratching can lead to scars. “As a kid, I had it so bad that I would scratch the back of my legs, and then I would get a suntan in the summer and just have, like, white spots everywhere,” McMahan said. McMahan said she still has “old eczema spots” and can’t get a spray tan during a flare because the results will look like a “hot mess.” One more reason to avoid scratching as much as possible? You can get an infection, Dr. Lee pointed out.
Act fast when you’re irritated
Dr. Lee noted that if she feels scratchy in bed at night, she’ll jump in the shower to wash off whatever could be irritating her skin, even though she’s wiped. “It can be a tough thing to deal with. You can lose sleep over it,” she said. “It can really affect your life in so many ways.”
This was one of the biggest tips the speakers shared. “I used to dry myself off when I got the shower and my dermatologist is like, no, no, no, you have to be damp,” Belleson said.
Why? “When you put water on your skin and it evaporates, it actually pulls out the moisture from your skin so you get more dry. That’s what triggers the eczema,” Dr. Lee explained. “The moment I get out of the shower, I put moisturizer on.” McMahan joked that she’s a “slick cat” when she gets out of the shower and “covered up like a Pilgrim” when she goes to bed to lock in moisture.
Consider using a humidifier in your room
Dr. Lee said this can be “very helpful” for eczema management. She suggested using a warm humidifier in particular because it can warm the room and keep humidity in the room, moisturizing your skin in the process.
Be on the lookout for new triggers
McMahan told the story of how she realized gel manicures triggered flares. “There was something about the bonding in the top of the gel nail,” she said, noting that she had to change her nail routine as a result. “I really felt a little insecure for a minute, I’m not gonna lie,” she said.
Focus on your diet
McMahan revealed that she views her diet as part of her eczema management, too. “If I’m eating too much sugar and I already know I’m stressed out, it’s me being proactive and saying, ‘Okay, you know it’s gonna be a stressful week. You know you’re not sleeping a lot, you’re on 15 different airplanes. So, take the steps to protect yourself. Let’s make sure we’re eating healthy from the inside out and all of those things,’” she said. “But if I’m drinking white wine and eating Butterfingers, you know your girl’s going to be itching.”
Meet with a dermatologist
Dr. Lee stressed the importance of meeting with a board-certified dermatologist if you have eczema and coming prepared. “I suggest you bring some notes—maybe like three or four questions,” she said. “It’s important to have a pen and to write down the answers that you hear, because you’re going to forget a lot of the things that they say.” Your doctor should be able to help you identify your triggers and set you on the path to the best eczema management plan for you.
This story was created independently by the SHE Media editorial team. Note, this article is for informational purposes only and is not intended as medical advice. Always consult a healthcare provider for any treatment decisions.
The Buchinger-modified fasting program is put to the test.
A century ago, fasting—“starvation, as a therapeutic measure”—was described as “the ideal measure for the human hog…” (Fat shaming is not a new invention in the medical literature.) I’ve covered fasting for weight loss extensively in a nine-video series, but what about all the other purported benefits? I also have a video series on fasting for hypertension, but what about psoriasis, eczema, type 2 diabetes, lupus, metabolic disorder, rheumatoid arthritis, other autoimmune disorders, depression, and anxiety? Why hasn’t it been tested more?
One difficulty with fasting research is: What do you mean by fasting? When I think of fasting, I think of water-only fasting, but, in Europe, they tend to practice “modified therapeutic fasting,” also known as Buchinger fasting, which is more like a very low-calorie juice fasting with some vegetable broth. Some forms of fasting may not even cut calories at all. As you can see below and at 1:09 in my video The World’s Largest Fasting Study, Ramadan fasting, for example, is when devout Muslims abstain from food and drink from sunrise to sunset, yet, interestingly, they end up eating the same amount—or even more food—overall.
The largest study on fasting to date was published in 2019. More than a thousand individuals were put through a modified fast, cutting daily intake down to about ten cups of water, a cup of fruit juice, and a cup of vegetable soup. They reported very few side effects. In contrast, the latest water-only fasting data from a study that involved half as many people reported nearly 6,000 adverse effects. Now, the modified fasting study did seem to try to undercount adverse effects by only counting reported symptoms if they were repeated three times. However, adverse effects like nausea, feeling faint, upset stomach, vomiting, or palpitations were “observed only in single cases,” whereas the water-only fasting study reported about 100 to 200 of each, as you can see below and at 2:05 in my video. What about the benefits though?
In the modified fasting study, participants self-reported improvements in physical and emotional well-being, along with a surprising lack of hunger. What’s more, the vast majority of those who came in with a pre-existing health complaint reported feeling better, with less than 10 percent stating that their condition worsened, as you can see in the graph below and at 2:24 in my video.
However, the study participants didn’t just fast; they also engaged in a lifestyle program, which included being on a plant-based diet before and after the modified fast. If only the researchers had had some study participants follow the healthier, plant-based diet without the fast to tease out fasting’s effects. Oh, but they did! About a thousand individuals fasted for a week on the same juice and vegetable soup regimen and others followed a normocaloric (normal calorie) vegetarian diet.
As you can see below and at 2:54 in my video, both groups experienced significant increases in both physical and mental quality of life, and, interestingly, there was no significant difference between the groups.
In terms of their major health complaints—including rheumatoid arthritis; chronic pain syndromes, like osteoarthritis, fibromyalgia, and back pain; inflammatory and irritable bowel disease; chronic pulmonary diseases; and migraine and chronic tension-type headaches—the fasting group appeared to have an edge, but both groups did well, with about 80 percent reporting improvements in their condition and only about 4 percent reporting feeling worse, as you can see below and at 3:25 in my video.
Now, this was not a randomized study; people chose which treatment they wanted to follow. So, maybe, for example, those choosing fasting were sicker or something. Also, the improvements in quality of life and disease status were all subjective self-reporting, which is ripe for placebo effects. There was no do-nothing control group, and the response rates to the follow-up quality of life surveys were only about 60 to 70 percent, which also could have biased the results. But extended benefits are certainly possible, given they all tended to improve their diets, as you can see below and at 4:00 in my video.
They ate more fruits and vegetables, and less meats and sweets, and therein may lie the secret. “Principally, the experience of fasting may support motivation for lifestyle change. Most fasters experience clarity of mind and feel a ‘letting go’ of past actions and experiences and thus may develop a more positive attitude toward the future.”
