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 parent’s 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.¹
The basic rule is not to let eczema interfere with your life.
What is Eczema?
Eczema is a group of skin conditions that cause skin to become red, irritated, itchy, and sometimes develop small, fluid-filled bumps that become moist and ooze.
There are many forms of eczema, but atopic eczema is one of the most common and severe. Doctors don’t know exactly what causes atopic eczema, also called atopic dermatitis, but they think it could be a difference in the way a person’s immune system reacts to things. Skin allergies may be involved in some forms of eczema.
If you have eczema, you’re probably not the only person you know who has it. Eczema is not contagious like a cold, but most people with eczema have family members with the condition. Researchers think it’s inherited or passed through the genes. In general, eczema is fairly common – approximately 1 in 10 people in the world will be affected by it at some point in their lives.
People with eczema also may have asthma and certain allergies, such as hay fever. For some, food allergies (such as allergies to cow’s milk, soy, eggs, fish, or wheat) may bring on or worsen eczema. Allergies to animal dander, rough fabrics, and dust may also trigger the condition in some people.²
Signs and Symptoms
It can be difficult to avoid all the triggers, or irritants, that may cause or worsen eczema flare-ups. In many people, the itchy patches of eczema usually appear where the elbow bends; on the backs of the knees, ankles, and wrists; and on the face, neck, and upper chest – although any part of the body can be affected.
In an eczema flare-up, skin may feel hot and itchy at first. Then, if the person scratches, the skin may become red, inflamed, or blistered. Some people who have eczema scratch their skin so much it becomes almost leathery in texture. Others find that their skin becomes extremely dry and scaly. Even though many people have eczema, the symptoms can vary quite a bit from person to person.²
What do Doctors do?
If you think you have eczema, your best bet is to visit your doctor, who may refer you to a dermatologist (a doctor who specialises in treating skin). Diagnosing atopic eczema can be difficult because it may be confused with other skin conditions. For example, eczema can easily be confused with a skin condition called contact dermatitis, which happens when the skin comes in contact with an irritating substance like the perfume in a certain detergent.
In addition to a physical examination, a doctor will take your medical history by asking about any concerns and symptoms you have, your past health, your family’s health, any medications you’re taking, any allergies you may have, and other issues. Your doctor can also help identify things in your environment that may be contributing to your skin irritation. For example, if you started using a new shower gel or body lotion before the symptoms appeared, mention this to your doctor because a substance in the cream or lotion might be irritating your skin. Emotional stress can also lead to eczema flare-ups, so your doctor might also asked you about any stress you’re feeling at home, school, or work.
If you’re diagnosed with eczema, your doctor might:
- prescribe medications to soothe the redness and irritation, such as creams or ointments that contain corticosteroids, or antihistamine pills.
- recommend other medications to take internally if the eczema is really bad or you get it a lot.
For some people with severe eczema, ultraviolet light therapy can help clear up the condition. Newer medications that change the way the skin’s immune system reacts may also help. If eczema doesn’t respond to normal treatment, your doctor may do allergy testing to see if something else is triggering the condition, especially if you have asthma or seasonal allergies. If you’re tested for food allergies, you may be given certain foods (such as eggs, milk, soy, or nuts) and observed to see if the food causes an eczema flare-up. Food allergy testing can also be done by pricking the skin with an extract of the food substance and observing the reaction. But sometimes allergy testing can be misleading because someone may have an allergic reaction to a food that is not responsible for the eczema flare-up.
If you’re tested for allergy to dyes or fragrances, a patch of the substance will be placed against the skin and you’ll be monitored to see if the skin irritation develops.²
Can I Prevent Eczema?
Eczema can’t be cured, but there are plenty of things you can do to prevent a flare-up.²
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.¹
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.¹
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.¹
Many Children miss a good deal of schooling because of eczema. Most young people say 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.
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 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.¹
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.¹
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!
In addition, these tips may help:
- Avoid substances that stress your skin. Besides your known triggers, some things you may want to avoid include household cleaners, drying soaps, detergents, and fragranced lotions.
- H2O is a no-no. Too much exposure to water can dry out your skin, so take short warm/tepid – not hot- showers and baths and wear gloves if your hands will be in water for long periods of time. Be sure to gently and thoroughly pat your skin dry, as rubbing with a coarse towel will irritate the eczema. Also, it isn’t the water that causes your skin to react; it’s the water evaporating if not dried soon enough.
- Say yes to cotton. Clothes made of scratchy fabric like wool can irritate your skin. Cotton clothes are a better bet.
- Moisturise! A fragrance-free moisturiser will prevent your skin from becoming irritated and cracked. Find a suitable product at your local Pharmacy.
- Don’t scratch that itch. Even though it’s difficult to resist, scratching your itch can worsen eczema and make it more difficult for the skin to heal because you can break the skin and bacteria can get in, causing an infection.
- Keep your cool. Sudden changes in temperature, sweating, and becoming overheated may cause your eczema to kick in.
- Take your meds. Follow your doctor’s or dermatologist’s directions and take your medication as directed.
- Unwind. Stress can aggravate eczema, so try to relax.
Dealing With Eczema
There’s good news if you have eczema – it usually clears up before the age of 25. Until then, you can learn to tune in to what triggers eczema and manage the condition. For example, if you have eczema and can’t wear certain types of make-up, find brands that are free of fragrances and dyes. Your dermatologist may be able to recommend some brands that are less likely to irritate your skin.
Your self-esteem doesn’t have to suffer just because you have eczema, and neither does your social life! Getting involved in your school and extracurricular activities can be a great way to get your mind of the itch. If certain activities aggravate your eczema, such as swimming in a heavily chlorinated pool, suggest activities to your friends that won’t harm your skin.
Even if sweat tends to aggravate your skin, it’s still a good idea to exercise. Exercise is a great way to blow off stress – just try walking, bike riding, or another sport that keeps your skin cool and dry while you work out.
ECZEMA ASSOCIATION OF AUSTRALASIA INC
PO Box 1784 DC
CLEVELAND QLD 4163
1300 300 182