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Tag: eczema

  • My Life With Moderate to Severe Atopic Dermatitis

    My Life With Moderate to Severe Atopic Dermatitis

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    By Ashley Ann Lora, as told to Stephanie Watson

    I was diagnosed with atopic dermatitis when I was 2 years old. I don’t remember much of it at that age, but my parents sure do. The redness and bumps on my face are obvious in almost every photo of me from back then. It’s very clear from those pictures just how much the condition truly affected me.

    I remember sleeping with my parents to try to keep myself from scratching my skin all night. I missed a lot of days of school, especially when it got severe.

    There were so many things I felt like I couldn’t do because of eczema. It stopped me from playing sports, hanging out with my friends, and doing what “normal” kids do. I shed a lot of tears during that time.

    Finally, there was a moment when the eczema went dormant. It was the best 2 years of my life up to that point. For the first time, I was able to grow out my nails and wear short-sleeved shirts. I truly believed that my eczema was gone. But then, on a family trip to an amusement park, I got super sick and the eczema came back with a vengeance. My dream of being eczema-free was gone in a matter of hours.

    Tests and Treatments

    Because eczema and allergies are closely related, I went through allergy testing. My doctor made all these little pricks on my back and applied different substances to see if I was allergic to them. There must have been 50 or 60 different marks on my back. I was allergic to almost every one of them, including trees, grass, and even certain types of rubber.

    I went to a lot of doctor appointments from elementary school all the way up to high school. But from high school to college, I had given up on doctors because every visit was the same. I’d go into the exam room, the doctor would look at my skin, and within 5 minutes I’d walk out with a prescription for topical steroids.

    The steroids would help temporarily, especially when my atopic dermatitis got really bad. But it felt like a Band-Aid, because eventually it would come back even worse. Then I’d have to go through the whole process again.

    I had a love-hate relationship with mirrors growing up. I didn’t feel good about myself for a very long time. It was hard. Eczema affected me physically, socially, and psychologically. It felt very lonely because I thought I was the only one in the world living with this condition.

    My Healing Journey

    November 2014 was the beginning of my healing journey. I was in the middle of one of the worst flares of my adult life. I tried going through the same routine of using topical steroids, but this time it didn’t work.

    I said, “enough is enough” and started doing my own research on eczema. I learned about topical steroid withdrawal and started to go through that process. It was rough. I had used steroids for more than 20 years. When I went off them, I had severe withdrawal symptoms that left me bedridden for almost a year and a half.

    I lost half of my hair and part of my vision. My skin looked like a combination of snake and elephant skin. I shed so much that I constantly had to vacuum my bed and every corner of my house. It was like my body was going through a process of transforming itself.

    In the middle of withdrawing from steroids, I got into a clinical trial of the biologic drug dupilumab (Dupixent). That was a game-changer. With that drug, I was finally able to start enjoying life. My skin was the clearest it had ever been. I felt normal!    

    In 2017, my skin was doing so well that I started to withdraw from dupilumab. I wanted to see how my skin would do without it. I wouldn’t recommend that approach for everybody, but I had confidence that my body could heal itself.

    I’m currently not taking any medication. I’ve been focusing on more holistic practices like meditation, therapy, exercising, and eating foods that make me feel good. I’ve learned what works for me by seeing what has worked for other people.

    Regaining Control

    The biggest lesson I’ve learned during my journey is that my eczema is correlated with my emotions. A lot of people say stress triggers their eczema. For me, anger, sadness, and depression trigger it, too. As I’ve become more aware of my emotions, I see how they affect me and I’ve learned to control them through meditation and breathing.

    Years ago, I let eczema take over my life. I would get into an itching cycle and my whole world would crash down around me. I lost a lot of who I was because of it. I don’t remember much of my childhood because the eczema was so traumatic and it consumed so much of what was good about my life.

    I’ve done a full 180 since then. When I began accepting my eczema and figuring out how I could work with it, I got my life back. There was even a point when I began referring to my eczema as “she.” She became my best friend. When she flared up, I would ask her how we could work together to heal. By personifying my eczema and relating to her instead of seeing her as my enemy, I started healing more quickly.      

    I still flare up, but atopic dermatitis no longer controls what I get to do on a particular day. My condition is no longer the deciding factor in what I wear, where I go, and who I hang out with.

    In 2015, I started calling myself an eczema warrior. I am a warrior, in a sense, because I’ve courageously conquered my eczema (mentally more than physically) and continue to do so. I’ve come to terms with my eczema. I’m proud of her and I’m proud of how far we’ve come together.      

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  • Which Atopic Dermatitis Treatments Work Best?

    Which Atopic Dermatitis Treatments Work Best?