As a consensus panel of fasting experts concluded, “Nutritional therapy (theory and practice) is a vital and integral component of fasting. After the fasting therapy and refeeding period, nutrition should follow the recommendations/concepts of a…plant-based whole-food diet…”
Dealing with eczema (or any skin condition for that matter) can be an expensive and exhausting journey. Knowing which products and ingredients to use to help ease the pain and itch can be vital in making your day-to-day more comfortable, and even improving your condition.
For soothing eczema, according to the experts, one of the best types of products to use at home is an emollient. In fact, “emollients are one of the cornerstones of the treatment of eczema,” said Dr Amélie Seghers, consultant dermatologist at the Cadogan Clinic.
“People with eczema have an impaired skin barrier, which essentially means their skin has small cracks that allows for moisture to escape,” Dr. Cristina Psomadakis, dermatologist and Vaseline ambassador, explained. “The same goes for people with skin conditions like psoriasis or ichthyosis. When skin doesn’t have enough moisture in it, skin cells don’t shed properly, leading to a dry flaky appearance. Using an emollient throughout the day helps fill in those small cracks, smoothes the skin over, and prevents moisture from escaping,” she added.
So, what actually is an emollient? “The term emollient can refer to one of two things. It is often used as a generic term for a moisturiser; meaning a product that is used to soften and moisturise the skin. However, it can also refer to a specific group of ingredients that smooth the skin,” said Dr. Psomadakis. In terms of what they do for you, Dr. Seghers explained that “emollients rebuild the skin by improving the skin barrier and in doing so, prolong the time in between flares and also decrease the need for prescription creams such as steroid creams.”
Ingredients used in common emollient products include ceramides, plant oils, petroleum jelly, collagen, and shea butter, explained Dr. Psomadakis, noting that “the best emollients combine all three categories of ingredients: humectants, occlusives, and emollients.” (A little refresher: humectants draw moisture in and occlusives are a physical barrier to stop moisture escaping, whilst emollients soften and moisturise the skin).
Even better, when emollients are paired with ingredients such as hyaluronic acid, glycerin, niacinamide, collodial oatmeal, and squalane, it can contribute to helping calm inflamed skin, said consultant dermatologist Dr. Sharon Belmo.
Emollients come in various forms of products such as “soap substitutes, sprays, lotions, creams, and ointments – with ointments being the thickest and greasiest,” said Dr. Belmo. “This means you can always find an emollient that will suit you.”
If you ever find yourself feeling a little overwhelmed with choice, Dr. Seghers has some wise words. “The best moisturiser is the one the patient will use! As a general rule of thumb, most moisturisers found on the shelves in pharmacies should be good enough. Avoid the perfume-smelling milky moisturisers from the high street.”
If you’re looking for some specific dermatologist-recommended emollients, keep reading.
Image Source: Getty and Photo Illustration by Becky Jiras
Welcome to Show the Receipts, a new series where we ask interesting people to share exactly how much it costs to get shit done. No matter the task, we’re tracking every last dollar from start to finish. Up next: treating eczema.
“I call it my Spider-Man story,” she tells PS. Villezon was traveling overseas when the bite happened, which was followed by a small itching sensation that turned into something more. “My skin started to dry out to the point where I would get lacerations and blisters on my hands,” she says. After a few visits to an internal medicine doctor, she was diagnosed with Pompholyx eczema, a form of atopic dermatitis that typically affects the hands and feet and presents in the form of blisters.
After being prescribed a steroid cream she says only “masked” her symptoms, Villezon started on a journey to explore Eastern medicinal approaches to healing her eczema and her body. “I wasn’t able to use the cream on a consistent basis because of potential side effects like steroid withdrawal,” Villezon says. She still paid monthly visits to a dermatologist and internal medicine doctor for prescription treatments, which were at least partially covered by insurance, but switched her diet to whole foods only and began taking supplements, which was the bigger expense.
Here’s the full cost breakdown.
Task: treating eczema Occupation: martial artist, herbalist, and content creator Location: Los Angeles, California Timeline: 1 year
The Receipts:
Dermatologist appointments: $60 copay with insurance per month, or $720 per year Supplements: $400 per month, or $4800 a year Prescription treatments: $80 per month, or $960 a year Over-the-counter skin-care products: $67 per month, or $804 a year Special diet: $400 per month, or $4800 a year Gloves: $20 per month, or $240 a year Total Cost: $12,324
How I Did It
Villezon’s approach to treating her eczema starts from the inside. “When I got formally diagnosed I started wondering what I could do internally to take care of myself,” she says. “For me, it really came down to addressing a lot of the things that I was putting into my body.” Here, she’s sharing some of the big takeaways worth noting.
PS: What was the most surprising expense of this process? Nelita Villezon: Revamping my diet and supplement routine was the most expensive part of this entire process for me. Yes, going to the doctor is expensive and we always tell people to be healthy but there is a flip side to that. It’s really expensive to start eating solely fruits and vegetables. Then when you factor in the supplements and vitamins, these things can cost hundreds of dollars per month.
PS: What were you surprised that insurance would or wouldn’t cover? NV: When I was first diagnosed, I was living in Dubai. So when I’d go to the doctor I could access all the products I needed pretty easily without prescriptions. Here, it’s the complete opposite. I’d have lacerations on my hands and have to go through a whole process to see a doctor (and therefore have to pay money) to get a prescription. It was crazy to me that there were so many hoops to jump through for something that so severely impacted my way of life and livelihood.
PS: Where did you cut costs to accommodate your treatments and medications? NV: The places where I cut costs the most was honestly just my everyday social life. I knew that eating good foods was an important to me and that I need to eat at home more. So I couldn’t necessarily go and hang out with friends if all we were doing was eating out. I had to make a decision of what I valued more: a good time or good health? Even my beauty maintenance was impacted – I got extremely minimal and would often either skip out on products I used for my hair, makeup, and nails or get a generic brand version.
PS: What were some of the more unexpected lifestyle expenses you faced with eczema? NV: This is going to sound weird, but gloves. My boyfriend makes fun of me because of how many I buy, but I really do need them – I can’t touch everything, my hands will dry up and crack. I also had to get allergy testing because sometimes my eczema would flare up due to me being allergic to something, but unless you get the test you wouldn’t know what those triggers are. I learned that I was allergic to certain metals so I had to swap out a good amount of my pots and pans to higher quality ones, which in turn, was more expensive. I also only use hypoallergenic detergent now.
Final Thoughts
Villezon recognizes that her wholistic approach to eczema is a bit more expensive than most routines. If you’re interested in exploring a similar route, she also advises to not overwhelm yourself. “I swear by Vaseline ($4) and the Eczema Relief Cream ($12) from Goldbond,” Villezon says. “The process of healing your eczema will take a lot of trial and error, but it will be so worth it in the end.”
