The teenage years can sometimes be the worst for people with eczema. This is not because the condition gets worse at this time: it can get better. As the skin gets greasier the eczema often improves and it is not uncommon for someone who has had eczema severely as a child to become much better at puberty while his non-eczematous friend discovers zits in a big way!
On the other hand, some people find that they have been free of eczema for a while only for it to come back in adolescence: others develop the condition for the first time during the teenage years. It is a very individual condition.
As a child you were very much in your parents’ hands when it came to looking after your skin. Maybe they fussed a lot and insisted on creaming you at all times of the day and night. Or perhaps they were very laid back about the whole thing and only got busy when the skin got very bad. However they treated it and whatever you think about the way your parents handled your eczema, the point is that it is becoming your responsibility now. Your attitude to your skin is the only one that counts.
The best way to treat eczema is to remember about it at the right times and then do your best to forget about it at other times. Remember you have eczema at bath times and bed times and treat it with the appropriate creams. And forget about it when you go out on a date! In other words take control. Remember the eczema when you see you have been placed by a sunny window or hot radiator in a classroom and tell the teacher that it will make your skin itch. Get yourself moved to give yourself a chance of forgetting it after that.
Making a fuss is something we all hate and for a teenager the embarrassment is definitely not wanted. But the point is if you get itchy you are going to be noticed scratching anyway, so you might as well get noticed for being a positive person rather than one who gets pushed around.
The basic rule is not to let eczema interfere with your life.
Taking control of your eczema is the most important thing you can do for yourself. To do this you need to make a daily routine of bathing in tepid water to which a moisturiser has been added and then apply an emollient afterwards. It is extremely important to keep your skin moisturised and you will need to apply some form of emollient at least two to three times a day. Don’t stop doing this as soon as your skin starts looking better as it may not be healed underneath. If you let it get dry it will itch; then you will scratch and you will be back where you started. Keep up the treatment for some time after the skin seems healed and always keep your skin from getting dry.
If you are using a steroid cream apply it first, before the emollient. Another thing you should do daily is check your nails. Make sure they are clean and short. Try hard not to scratch; see if you can get into the habit of patting or rubbing instead.
Also try and avoid the most obvious triggers. There are different environmental factors that can affect your eczema and hopefully you will be able to avoid some of them. Dietary factors are less likely to be a cause of your eczema than if you were very young; and special diets can mean missing out on parties and outings which is the last thing you want to do. On the whole a diet is not the best way to tackle eczema at this time, but if you think something you eat may be triggering the eczema look at your diet. As a rule a balanced and healthy diet that keeps you fit is good for your skin.
School or college
Worry and anxiety can aggravate eczema. Emotional upsets which make you perspire can trigger the itching. Everyone at school and college has some worries but you can help yourself by making the environment as comfortable as possible.
Chlorine can aggravate eczema but not usually to the point where you have to give up swimming. You will need to make time to apply the emollients beforehand and shower and re-apply the cream after the swim. Again, try and ignore the hurt and embarrassment. If you notice people staring or looking at you with disapproval just tell them it’s not catching and therefore should not concern them.
Many Children miss a good deal of schooling because of eczema. Most of the young people I have spoken to while writing this book have said that much of the time it was not because of the eczema condition but because they couldn’t face the teasing of their peer group. Paul, who is now an adult, wrote this description of his school life in Exchange, the journal of the National Eczema Society.
‘My concern was summoning up the courage to go to school each day to face the same taunts and bullies. The parental advice that I received about these people was that they would soon get fed up with making fun of me and they would then pick on someone else. The truth was that they didn’t pick on someone else and they didn’t go away: they were there for 13 years.
There is a saying that goes: ‘Sticks and stones will break my bones, but names will never hurt me.’ In my experience words certainly can brow-beat you into submission, and I have to say that there were times when I deliberately faked illness so that I had a day off from the hassle.
When you’ve had a particularly bad night and you have slept barely more than a couple of hours; when you’ve had to get up in the morning to go to school knowing that the first lesson of the day was a chemistry exam; when you know that you aren’t going to do well in the test because you’ve missed the last two weeks’ work and you haven’t had time to catch up on it; when you feel sore because it is winter time and the bike-ride to school has fairly ripped the skin from your face because it is so cold; and when you then have to face all the name-calling on top, let’s just say that it can be very hard putting on a cheery face.’
If you are subject to teasing or name calling you can ask your teacher to help. A class discussion during form time on eczema and other conditions could be very valuable. The Eczema Association has a special school pack to help.
If you have missed out on school work, or are going through a bad patch with your eczema, ask for extra work to do at home. Don’t leave it to your teachers or parents to suggest it. They may feel bad about putting an extra burden on you. If you feel you can do it, grit your teeth and ask for work! At the end of the day, it is you who will benefit. If you find you cannot understand the work because you have missed the lessons, talk to your teacher and/or your parents. Special coaching, extra lessons or home tutoring may be arranged.
If eczema on the hands makes you a slow worker, try to develop your computer and word-processing skills if you get the opportunity.
Lack of sleep and sleepiness because of antihistamines are common problems for someone with eczema.