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    There are many tools to treat atopic dermatitis (AD), both over-the-counter and prescription. You can try ointments and creams, or your doctor might suggest light therapy, or medications you take by mouth or get as a shot.

    “There are constantly new treatments arising for atopic dermatitis that help lessen the burden and make treatment more effective,” says Geeta Patel, DO, founder of River Oaks Dermatology in Houston.

    “Topical steroids are currently the mainstay of treatment, but they’re not always the most effective,” she says. What works well for one person doesn’t always work well for another. It may take time to find the right treatment.

    Your doctor will make recommendations based on how severe your AD is and what areas of your body it are affects.

    Best Treatments for Mild AD

    “Mild atopic dermatitis usually involves topical therapy,” Patel says. If you have mild AD, your doctor may recommend one of these topical treatments:

    Topical steroids. These creams or ointments relieve itch and ease inflammation. You put them on red or inflamed skin.

    Topical steroids come in different strengths. Prescription steroids are usually more effective than over-the-counter products. The stronger it is, the more effective it may be to control inflamed skin. But it may have more side effects, like thinning your skin. Never use high-strength steroids on your face, armpits, or groin. For long-term use, get the lowest strength you can.

    Topical calcineurin inhibitors. These creams and ointments have drugs that target your immune system to suppress inflammation and ease symptoms of itching in mild to moderate AD. They’re safe to use long-term. You put them on after you moisturize your skin, but some have rules about how soon you can use them afterward, so check the prescribing info. Examples are pimecrolimus (Elidel) and tacrolimus (Protopic).

    Topical PDE4 inhibitors. These topical medications put the brakes on inflammation by blocking PDE4, an enzyme that triggers it. They reduce itching, redness, thickened skin, and oozing in mild to moderate AD. Right now there’s only one FDA-approved PDE4 inhibitor. It’s called crisaborole (Eucrisa). It’s approved for people ages 3 months and older, and you can use it long-term on all body parts.

    If you have mild AD, your doctor may also tell you to:

    • Avoid triggers
    • Moisturize after bathing
    • Eat well
    • Manage stress
    • Sleep well

     

    Best Treatments for Moderate to Severe AD

    If you have moderate or severe AD, your doctor may recommend:

    Wet wrap therapy. With this treatment, you wrap the affected skin with wet bandages after you apply moisturizers or topical corticosteroids. “Wet dressings help relieve itching, heal your skin, and help your creams or ointments to be more effective,” Patel says.

    Your doctor will tell you how to do it and how often.

    Oral medications. If creams don’t work, your doctor may recommend oral medication. “These work by slowing your immune system response, which can help to reduce the severity of symptoms,” Patel says.

    Ultraviolet light or phototherapy. “Light therapy is often used to treat severe eczema that doesn’t respond to creams,” Patel says. The treatment exposes your skin to a controlled amount of natural sunlight, UVA, or UVB light to help with symptoms.

    It usually involves going to your dermatologist’s office 2-3 times a week. Try to be patient. “It can sometimes take 1-2 months to take effect,” Patel says.

    Dupilumab (Dupixent). This new lab-made medication can lessen inflammation, itching, how severe the disease is, and how far it has spread. You get it as a shot. Your doctor may recommend it if other treatments don’t work or if you can’t use products you rub onto your skin.

    “Trials have shown that most people experienced clear skin and reduced itching after about 16 weeks,” Patel says.

    Complementary Treatments for AD

    These treatments may help ease your symptoms:

    Mind-body practices. “Stress can worsen atopic dermatitis,” Patel says. Managing it can help cut down on flares. Try mindfulness meditation, yoga, tai chi, acupressure, hypnosis, or biofeedback, where you learn how to control things your body does, like your heart rate, to help you relax. These practices may also help if you scratch a lot.

    Massage therapy. Massage is known to relieve stress, so it may cut back on flares. Choose a therapist who’s accredited and has experience working with people who have similar skin conditions. Make sure they don’t use oils or lotions that might trigger your AD or make it worse.

    Coconut oil. Studies suggest applying coconut oil to your skin may lower staph bacteria and help prevent infection. “Apply it once or twice a day to damp skin,” Patel says. Choose virgin or cold-pressed oils, which don’t have chemicals.

    Sunflower oil. “Sunflower oil boosts the skin’s barrier function, helping it retain moisture. It also has anti-inflammatory properties,” Patel says. Put it on twice a day, once after bathing so your skin is wet.

    You may have heard that vitamins, supplements, and probiotics help with AD. But there’s not enough research to support taking them, and they may be harmful if you’re taking certain medications.

    Lifestyle Tips for AD

    Take these steps to help your treatments work better and relieve symptoms:

    Take a lukewarm bath. Keep it to 10-15 minutes. Then pat your skin dry and apply moisturizer while it’s still damp.