Ariel Baker is the associate editor for PS Beauty. Her areas of expertise include celebrity news, beauty trends, and product reviews. She has additional bylines with Essence and Forbes Vetted.
Eczema is a chronic skin condition that affects one in 10. It’s most common in children, although one in four people with the condition don’t have symptoms until they’re adults.
It irritates the skin, leaving it patchy and red for stretches of time. It occurs due to a combination of genetics and environmental situations. Flare ups of the condition can occur from pollen in the air or the types of foods and drinks you ingest. Some experts believe that eczema is more common in developed countries because of clean living conditions, childhood vaccines that lower infection rates, and antibiotic use. These things change your immune response and make you more likely to have atopic diseases, like eczema. But can CBD whelp with eczema.
Eczema, is traditionally treated by managing its most prevalent symptoms in order to prevent flare ups. The condition is not contagious and can be very different from person to person, with the most prevalent symptom manifesting as patches of itchy skin.
There is no cure for eczema, which is why people who suffer from this ailment have to be careful, moisturizing their skin often, while also looking for effective ways of avoiding triggers. The ways in which people treat their eczema are varied and personal, ranging from warm baths and gentle soaps to wearing soft cotton clothes to avoid pain.
Photo by Maria Fuchs/Getty Images
Seen everywhere from Amazon to Instagram, CBD has garnered some acclaim within the beauty and skincare industry. Although there’s a lack of scientific research on CBD due to the compound’s strange legal standing, many experts are hopeful in the effect it could have on eczema.
CBD has anti-inflammatory properties which seems to help reduce irritating eczema symptoms such as itching, pain, and dry skin. Research has shown the endocannabinoid system also plays a role in skin health.
Different studies have shown CBD is effective in providing anti-inflammatory effects and managing skin irritation. There are also studies that have found CBD has antioxidant properties, which could help prevent infections when skin has been damaged by eczema and is at its most vulnerable.
There hasn’t been enough research on the use of topical CBD in people with eczema. A small study published in 2019 in Clinical Therapeutics which found. a CBD ointment helped clear skin and reduced itch and the sleep loss it caused.
Research also suggests CBD is anti-microbial, with some data showing it works about as well as antibiotics to kill Staphylococcus aureus. Staph can infect the skin of people with atopic dermatitis, triggering flares and other complications.
While eczema can technically crop up at any time, it (unfortunately) thrives in winter. Since eczema is a form of severely dry skin, it’s often exacerbated by cold weather and dry air, meaning winter makes the skin issue that much worse, but there are plenty of factors that might cause a flare-up.
“We don’t know the exact cause of eczema,” says Azadeh Shirazi, board-certified dermatologist. “We do know that people develop eczema as a result of genes and environmental factors. People with eczema often report other sensitivity conditions such as asthma and hay fever. There are multiple inherent factors involved, including skin-barrier disruption, imbalance of the skin’s microbiome, and immune dysregulation. Environmental factors such as cold or dry weather; contact with sensitizers such as fragrance, dyes, or preservatives; and stress all play a huge role. Research has found having an imbalance of microbiome in the gut can increase inflammation in the body and exacerbate eczema.”
If you want to try to stop eczema before it starts (or becomes a bigger issue), I asked Shirazi for her best prevention tactics. Keep reading for the tips.
By Shilpi Khetarpal, MD, as told to Sarah Ludwig Rausch
The path to getting a diagnosis of atopic dermatitis (AD) can be long. Many times, people have tried over-the-counter treatments, home remedies, or products that are marketed for eczema that may or may not help.
It can sometimes be a long journey, with trying a lot of things that don’t necessarily improve or relieve symptoms because the condition isn’t being treated properly. For example, I’ve heard people say they’ve read about the benefits of using something like apple cider vinegar on their skin. Even though it’s natural, apple cider vinegar can actually make the skin worse and make it more uncomfortable by causing irritation called irritant dermatitis.
Atopic dermatitis is a subset of eczema. We see it many times in people who have a personal or family history of eczema, seasonal allergies, or hay fever. Eczema is a broader term, but for the most part, the two terms are often used to mean the same thing.
Challenges and Changes
When you’re newly diagnosed with AD, there may be several challenges.
The first — and we see this all the time with our patients — is that you have to change everything you do in terms of caring for your skin. You may enjoy products that have fragrance, but you will have to switch them all to ones that are fragrance-free. This can be a real change for people, and often for everyone in the household too, since they’re going to have to change the soaps and moisturizers the family uses.
Another frustrating thing about AD is that sometimes, it’s really itchy and uncomfortable, but your skin looks normal. In dermatology, we sometimes call eczema “the itch that scratches.” It looks normal, but then it starts itching, so you scratch it, and then you get the rash or the typical appearance of eczema. Kids, especially, sometimes feel that their parents don’t believe them because the skin can look normal. Yet they get these sensations of itching and discomfort that may not show up as classic eczema for days to weeks after they get that sensation.
Continued
You’ll have changes to make after your diagnosis, too. Depending on how severe the eczema is, we give most of our patients prescriptions — medications to either put on your skin or take by mouth — to help calm down the inflammation.
But a big part of treatment involves changing your entire skin care routine. For example: Using specific moisturizers multiple times a day with ingredients like ceramide and hyaluronic acid. These ingredients trap water in the skin and repair that barrier.
You’ll need to use fragrance-free, gentle soaps and change your laundry detergents, fabric softeners, and fabric sheets to free and clear products. Everything that touches your skin will need to be changed to a simple, allergen-free product. For people with severe eczema, we recommend sticking with simple 100% cotton clothing because some of the polyester blends can actually irritate the skin.
You definitely have to be dedicated to stick with your treatment. You need to use your moisturizer after you shower and then use your prescription medications on the areas of eczema. All the changes can be a big challenge for some people or, at the very least, quite different from what you’re used to doing.
Misconceptions
There are a couple of mistaken beliefs when it comes to atopic dermatitis. The first is that it’s contagious. Kids at school might tease kids with eczema or say, “They have that rash; it’s contagious.” A married couple will say, “He has eczema. I don’t want to get it from him, so we sleep in separate beds.” We know that’s not the case. It’s just a defect in the skin barrier that makes it less able to trap water.
The other misconception is that people with eczema don’t have good hygiene — they’re not clean enough, or their skin is dirty — which is also not true. It doesn’t come up often, but we definitely do hear those two.
Education and Support
I think it’s important for people with AD to have a support group. There are some online resources for that. Education about the condition itself is crucial, too. I find that visual aids can help explain what it is and how it works.