If you find you are very sleepy in the mornings, try and take the antihistamines earlier on in the evening so that you get less of a hangover effect. Alcohol can increase the sedative effects of a antihistamine drugs so it is best avoided. Conversely if you find the antihistamine you are on is no longer lessening the itch, it is probably because your body has got used to it. Change to another one.
Examination times seem to coincide with high pollen counts and hot weather. This is not good news for a person with eczema, particularly as stress is another aggravating factor. If your eczema is likely to flare up at this time, ask your parents to warn the head teacher in plenty of time so that everyone is prepared should the situation arise. If your eczema is severe the head teacher can inform the examining board who can arrange for you to have extra time to finish each exam particularly if you have, or have had, writing difficulties. They may give permission for you to record answers on tape and they may even re-locate your exams to a hospital ward.
In any event, don’t forget to ask your teacher to let you take the exams in a cool room, away from the window. This is not making a fuss – it really does make a difference. And don’t forget to wear cool cotton clothes.
It makes sense to take eczema into consideration before embarking on a career as it can flare up again under adverse conditions. Hand eczema in particular can cause problems in certain areas of employment. Here are some of the jobs which may best be avoided:
- Animal handling: exposure to dander and fur
- Catering: constant exposure to water, detergents, raw fruit and vegetables.
- Domestic work: constant exposure to water, detergents and chemicals.
- Engineering: constant exposure to cutting oils, suds and lubricants.
- Hairdressing: exposure to water, shampoos and colourants
- Nursing: frequent hand-washing, contact with irritants and the risk of cross-infection.
- The Armed Forces: entrance requirements, potential exposure to the weather and so on, may cause problems.
- Work with cement: because of the chromate in cement.
You can see why a good, all-round education is so important! Jobs that require a good deal of exercise in the brain department are not at all harmful to the person with eczema!
Teenagers’ personal stories
Here are personal accounts from three teenagers who have had eczema most of their lives.
I’ve had eczema since I was a baby. It was reasonably bad when I was little; then it cleared up but when I was 15, I got some kind of blood virus. And then the eczema really flared up. It started gradually and then all of a sudden it was everywhere: all over my body; all over my limbs; my trunk and my face. It was raw most of the time.
I was so itchy all of the time I was nearly out of my mind. I couldn’t stop myself scratching but I got very scared when I scratched because I knew what the result was going to be. I just couldn’t stop myself, I used to rip my skin open.
I couldn’t sleep. I’d snatch about 10 minutes here and there. I couldn’t lay the quilt over me. It hurt to lie down on the bed. As soon as I had contact with the sheet it would aggravate the eczema or the sheet would stick to my skin.
I tried to have a bath as often as I could to keep down the infection but it was very, very painful. My mum used to bathe me which was embarrassing because of my age. I needed to have baths regularly but it was so painful I would cry. I had the emollient creams and steroid creams as well as antibiotic tablets. It would calm it down for a few days but it would just erupt again. Nothing seemed to help at all.
Because it was all over my face people would stare at me. One woman was walking along staring at me and she actually knocked into my mum because she wasn’t looking where she was going. It’s funny now but at the time it really upset me. I just burst out crying. Sometimes when I went shopping the sales assistants would drop the money on the counter because they weren’t watching what they were doing, they were watching my face. It was very upsetting. In the end I never went out of the house. I didn’t even like members of my family coming around – just my mum and dad and that was it.
Looking back on it now I don’t know how I coped. I couldn’t walk because of the eczema and I couldn’t put my clothes on because I was too sore. I just sat in the house with a pair of knickers on. Because it was so raw I was hot all of the time. It felt as if I was on fire. Even in the middle of winter I had to have fans going all over the house.
I was sent to a skin clinic at the hospital and they did patch tests on me. But the only thing they found I was allergic to was plaster! They tried to help but my skin was no better and eventually they said to me, “There’s nothing more we can do for you, Shelly, don’t come back unless it gets worse.” As I felt at the time that it couldn’t get any worse, I was not happy with that at all, but there was nothing I could do.
My emotions were in a complete turmoil. I would continually cry and become very depressed. Other times I was very angry and often asked myself the well-known cliché “Why me?” I would long for a cuddle from my mum and dad, but this wasn’t possible as it was just too painful. Other times I would feel immense guilt for what I felt I was putting my mum and dad through. My mum looked after me 24 hours a day. They would take it in turns to stay up all night with me; then dad would do a full day at work. I became their focus in life which I felt very guilty about, but I couldn’t cope without them.
Eczema doesn’t just affect and take control of the sufferer, but those who care too.
We tried a homoeopath – again it got better for a little while, a few days, and then it just erupted again and sometimes got twice as bad. My mum was at her wits’ end. She phoned the National Eczema Society and they recommended going to see Dr Rustin in London, UK, which I did.
First of all he put me on lots of steroids to take orally. It was quite a high dose – six a day for about a month.
My skin had to be completely clear before I was put on the Chinese herbal tea. After taking the steroids and before taking the tea I had to take four packets of Chinese herbal granules a day in order to see if I was suited to the treatment, which I was. My skin cleared completely and I started taking the tea. The eczema started to come back in a few patches but it was found that I wasn’t on the right dose. I was taking less than I should. The dose was put up to four tea bags. Again it started to come back all over my body but it was just dry patches. The rawness was on my arms.