    Moisturize twice a day. Apply moisturizing cream at least twice a day to strengthen your skin’s barrier.

    Prevent scratching. If your skin is itchy, try pressing it instead of scratching. “Covering the itchy area also helps stop you from scratching it,” Patel says.

    Use a humidifier. “Hot, dry indoor air can dry out sensitive skin and worsen itching and flaking. A portable home humidifier or one attached to your furnace adds moisture to the air inside your home,” Patel says.

    Avoid irritants. Choose mild soaps and detergents without dyes or perfumes. Avoid fragrances and cosmetics with chemicals, wool and synthetic clothes, and smoke. Keep your home clear of dust mites. Avoid foods that might trigger a flare.

    Take allergy medication. Over-the-counter antihistamines like cetirizine (Zyrtec) and fexofenadine (Allegra) may help with itching. If your itch is severe, you can try diphenhydramine (Benadryl). It may make you drowsy, so take it at bedtime.

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  • Is It Dry Skin or Atopic Dermatitis?

    Is It Dry Skin or Atopic Dermatitis?

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    For years, George Kramb, who’s 29 and lives in San Diego, CA, thought he had a severe case of dry skin.

    “I had dry skin basically my whole life. It was always flaky, irritated, and even got to the point of cracking,” he says. Sometimes, in the winter, his fingers were so cracked and dry that he couldn’t open his hands.

    Kramb tried over-the-counter ointments like Aquaphor, Cetaphil, and Gold Bond. “I used practically every single lotion and ointment that CVS sells, and nothing worked. It would offer temporary relief but didn’t address the underlying problem,” he says.

    What Kramb didn’t know was that he didn’t just have dry skin. He had atopic dermatitis. “It wasn’t until I was a teenager and saw a dermatologist that I got a proper diagnosis,” he says.

    What Is Atopic Dermatitis?

    Atopic dermatitis (AD) is a skin condition where itchy rashes come and go. It’s usually associated with some type of allergy.

    “Unlike dry skin, AD is a chronic inflammatory disease,” says Annabelle Garcia, MD, a board-certified dermatologist and owner of Sonterra Dermatology in San Antonio, TX. “Symptoms often appear as a rash on your skin. In its moderate-to-severe form, AD can cause constant itching, which can lead to cracking and bleeding of the skin.”

    Common AD skin symptoms include:

    • Dry, discolored skin
    • Itching
    • Painful or sore skin
    • Rashes that may ooze fluid or bleed from scratching
    • Sleep problems from itching
    • Thick, hardened skin from scratching

    Experts don’t know exactly what causes AD, but it may be related to your genes and environment. If you or your family members have asthma or allergies, you’re more likely to get AD.

    “Atopic dermatitis typically begins in childhood but can appear at any age,” Garcia says. For some people, it tapers off when they get older. Others have it their whole life. AD may get better at times and then flare up at other times.

    How Is AD Different From Dry Skin?

    AD is more than dry skin. “While both dry skin and AD can make your skin flaky, AD can also include red or dark rashes and persistent itch that can lead to oozing and bleeding skin lesions,” Garcia says.

    If you have AD, you may have an itch-scratch cycle. Your rash is itchy, so you rub or scratch your skin. That causes more irritation and itching, so the cycle of itching and scratching keeps going.

    With AD, a chronic condition drives your symptoms, Garcia says.

    Getting the Right Diagnosis

    Atopic dermatitis can be difficult to diagnose, Garcia says. Your rash may look like psoriasis or poison ivy. If you have dark skin, it may be less noticeable, and it may take longer to get the right diagnosis.

    If you have an itchy rash, see your doctor. “It’s important to know if you’re living with AD so you can take the necessary steps to control your skin health and find a proper treatment,” Garcia says. Topical creams may help with dry skin symptoms, but you might need a stronger treatment to target the cause.

    Kramb had a feeling his dry skin could be AD because some flare-ups were severe. “My theory was confirmed when I met with the dermatologist, they prescribed my first steroid ointment, and it did wonders,” he says.

    Treating AD

    Finding a treatment that works for you is a process. If one doesn’t work, your doctor may recommend another.

    It took Kramb a while to find the right mix. He tried a range of over-the-counter and prescription treatments, but they didn’t help. Later, he found that steroid ointments and creams work best.

    Kramb says learning that his dry skin was atopic dermatitis inspired him to help others. He created PatientPartner, which helps people who have similar health conditions connect so they can learn from each other.

    “A lot of people are nervous and scared to share their health conditions with others,” Kramb says. “I wanted to create a safe place for them to share with one another so they can learn and build a community.”

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