It’s really important to teach people how to care for their skin to prevent flare-ups. Once it’s flared, we give them prescriptions, but what can they do to keep their skin healthy and prevent those flare-ups from happening? They need to be educated about the clothing they wear and the products they use, things that may not be as obvious as we think.
Continued
You Have Options
Trying all these new things can be very frustrating, so seek care from your dermatologist if you’re not sure what’s going on with your skin or your routine isn’t working. There are so many other conditions that can look like eczema that may or may not actually be eczema. Plus, there are a lot of new medications that are fantastic and can greatly improve your quality of life.
And don’t discount how much good skin care can actually help. Just following simple recommendations can go a long way in preventing flare-ups in the future.
I’ve had atopic dermatitis (AD) as long as I can remember. The first time a doctor gave me a diagnosis was when I was 18 years old and in the Marines.
Having AD used to affect my mood a lot. When I was younger and more insecure, I wouldn’t wear short sleeves if I was having a flare-up. I hardly ever wore shorts. At the pool, I wouldn’t take my shirt off. I’d even cancel plans with friends.
Now that I’m in my 40s, I’ve gotten past all that. I care less about what people think. Now, when I choose what to wear, it’s based on how comfortable it is. My AD doesn’t really change my mood unless I’m having an episode that I can’t get under control and the itching is nonstop.
It’s taken some trial and error, but I’ve gotten better at managing my daily life with AD.
Daily Rituals
On a typical morning, I wake up and take a cool shower. I avoid hot showers because they increase inflammation, which makes my AD worse. Then I moisturize my body, focusing mostly on my arms and legs.
I make sure to drink a gallon of water every day. I’ve found that if I’m dehydrated, I get dry skin, which can make my eczema flare up.
When I leave the house, especially in the summer, I’ll take a bottle of lotion, itch cream, hydrocortisone cream, and allergy pills with me. It’s good to have them on hand in case I need them when I’m out.
I find that my AD gets worse in the spring. Pollen has a really negative effect on me and my AD, so springtime can sometimes feel miserable.
Treatment: Trial and Error
My AD mostly shows up behind my knees and on my arms, especially my elbows. But in the past few years, it’s started to show itself in my eyebrows. Heat, stress, and spring allergies cause it to flare more than other times of the year.
Continued
I’ve tried a lot of treatments and remedies. I’ve tried medical-grade lotions, oatmeal baths, oral allergy medication, anti-itch medication, warm baths, and mild soaps. I’ve even tried some late-night infomercial remedies, which never work.
I found that what works best for me, besides changing my diet, is hydrocortisone steroid cream. It reduces the inflammation, which eases the itching and allows it to heal faster. I use the steroid creams when I get a flare-up, and then I apply it twice a day for a few days.
When I’m about to get a flare-up, it’ll start to itch, and then my skin will become red and inflamed. I’ll put the steroid cream on and wait to see how bad it gets. If it doesn’t go away after 7 days, I’ll have to see my dermatologist to get a stronger ointment.
I owe a lot to changes I made to my diet. When I was in my late 20s, a friend and I made a bet to see who could lose the most weight. I started eating healthier and stopped drinking alcohol, and I noticed that my flare-ups and everyday rashes decreased. So I made the connection and never went back to my old habits.
I no longer drink alcohol. I don’t eat processed or greasy foods. These changes have helped more than any other treatment has, especially not drinking alcohol and eating a whole-foods diet.
(If you were wondering, I did win the bet.)
I’ve also stopped using things that cause flare-ups, and I’ve found a few tricks that make it easier. I shaved my head years ago because it kept me cooler, and I figured out that certain types of shampoo and conditioner would make AD flare up on my eyebrows.
Now that I know what I’m doing, my flare-ups are less severe. I think knowing your triggers and avoiding them makes a big difference. For me, it’s heat, dehydration, greasy or processed foods, alcohol, and spring allergies.
Continued
Getting Over the Hurdles
My biggest hurdle is being disciplined when it comes to my diet. If I have one day where I let myself eat greasy or processed foods, it can take me weeks to get my skin back to normal. I’ve become much better at staying on track as I’ve gotten older.
Stress is another hurdle. It definitely plays a role in my flare-ups. I’ve had to learn how to manage my stress and anxiety to keep it under control. My doctor prescribed a mood stabilizer to control my anxiety problems. And as I’ve gotten older, I’ve learned to always do what’s best for me and my family over anything else, which makes my worries and anxiety very low.
Every day is different, but it’s been a learning experience. Now I can say I’ve figured out how to live well with AD.
I don’t really notice my atopic dermatitis (also known as eczema) anymore, which is completely shocking to me. I used to be the polar opposite. I spent so much time and energy worrying if people were looking at my face or wondering why my arm was red. Now, unless my skin gets itchy, I forget I have eczema.
For example, I went on a date recently with a rash on my face. I didn’t even think about what my skin looked like until afterward. In the past, I would’ve thought, “No, I’m not going out on this date. I have a patch on my face. I don’t look good, and I’m not going to make a good first impression. I don’t want them to see me like this.”
I started to feel more comfortable with my bare skin about 5 years ago, when I started posting about atopic dermatitis on Instagram (@eczemalove). And when I look in the mirror now, my eczema isn’t the first thing I see. That’s a huge relief, because it’s all I saw before.
Learning to Love My Skin
Technically, I had eczema as a baby. But I don’t remember that time because, well, I was a baby. I didn’t have symptoms again until I was 11 or 12. That’s when I was diagnosed with atopic dermatitis.
It wasn’t easy going through middle and high school with a rash covering my face. I was very self-conscious for a very long time. But I got tired of feeling down about it. So, when I was 19, I started sharing more about my real skin.
I took to social media because I wanted to normalize the condition. I think people view eczema as weird because they never see it and they don’t know anything about it. I wanted to change that.
Of course, I wasn’t confident right away. It was a process. My first posts included tips on the best makeup to hide eczema. I knew I shouldn’t be ashamed of what my face looked like, and I told other people the same thing. Yet there I was, covering up. I felt like a hypocrite.
Continued
I decided to practice what I preached and show my bare skin. Ever since then — and it feels like it happened suddenly — I’ve felt free not worrying about what other people think. That’s changed how I see myself, in a good way.
My symptoms got better, too. This probably goes without saying, but I’ve found that the less I put on my face, the better my skin feels.
I still love doing my makeup. I just put it everywhere except my eczema patches. That’s partly because it’s physically uncomfortable to cover up. It can make my skin very itchy, and it stings a lot of the time. All day, I just want to scratch my foundation off. If I do, my skin ends up looking and feeling worse.
