Quick introduction here: I’m not a doctor. Not an allergist or a dermatologist or any kind of -gist at all. I’m a mom and my daughter has severe eczema and we have spent the last six years talking to doctors and running her to specialists and buying every product under the sun. I’ve really wanted a complete guide that goes over causes and medicines while also including trigger information, home remedies, diet changes, and eczema products that really work. I couldn’t find one, so I wrote one. Here it is:
Eva was diagnosed with eczema during the first three months of her life, but at the time we didn’t think it was unusual. I have always had eczema, but my eczema is some scaly patches on my legs or maybe a dry patch or two on my arm when the weather is really cold. Eva’s eczema is different. It’s constant and it shows up all over her body, particularly when she’s exposed to something. In the beginning, she was likely having a reaction to cat hair because she’s allergic and we had two cats, but we thought that all babies were just prone to red skin irritation and we didn’t do much for it.
Looking back, there were things that should have been huge flags, like an irritation around her lips that would bleed occasionally and flake constantly. She also has always had dry fingers that occasionally get stiff, swollen, and cracked because the skin is so inflamed.
How eczema works and the connection between eczema and food allergies:
Eva has severe allergies to food and some environmental triggers. Frustratingly, it’s very possible that if we had managed her eczema more as a baby, her allergies wouldn’t be quite this bad. They can’t say for sure, but that’s the theory. Let me explain –
Your skin is made up of skin cells all squished together and those skin cells have these bands between them that help your skin act as a barrier to keep all of your inside stuff in and all of the outside stuff out. The bands between are made up partly of a protein called profilaggrin and the instructions for making that protein are in the FLG gene.
For people with eczema, the theory is now that something has gone haywire with the FLG gene so the instructions for making that profilaggrin protein don’t come through correctly and you end up with weak or non-existent protein bands between the skin cells.
When the barrier between the skin cells is compromised, the skin stops working efficiently at keeping things in/out. That means that all sorts of stuff gets into the skin (dirt, germs, tiny food particles, allergens) and the water that’s supposed to keep your skin hydrated and healthy starts sneaking out.
With things like dirt and germs getting in under that outer barrier of skin cells, it’s no surprise that that can cause irritation. However, there’s a relatively recent theory that little bits of allergens, food particles, and things like that are triggering allergies. That might partially explain why there’s such a strong connection between eczema and severe allergies.
The science here is a little over my head (not a doctor!) but the way our allergist explained it is that there are things in your body that show up to fight these things that are sneaking into your skin and the constant barrage of “alien” allergen particles trains your body to have a screwy overreaction whenever you try to bring those allergens in the normal way (like by eating peanut butter or inhaling pollen while walking in the park). Again, get a real doctor to explain the specifics but the basic idea is that people with eczema end up having immune systems that are overworked because of all the extra invasions.
Add to that the fact that water is sneaking out, which causes dryness, and you’ve got the perfect environment for painful itchiness. The inflammation under the surface from the battle against alien invaders eggs on the itchiness on top as the skin begins to be dry and less stretchy, so people with eczema scratch and cause damage to this poor skin that’s already all wiped out and then that trauma makes more inflammation and you have a vicious cycle that’s hard to break. That’s why a lot of people with serious eczema go between light flares of irritation and heavy flares of irritation with no periods of 100% healthy clear skin.
Frustrating and unfair and, at the moment, not curable. Blah!
How to treat an eczema flare:
The good news is that there are a lot of things you can throw at eczema and some things seem to work better for some people but the basics are the same for everyone. You have to (1) keep the skin hydrated, (2) reduce the chance of irritation/infection, and (3) give your immune system as much of a break as you can.
To keep the skin hydrated, we…
/// use every brand of lotion that Eva isn’t allergic to. Since she’s allergic to nut and sunflower oils, we do have to avoid a bunch, but by rotating brands and trying different things at different times we’ve managed to disrupt that bad cycle. Be sure to ask your pharmacy counter if you they keep any non-prescription lotions back there for major skin irritations. They know where the good stuff is. Also, steer clear of fragrances because most eczema patients will only be more irritated by those.
/// use baths with collodial oatmeal and coconut oil, again avoiding any bath product with fragrance or color. Little note – milk baths aren’t a good idea, especially for babies with eczema, because it’s not particularly moisturizing and the milk can end up being one of those alien allergens sneaking in.
/// have Eva sleep in gloves to keep the thick lotions on and keep her from rubbing her topical steroids on her face and eyes.
/// have Eva take Vitamin E supplements.
/// feed Eva lots of natural fats like coconut oil, avocado, etc.) while avoiding things that are inflammatory when her skin is very bad (sugar, tomatoes, cocoa).
/// have Eva wash her hands with gentle facial cleanser instead of traditional anti-bacterial soap.
/// have a salt lamp in her room. (Does this actually work? No idea but she thinks it’s cool so whatever.)
To reduce the chance of irritation/infection, we…
/// use bamboo wraps and organic cotton clothing to reduce rubbing when her skin is irritated.
/// alternate moisturizing baths with bleach baths (a quarter cup of bleach into plain bathwater) to kill bacteria on the surface of the skin.
/// change “sweaty” clothing like socks, winter wear, and dance gear as soon as we can.
/// use topical steroids to kill bacteria and help restore the skin as a barrier.
/// wash her bedding in hot water with double rinses at least once a week.
/// take blankets with us if she has to sit somewhere unfamiliar for a long period of time, like at a movie theater, to reduce allergen exposure.
To give her immune system a break we…
/// have her take oral probiotics.
/// limit time outdoors if she’s having a bad flare.
/// limit variety in her diet if she’s having a bad flare.
/// have her take oral steroids if it’s really bad.
Life with eczema:
Realistically, I can’t say that we’re winning the battle with eczema. Eva’s skin is 90% under control but she still flares out of nowhere and the solutions we’ve come up with include doing things like sending a huge box of band-aids to her school because there’s just no way she’s getting through the first grade without bleeding from her fingers at least once a week.
The thing is, though, when we don’t throw the kitchen sink at it and change up all the lotions and do all the baths and watch her diet, etc., it gets really bad quickly and suddenly the situation isn’t just that she’s itchy. It’s that her skin is raw and open and her digits are too swollen to bend and she’s at a huge risk for a bad allergic reaction to something minor because her immune system is already so crazy. So we do what we do and hope it gets better as she gets older.
The one thing that totally worked:
Also, we have found one thing that was a miracle cure and I highly recommend doing it if you can. We took her to Hawaii.
I had heard that exposure to sunny beaches is a great treatment for eczema but we were shocked and how quickly her skin cleared up during a week in Maui this past year. We live in dry Salt Lake City and it’s very hard on her skin so seeing her reaction to those two climates back to back was amazing and also pretty guilt-inducing as a parent. We can’t afford to move her to Maui and we can’t even afford to take her every year BUT if you’re really looking for something that might make a difference, I thought I should pass that along.