The skin condition in which the skin is very dry, itchy, and flaky is called eczema, or atopic dermatitis.
The barrier of the skin is compromised. Most babies who experience eczema or atopic dermatitis do also later in adulthood, and there is a connection to allergy (called the allergic triad) in which individuals who are afflicted with eczema may also have asthma and rhinitis (a runny nose that is triggered by allergy).
Eczema is not a deadly disease, so there aren’t much finances put in the direction of this condition since those with mild eczema don’t understand that it truly does influence their physical, emotional, and mental well-being, and that the constant suffering isn’t a proper quality of life.
The sleepless nights with scratching, waking up with bloody sheets, showers that are painful and sore, itching with stress and sometimes itching for no reason at all, and not knowing the causes from one day and the next. The peeling skin from cortisone, and sometimes the need for cortisone shots, antihistamines, immunosuppressives to stop the immune response… these are all eczema realities.
Being told you are doing something to elicit this, that you don’t want to stop, that you won’t feel better and that it somehow is related to self-control. Tell that to individuals with eczema. All they want is to stop scratching.
What your dermatologist won’t tell you …
- Dermatologists do have an excellent knowledge of the skin, they are trained in that organ. However, sometimes when we look exclusively at an organ we are more apt to see symptoms only rather than cause.
- Eczema is a tough condition to crack, because where the pathology lies is often deeper than the skin’s surface.
- There absolutely are ways to reduce inflammation associated with eczema, and there are known triggers which can aggrevate an immune response.
So why don’t you know about them?
1. Not everyone with eczema is afflicted with the same triggers — This is unfortunately true. There are however a series of patterns which DO ring true, which I will discuss in a minute.
2. Some of the things which can help eczema overall take time and patience. Many patients who are itchy and sore just want relief. Eventually however, you have to ask yourself, do you just want symptomatic relief or can you get to the bottom of the triggers?
3. Triggers like food allergies that often go diagnosed for those with eczema because the methods of testing are unfortunately not covered, or very rarely discussed within our medical system. OHIP does not cover either IgE blood testing for foods or IgG delayed-type hypersensitivity blood testing for foods, and as a result, it is expensive for patients to pay out-of-pocket for every potential trigger — and there can be many. IgE skin scratch tests offer mostly false negatives for those with skin issues — the skin is such a mess to begin with — it does not react when it is supposed to, and does when it should not.
What Are The Triggers for Eczema?
- The inborn immune system contains the breakdown in eczema. It is the part of our immune system whose function is to inform the body what’s foreign and what’s not in our gastrointestinal tract, lungs, and skin from the moment we are born. This actually makes sense, since these are the likeliest ways to succumb to infection when we are babies. However, if any part of this system is influenced by something perceived as foreign, the other parts of the system are as well struggling.
Researches demonstrate that the gastrointestinal tract is where this breakdown occurs, and it can often occur before birth. Mothers who are given good bacteria or probiotics, and specific strains of probiotics that balance a very reactive innate immune system, do prevent and reduce the incidence of eczema in children of mothers with eczema or a genetic connection to eczema. Bacterial balance in the gastrointestinal tract is a very important part of eczema management.
- Eczema breakouts occur reliably with certain foods. These food groupings have allergy potential, and some types of eczema are more prone to allergy (IgE-associated atopic dermatitis) versus those that are not IgE-associated. IgE is an immunoglobulin or protein produced by our body in the response to allergy.
What has been linked with eczema is food like: dairy proteins, wheat and wheat gluten, tomatoes, citrus and citrus juices, nuts, certain fruits (apples from specific trees that have links to oral allergies, peaches and cherries from the prunus family) potatoes, and refined and synthetic sugars. Many people react differently to these foods, so evidence is mostly inconclusive. That does not however mean that we should discount all of the research completely! It means that it will take more work to determine what the cause is. Food allergies are the leading culprit in eczema.
- Hormone systems can be also added, as stress and stress hormones have the ability to increase inflammation. Stress hormones and the hormone connection can also be an important contributor in eczema.
Chronic inflammation is an ongoing issue in eczema. Corticosteroids help with the local inflammation, but they do not support systemic inflammation. Important things like good quality omega-3 oil can really support inflammation pathways and act like cortisone and cortisol, but they can also help to support the production of a good skin barrier. The skin barrier and its inability to stay intact and produce adequate oils as a protectant is an issue in eczema.
Why should I care about getting to the root cause if my immunosuppressives are doing the job?
Tacrolimus, Protopic and Elidel are immunosuppressives that can help you a lot, but we should mention the side-effects from them. The side-effects have links to carcinogenesis. This article is not trying for you to stop using them or to scare the people because there have positive effects too. We just want for everyone to understand that with finding the root-cause you will prevent further risk from their use.
If you find the triggers of eczema, what can you expect for your life to look like with eczema?
Improved health will come along but you still need a lot of patience, because you might need to continue with the immunosuppressives, but you can sure reduce the amount that you depend on them. And you should handle the stress differently than others and you might have to avoid certain foods. Of a great importance are good quality moisturizers in order to deal with dryness and to keep the skin barrier intact.
You should not give up, that is why we said you will need a lot of patience. Everything ends with good, and if it is not good then it is still not the end. So do not give up!