Now, I want to put only helpful products on my skin, like a good moisturizer. That means I don’t have to worry about worsening my symptoms with stuff I don’t really need.
All About Comfort
I also think my symptoms got better because I’m less concerned about my appearance — and stress tends to trigger my eczema. I still worry about other things, just not whether someone is staring at my patches.
I’m not saying you have to uncover your eczema. You may not be able to do that, at least not cold turkey. If you want to show your natural skin, you can think about doing it gradually. Start to show a little more than you normally would, but always do what you’re most comfortable with.
My main advice is this: No one really cares about your eczema. At least they probably don’t care as much as you think they do. Take dating, for example. I thought guys wouldn’t want to talk to me or have anything to do with me. But the people I’ve met are fine with it. My boyfriends have been wonderful. It’s very refreshing.
Plus, I know I don’t focus on someone else’s skin condition. So many people have them. They might have acne, rosacea, vitiligo, or psoriasis. But, personally, that’s not something I pay much attention to.
Continued
The Positives
I honestly don’t think I would have this confidence without my eczema, which sounds crazy. But it gave me a reason to focus on my skin and think about what it means to hide it.
It’s also given me a lot of really cool opportunities. The first company that ever reached out to me was Dove. I was in their DermaSeries campaign about a year after I started on Instagram. That’s a line of products for people with psoriasis, eczema, or really dry skin.
I also work with a lot of other brands now. It’s nice that companies make an effort to feature people who actually have eczema. In the past, you’d see a skin care line where they’d show someone with perfect skin. That’s not realistic for people like me.
I no longer expect my skin to be perfect. It took me a long time to get out of that mindset. When you’re diagnosed with eczema, you think each new product might be the one that’ll make it go away. But the reality is, that’s probably not going to happen.
I’ve accepted this is a lifelong condition. I don’t need to hide it. And whatever makes my skin more comfortable is great.
Connecting With Others
I’ve seen that what I post helps other people. A lot of people tell me, “I’ve never seen anyone who has eczema like me. But yours looks exactly like mine. Thank you for showing people what it really looks like. I feel less alone.”
What I really love is when people message me and say, “You know, I really didn’t want to go to the beach. Normally, I cover up. But yesterday, I decided that I didn’t want to. And I went to the beach and had a really good time, and I didn’t feel self-conscious. It was great.”
When I see other people’s confidence, that boosts my own confidence. That makes me think maybe we’re on to something here.
Atopic dermatitis treatments have come a long way.
In the past, we had to use immune-suppressing drugs in people with moderate to severe disease. Many doctors, especially those without expertise in skin care, have used oral steroids. But we can’t keep people on these drugs long-term. Steroids cause serious side effects like weight gain and high blood sugar. They also have a rebound effect: The atopic dermatitis comes back pretty quickly, and with a vengeance.
Other immune-weakening drugs like cyclosporine, methotrexate, mycophenolate, or azathioprine have been the favorite of dermatologists. But these are also strong medications that need frequent blood tests to watch for side effects.
We needed a new treatment approach. Atopic dermatitis is a serious problem. The itch can be so severe that it keeps people up all night scratching. Severe flares can affect your ability to go to school or work and to have a social life.
It’s exciting to live in an age where we can create medications to target the pathways underlying diseases. That’s being done right now with atopic dermatitis.
Finding the Cause
From studies, we found that people with atopic dermatitis have an immune system imbalance. Their bodies make too much of certain things that inflame their skin when they’re exposed to irritants, bacteria, or allergic triggers like pollen and pet dander.
We know that the skin barrier is flawed in atopic dermatitis, which makes our skin-based immune system react more than usual when triggered on the surface. In addition, many people with atopic dermatitis do not have enough of an immune response against bacteria on their skin. All of these factors work together to trigger atopic dermatitis flares.
By understanding the driving forces behind the disease, we’ve been able to develop treatments that target the out-of-control immune system. Now, we can manage atopic dermatitis much better.
New Treatments
The FDA has approved two new treatments for atopic dermatitis in recent years. Crisaborole (Eucrisa) is the first phosphodiesterase-4 (PDE4) inhibitor. It’s a cream that blocks the enzyme PDE4 to reduce inflammation.
Continued
Dupilumab (Dupixent) is a biologic drug. It blocks the effects of proteins called cytokines that the immune system makes: interleukin-4 (IL-4) and interleukin-13 (IL-13). These contribute to the inflammation, reduced skin barrier, and severe itch of atopic dermatitis. Blocking them reduces the inflammation and the itch.
This drug has transformed atopic dermatitis treatment. Though it doesn’t work for everybody, in those it does help, it is life-changing. Sometimes, it starts to work in the first weeks after starting it.
The other advantage of dupilumab is its safety, especially in children. Immune-suppressing drugs like cyclosporine come with long-term risks like kidney damage and high blood pressure. That’s why we have to do regular blood tests in people who take these drugs.
With dupilumab, we don’t need to do blood tests. The only side effects are reactions where the needle goes in and possibly inflammation in the eye, which an eye doctor can treat. So now we can feel more comfortable treating patients safely.
Dupilumab has really been a game-changer. My patients tell me how it has changed their lives. Some of them hardly have to use the thick creams anymore to control the itch. They can play sports and go to parties again.
Coming Soon
Dupilumab is just the tip of the iceberg. Two more biologics should be coming out in the next year or so. Like dupilumab, they also target the effects of IL-13, and they have a similar safety profile. That means we’ll have more safe choices to prescribe for our patients.
The other group of medications for moderate to severe atopic dermatitis that’s coming out is the Janus kinase (JAK) inhibitors. These drugs block the messages that signal the immune system to make more cytokines.
Three JAK inhibitors are in development, and they look promising. One of them, abrocitinib, worked better than dupilumab in a head-to-head study.
Unlike injected drugs like dupilumab, JAK inhibitors come as a pill that you take daily. That is a huge plus for people who don’t want to get shots.
The big question is safety. Two JAK inhibitors that are used to treat rheumatoid arthritis and are in development for atopic dermatitis have a black box warning on the label about serious risks like cancer, blood clots, and infections.
None of these risks has come up in the studies on atopic dermatitis. But JAK inhibitors can cause nausea, headaches, acne, and higher odds of herpes infections, with risks depending on the drug. Also, people who take them will need blood testing to watch for problems.
Continued
New Topicals
A few new topical drugs — meaning you put them directly on your skin — are in development, including a topical version of a JAK inhibitor. We’re excited about these drugs because they’ll offer an alternative to topical steroids.
Another PDE4 inhibitor is also in the works, and it may be more potent than crisaborole.
Tapinarof is the first in a new class of topical drugs called a therapeutic aryl hydrocarbon receptor modulating agent (TAMA). It works in a different way to reduce the inflammation and itch of atopic dermatitis.
One problem for many people who use nonsteroid topical drugs that are currently on the market for atopic dermatitis (topical calcineurin inhibitors like tacrolimus and pimecrolimus; crisaborole) is burning or stinging. All of these new nonsteroid drugs seem to be less likely to cause these problems than ones we have now.
Another new treatment is a skin spray with healthy bacteria. These good germs fight off the bad bacteria that make atopic dermatitis worse and cause infection.
A few of these sprays are in development, and I think they will be very interesting to watch. They may be able to reduce inflammation and improve atopic dermatitis. Plus, I think a lot of people will like the fact that they’re natural — replenishing the “good bacteria” on the skin.
Up until a few years ago, Heather Sullivan’s 14-year-old son, Sawyer, had struggled with eczema his entire life. When he was just a baby, most of his body would be covered in intensely itchy rashes that bled and oozed when he couldn’t help but scratch. His family tried steroid creams, wet wraps, bleach baths, and all of the lotions. They tore up their carpet and replaced their sheetrock in hopes of eliminating triggers. At 15 months, he went on cyclosporine, a powerful immunosuppressant usually given to organ-transplant patients. It cleared him up, but the drug comes with potentially dangerous side effects over time. Doctors, Sullivan recalls, were “just appalled that my child would be on this amount of medicine at this age”—but his eczema came roaring back as soon as he went off it.
When a new eczema drug called Dupixent finally became available to Sawyer a few years ago, his turnaround was fast and dramatic. Within a week, his itchiness and redness started calming down. He felt and looked better. The condition that had dominated their lives began to fade into the background.
Doctors who treat severe eczema now speak of pre- and post-Dupixent eras: “It changed the landscape of having eczema forever,” says Brett King, a dermatologist at Yale. Today, a half dozen novel treatments are available for the skin condition, all of which work by quieting the same biological pathway in eczema; dozens more are in clinical trials. Unlike older drugs, these new ones are precisely targeted and in many cases startlingly effective.
Eczema, also known as atopic dermatitis, is characterized by red, itchy, and inflamed skin. It’s a very common condition, estimated to affect 10 percent of Americans. Of those, a large minority suffer from moderate to severe eczema that seeps into everyday life. “Just imagine scratching endlessly,” King says. “You wake up from sleep scratching. Your sheets are bloody in the morning.” The most basic eczema advice is to moisturize, and moisturize often, to protect the barrier of the skin. But scientists now know that eczema’s cause is not in the skin alone. Many patients also have “an over-reactive or overzealous immune system,” says Dawn Davis, a dermatologist at the Mayo Clinic. Their immune cells release chemicals that irritate nerves, causing itch, and even degrade the skin itself.
Topical steroids, such as over-the-counter hydrocortisone cream, can tamp down the immune reaction that flares in eczema. If these fail, doctors have resorted to more powerful oral steroids, such as prednisone, or other oral immunosuppressants, such as the aforementioned cyclosporine. The drugs can calm eczema, but because they suppress the overall immune system, they also do much more. Prednisone, for example, makes you more prone to infections as well as bone fractures, high blood pressure, and glaucoma when taken in the long term. Of course, for many people, eczema is a chronic condition that requires long-term treatment. “Prednisone is kind of like carpet bombing,” says Peter Lio, a dermatologist at Northwestern University. It blasts eczema away, but at a cost.
In contrast, the newer drugs, Lio says, are more like shotguns that target specific parts of the immune system—with less collateral damage. They fall into two broad classes. Monoclonal antibodies, such as Dupixent, intercept the immune-signaling molecules that trigger itch and skin inflammation. And then JAK inhibitors, which include pills such as Rinvoq and the topical cream Opzelura, scramble the signal after cells have received it. The development of these drugs came after years of research zeroed in on some of the key immune molecules dysregulated in eczema. But serendipity played a role too: The first such drugs were originally developed for other conditions, such as rheumatoid arthritis—only to be repurposed when researchers realized that they targeted the very pathways involved in eczema. The breakthroughs in eczema treatment, in fact, are part of a broader revolution in treating inflammatory disorders; both classes of new drugs are now used to tune the immune system in a whole host ofdifferent conditions.
The monoclonal antibodies and oral JAK inhibitors may have their own serious side effects, such as blood clots, which, Lio says, give some doctors unfamiliar with the new drugs—especially the latter type—pause. But the traditional drugs are not great either. “I’m frustrated that a lot of clinicians are very cavalier about prednisone and cyclosporine … They’re like, ‘Oh, they’re our old friends,’” he told me. “Then they get nervous about JAK inhibitors.” In his mind, the new drugs are simply the better option in terms of safety and efficacy.
Jonathan Silverberg, a dermatologist at George Washington University who specializes in eczema, says he now rarely uses the old oral steroids and immunosuppressants. When he does revert to them, it’s not for medical reasons: He ends up prescribing older (that is, generic and therefore cheaper) drugs for uninsured patients who can’t afford the new ones, or for patients who have insurance but are nevertheless denied coverage. “Insurance says, ‘Can it be fixed with a $10 medicine? Or does it really need the $1,000 tube?’” King told me. Getting patients these newer drugs can mean a lot of time fighting with insurance.
For now, these drugs have most dramatically improved the lives of patients with moderate to severe eczema—at least those patients who can access them. But doctors told me that topical JAK inhibitors, which are safer than the oral version, could one day be first-line treatments for mild eczema as well. “In a perfect world, I would love it if I never had to prescribe a topical steroid again,” Silverberg said, citing the side effects that come with long-term use. Topical steroids can thin the skin, causing stretch marks, fragility, and poor healing. But at the moment, steroids are also cheap and easily available. They’re not going anywhere as long as the new treatments still come with hefty price tags.
Last but not least, we have general skin infections. Now your bump could be caused by something else and then get infected, or it can be a sign of an infection to begin with.
“If a bump starts to blister, ooze yellow or green pus, have yellow crusting, or is associated with pain and swelling, it could mean that it’s turning into an infection,” Kobets says.
One common infection is impetigo. “Impetigo is a bacterial skin infection that can have honey colored crust, which can sometimes happen with worsening eczema or infected hair follicles,” Kobets says.
You could also have cold sores which start off as red, painful, burning, or itchy bumps and progress into fluid-filled blisters that crust over, she adds.
Chickenpox is another virus in the herpes family and typically affects children who are not vaccinated for it. It’s rare to have chickenpox only on the face and not the body, so that’s one major giveaway.
“If your redness is being caused by an inflammatory skin condition like acne, using targeted treatment to get your acne under control will help to fight redness,” says board certified dermatologist, Chief Medical Officer and Co-Founder of Fig.1, Courtney Rubin, M.D., FAAD.
Acne is a highly complex skin condition with many compounding factors including genetics, skin type, hormone levels, and more. Classic acne-easing ingredients like salicylic acid and retinol will be helpful for many, but each person is different.
If you’re looking to clear up breakouts, start here with our full guide to the many different types of acne. For those who have yet to find a successful treatment or those with cystic acne, visit a dermatologist for a customized treatment plan.
TUESDAY, March 28, 2023 (HealthDay News) — If you’re one of the millions of people with allergic asthma or eczema, you may be more likely to develop the wear-and-tear form of arthritis as you age.
This is the main finding from a new study that examined the risk of developing osteoarthritis among people with the two allergic conditions.
The study wasn’t designed to say how, or even if, these allergic diseases increase osteoarthritis risk, but the researchers do have a theory.
“Our group has done work showing that mast cells [a type of allergic cell] are increased in numbers in the joints of people with osteoarthritis, and their activity contributes to the development of osteoarthritis,” said study author Dr. Matthew Baker, clinical chief in the division of immunology and rheumatology at Stanford University in Stanford, Calif.
And asthma and eczema may be the tip of the iceberg, he said.
“It is possible that other atopic conditions such as seasonal allergies, food allergies and/or allergic rhinitis [hay fever] may provide a similar risk,” Baker noted.
These researchers did not look at these conditions in the new study.
For the study, they reviewed insurance claims from two databases. The first set included more than 117,000 people with asthma or eczema and 1.2 million people without these conditions. After eight years of follow-up, the risk of developing osteoarthritis was 58% higher among folks with allergic asthma or eczema than among their counterparts without these allergic conditions.
The risk of osteoarthritis was even higher among people who had both allergic asthma and eczema, the study findings showed.
About half of people with eczema also have allergic conditions such as hay fever, asthma or food allergies, according to the American Academy of Allergy, Asthma and Immunology.
The researchers also compared the risk of developing osteoarthritis among people with allergic asthma to those with chronic obstructive pulmonary disease (COPD), a lung disease that doesn’t involve allergic pathways. People with asthma were 83% more likely to develop osteoarthritis than those with COPD.
In the second database, the odds of developing osteoarthritis were 42% higher among people with either allergic asthma or eczema and 19% higher among those with both conditions. These findings weren’t as robust as those seen in the first set as they took body mass index (BMI) into account. (BMI is a estimate of body fat based on height and weight.) A high BMI is a risk for developing osteoarthritis.
The million-dollar question is whether treating asthma or eczema lowers arthritis risk. The researchers didn’t look at this in this study, but there is reason for hope.
Older research has linked the use of antihistamines with reduced structural progression in knee osteoarthritis, Baker said.
“We are hopeful that any number of drugs that work to inhibit mast cells or mast cell products [such as histamine] will reduce the incidence of osteoarthritis,” he said.
The study — published March 27 in the Annals of the Rheumatic Diseases — was funded by the U.S. National Institutes of Health.
The connection between osteoarthritis and allergic diseases could be the low-grade inflammation, said Dr. Theodore Fields, a rheumatologist at the Hospital for Special Surgery in New York City, who reviewed the findings.
The good news is that there are more treatments for eczema today than ever before and many more are in the pipeline.
“If treatment of atopic disease helps prevent or lessen osteoarthritis, there are a lot of options and will be more,” Fields said.
“For patients with eczema or asthma, this data can make them aware that they might be more likely to get osteoarthritis,” he said.
If you have an allergic disease and develop aches and pains in your joints, see your doctor, he advised.
“We have many strategies to improve the symptoms of osteoarthritis but don’t yet have a disease-modifying treatment,” Fields said.
“There can be some hope in this study for patients with eczema or asthma that their treatment for atopic disease might prevent or diminish their potential to develop osteoarthritis,” he added.
More information
The American Academy of Allergy, Asthma & Immunology has more on eczema.
SOURCES: Matthew Baker, MD, clinical chief, division of immunology and rheumatology, Stanford University, Stanford, Calif.; Theodore Fields, MD, rheumatologist, Hospital for Special Surgery, New York City; Annals of the Rheumatic Diseases, March 27, 2023
WEDNESDAY, Feb. 15, 2023 (HealthDay News) — How close a person lives to a major road could have an impact on their eczema risk.
New research suggests that folks who live farther from one are less likely to develop the skin condition.
A 13-year medical chart review focused on patients in Denver, from infants to age 18.
Those with eczema were compared to an equal-sized control group of patients without the condition. In all, the study included more than 14,000 children.
The researchers calculated the distance from their homes to a road with annual traffic of more than 10,000 vehicles a day.
The risk of eczema (atopic dermatitis) dropped 21% for every 10-fold increase in distance from a major road, the study found.
“In the end, we found children who lived 1,000 meters [0.6 miles] or more from a major road had 27% lower odds of atopic dermatitis compared to children who lived within 500 meters of a major road,” said lead author Dr. Michael Nevid, a fellow at National Jewish Health in Denver, who pursued this research after learning about a similar study in Asia.
“This is an early association study, so more work needs to be done to examine the pathophysiological mechanisms involved in the association,” Nevid said in a news release from the American Academy of Allergy, Asthma & Immunology.
The findings were published in a February online supplement to The Journal of Allergy and Clinical Immunology. They are also scheduled to be presented during a meeting in San Antonio of the American Academy of Allergy, Asthma & Immunology, Feb. 24 to 27.
More information
The National Eczema Association has more on eczema and the environment.
SOURCE: American Academy of Allergy, Asthma & Immunology, news release, Feb. 3, 2023
TUESDAY, Feb. 14, 2023 (HealthDay News) — Doctors have dubbed kids’ progression from eczema to asthma the “atopic march,” and they know more about how it affects white children than their Black counterparts.
Research scheduled for presentation at an upcoming meeting of the American Academy of Allergy, Asthma & Immunology (AAAAI) sheds new light on racial disparities.
The atopic march typically begins early in life with atopic dermatitis (eczema) and can eventually progress to asthma, as well as environmental and food allergies.
In the new study, the researchers found that while Black children are more likely to develop asthma, they’re less likely than white children to be evaluated for eczema by an allergist.
“We already know that Black children have higher rates of asthma,” said study author Dr. Ellen Stephen, an allergy/immunology fellow at Rush University Medical Center, in Chicago. “But the atopic march has just not been studied in Black children as widely as it has in white children.”
Her team reviewed medical charts of nearly 1,000 children, aged 18 and under, who were diagnosed with eczema at a single medical center.
In all, 728 Black children and 246 white children had an eczema diagnosis. Of those, 31% of Black children were likely to have an asthma diagnosis, compared to 10% of white children.
In all, nearly 47% of Black children and 69% of white children were evaluated by an allergist. Black children were also significantly less likely to have been tested for environmental allergens, the investigators found.
“Asthma is a common, potentially life-threatening condition affecting the children in our country, and allergist evaluation and environmental allergy testing can be essential to optimizing control of this disease,” Stephen said in an academy news release.
“To minimize existing health care disparities, more research must be done to help us understand what factors underlie the observed differences in the diagnosis and management of atopic diseases, so that we can overcome existing barriers to providing equitable asthma care,” she added.
The findings are scheduled for presentation at an AAAAI meeting on Feb. 25 in San Antonio. Research presented at medical meetings should be considered preliminary until published in a peer-reviewed journal.
More information
The U.S. National Institute of Allergy and Infectious Diseases has more about eczema.
SOURCE: American Academy of Allergy, Asthma & Immunology, news release, Feb. 3, 2023
I’ve had atopic dermatitis for as long as I can remember. When I was little, I remember getting a lot of rashes in the areas where my joints are — the insides of my elbows and knees. I was itchy all the time.
My pediatrician and the other doctors I visited at the time said it was normal for children to have eczema. They told me I’d eventually grow out of it.
Constant Itching
I was so itchy that I had trouble falling asleep. I wore long-sleeved shirts to bed so that I wouldn’t scratch at my skin during the night.
My whole life revolved around catering to my eczema. I’d check the weather every day. If it was very dry or windy, I wouldn’t go outside. Just my hair hitting my face in the wind would irritate my skin.
I used to wear mainly dark clothes. My skin would bleed because I always had open wounds from scratching, and I was afraid of staining my white clothes.
I was so self-conscious that I went to great lengths to hide my skin. I wore long sleeves, even in the summer. Sometimes I wouldn’t leave my house when my eczema looked particularly bad.
Missing Out
I felt excluded from normal childhood activities. Many of them would exacerbate my skin. For example, I couldn’t swim because it would dry out my skin and make my eczema flare up. And if I got too sweaty while exercising, I would break out in itchy hives. When my friends wanted to go out for something to eat after school, I felt too terrible to join them.
I didn’t grow out of my eczema as my doctors had predicted. Instead, it started to get worse in high school. I was so itchy that I couldn’t focus in class and I couldn’t sleep at night. I started falling further and further behind. Because I didn’t want to tell my teachers that eczema was to blame, I came across as a student who didn’t try very hard.
I wish people understood how chronic illnesses affect people. Whenever I had to miss class in high school, I would tell my teachers and friends that I was out because I was sick. For most other people, being sick happens for a finite period of time — as long as it takes to get over a cold or other infection. There was an expectation that I would fully recover within a week and be back at school. But because my condition was/is chronic, whenever I would become “sick” with a bad flare-up, I’d remain bedridden without any timeline for recovery. It could be days, but more likely weeks and months, before I stopped flaring up and could go outside again. And when I did return, I felt only slightly less terrible and was still barely able to function.
Few people realize that eczema is a disability. Those around me were constantly minimizing my experience, and the effect the disease was having on my day-to-day life. If I hid my condition people didn’t take me seriously, and if I was honest about it, they didn’t want to be near me. It was a lose-lose situation.
Eczema affected me so much that it took me an extra year to graduate from high school. It felt like the world was moving on without me.
Trying Everything
I have tried just about every medication, and a few alternative therapies, to manage my atopic dermatitis. I went to pediatricians, dermatologists, and allergists for advice. I rubbed on topical steroid creams of various potencies, and got steroid injections. I tried phototherapy, which is essentially a tanning booth that blasts UV rays at you. I used antihistamines and various lotions to try to tame the itch. Nothing helped.
I went on strong pills that suppressed my immune system. I remember the warnings on the bottles, which said these medicines were for people who had just gotten an organ transplant. That was pretty scary. I just wanted my skin to stop breaking out.
I also tried a lot of fad skin care trends over the years, like drinking 10 cups of water a day or rubbing coconut oil on my skin. None of them worked. Neither did the herbal remedies my family recommended.
My doctor tested me for allergies, pricking my skin to see if it broke out in hives. During one test, my doctor put patches of common allergens on my back. The tape irritated my skin so much that it itched for the entire 3 days that it took to do the test.
I took part in a clinical trial of a biologic drug used to treat psoriasis. I stayed in that study for a whole year, but the drug didn’t help me.
By the time I was 16, my doctors stopped telling me that my eczema would improve with age. At that point they realized it wasn’t going away.
Gradual Clearing
I was always looking for new treatments. One day, I saw a story about dupilumab (Dupixent) in the news, and it looked very promising. I reached out to my doctor, Emma Guttman-Yassky, MD, at Mount Sinai in New York. I had moved to California by then, because I was hoping the warm climate might help clear my skin. I told Dr. Guttman-Yassky that I really wanted to get on this new drug, and she helped to expedite the process with my insurance company.
It’s a very expensive drug, so a lot of insurance companies want you to “prove” that you need it. They ask for an exhaustive list of everything you’ve tried, along with proof that nothing on the market has worked for you. I had to go through an extensive rejection and appeal process before I finally qualified for a patient assistance program.
Once I got on the medicine, it took a while for it to take effect. It was very gradual. But at some point, I realized that if I had a scab, it would go away in 3 months instead of the 3 or 4 years it used to take to clear up. And when I would apply steroid creams, for the first time they actually worked.
It took 6 months to a year for me to experience the full effects of the drug, but today I see a huge difference. When I was growing up, eczema was all over my body. Now I have only a few patches here and there. It’s very manageable. Most of the time I don’t even notice it’s there.
Unfortunately, there’s no cure for atopic dermatitis. I still get flare-ups, and I have to be careful about being outside for too long because the wind can dry out my skin. But compared to what I had before, it’s really manageable.
I feel better than I’ve felt in my entire life. The year before I started dupilumab, I was failing high school. Now I’m studying mechanical engineering at the University of California, Berkeley. It’s been night and day for me.
