Eczema is not just skin deep

Chastin Dreyer a 31-year-old mom from Table View, Cape Town lives in a bubble of constant vigilance, searching and scratching. She lives in this bubble with two of her three children and their debilitating and chronic eczema.

What lives outside of the bubble?

Everything else. Freedom. Life. Itch-free skin.

Chastin’s two youngest sons have both been diagnosed with atopic dermatitis (caused by bacteria, allergens), contact dermatitis (caused by irritants such as grass, sand, animal hair) and allergy-related dermatitis (associated with hay fever and sinus related issues). What this means in simple terms is that their skin reacts to a lot of things, things they touch, things they breathe, things they eat, things they wear, things they live with, things outside, things they wash with, even things they cannot see.

But how bad can some itchy skin really be? Surely it is not such a big deal?

This where the effects of eczema go well beyond skin deep.

1. Eczema can lead to the ER.

Chastin’s middle son began to experience severe flare-ups at when he was about one and her youngest began at about two. She recounts a bad flare-up that her middle son had at 15 months old, “the skin on his face, tummy, behind his legs and along his forearms were so irritated, scaly and inflamed they started to bleed”.

Nothing they tried would soothe the pain or alleviate the irritation enough to allow his delicate baby skin to heal. They ended up at the emergency room of their local hospital.

“And that wouldn’t be the last time that a flare-up led to us seeking emergency medical relief and treatment.”, she says.

This sounds like anybody’s worst nightmare, a seemingly benign thing, an itch, that has the ability to become a constant and terrible torture. But imagine being the parent and it is YOUR baby being tortured by their own body and you are helpless to stop the torture.

Chastin explained how it was incredibly painful for sons, especially when it came to bathing or when they would sweat or rub/scratch at the irritation (try stopping a toddler from scratching an itch). They would complain of a burning pain constantly and when healing did take place it would become incredibly itchy.

Flare-ups would typically start off in the highly moisture-orientated areas of the body, the boys’ faces (especially when they were teething or ill), tummy, behind the legs and in the crooks of the arms and forearms. The areas would start off with a slight rash but as it became more irritated and inflamed it would end up looking more like a case of terrible acne, extremely red with raised bumps and a scaly look with open and raw areas of the skin.

2. Eczema can stop kids from being kids.

As a family, Chastin says, they have become acutely aware of the products they use, something as simple as their choice in washing powder and even the fabrics used in their clothing or linen. But this is not the hardest part of having to be mindful of everything they do, buy, apply or consume, the hardest part is how the skin condition interferes with their fun as a family and their fun as just typical kids.

“If we as a family plan on going out to the beach, we have to be very mindful as the combination of the salt in the water as well as the sand from the beach has on more than one occasion led to us having to cut our trip short and ended with many tears and us racing home to get my son into a shower as fast as possible. My youngest son tends to avoid the water and sand altogether.”, she says.

Sports is also difficult as the grass, the sweat and the constant friction of clothing against skin during movement. Petting animals is almost impossible, Chastin’s sons adore the family’s cats but if they cuddle them too much, it will lead to a flare-up.

Thus the boys’ physical interaction with the cats is monitored and controlled, and as far as possible not allowed.

All of these things are things that prevent her kids from being just kids, prevents them from doing the things kids love to do – play outside, run around and get sweaty and dirty, swim at the beach or in the pool, cuddle their fur-friends or eat random junk.

And not only can they not do these, but those around them also cannot do them either – their family and their friends.

Mareli Fischer, Clinical Psychologist at Claremont Practice, echoes Chastin’s concerns, “It is extremely challenging to explain to boisterous young kids why they need to be extra careful, why they cannot participate in some outdoor activities and why they are supposed to stay indoors. Many children will feel frustrated, throw tantrums of rage or act out in anger. Quite often, parents then have to deal with the sullen, sulky behaviour and disappointment. More than anything, children want to feel a sense of belonging to their peer group and able to participate in fun activities. Not being able to do so can lead to low mood, irritability and low self-esteem.”

3. Eczema can destroy self-esteem. Eczema can lead to symptoms of anxiety, low mood and or depression.

All of this can lead to feelings of alienation and or self-loathing as these kids feel like a handicap to their peers and friends. Bullying can become a problem as eczema suffers skin is often thin from long term cortisone use making it highly susceptible to injury. Their skin often looks inflamed, red and irritated, resembling bad acne.

According to Fischer, “When children and teens feel left out, ostracised or made fun of by their peers, they feel worthless and hopeless, lonely and sad. Having eczema flare-ups will make kids self-conscious because other children might ask uncomfortable questions or tease them about their appearance. Bullying often leads to symptoms of depression and anxiety, as well as low self-esteem.”

The effects of eczema do not remain in the realm of childhood, they follow you into adulthood. “Eczema symptoms can have a significant negative impact on the overall quality of life of those afflicted. Physical symptoms of itchy, inflamed skin can lead to great discomfort and even pain. Anxiety symptoms and low mood/depression are often diagnosed in patients who struggle with eczema. They are often frustrated by physical discomfort, which can lead to interrupted sleep and feelings of hopelessness. They often feel embarrassed and socially isolated by the appearance of inflamed skin and this also leads to low self-esteem.”, asserts, Fischer.

She has some guidance to give parents whose children are suffering from bullying or are emotionally distressed because of their skin condition.

“Take care of their emotional health by teaching them to address negative self-talk, give them an outlet for their feelings through creativity, talking or play. For both adults and children who struggle with eczema, learning to manage stress better is of great importance. Stress disrupts our homeostatic balance, and causes an increase of inflammation in the body, which leads to eczema symptoms worsening.”

4. Eczema can force a parent to obsessively seek out treatments to cure or at least calm the condition.

Chastin has tried everything under the sun to find some solution to her family’s skin issues.

“We have tried everything from over the counter allergy creams and syrups to cortisone, vitamin supplements, glycerin ointments and homemade pharmacy made ointments, coconut oil and even a cream that they use for moisturizing and healing cows udders (that is probably the weirdest one).”, but nothing was the miracle cure she was hoping to find.

Unfortunately, there is no cure for eczema/ dermatitis, says Chastin, “It is a chronic condition that we will have to live with for the rest of our lives. There are precautions and steps we take to address the flare-ups and help the skin heal quickly and effectively but in most cases, all you can do is ensure that you are careful and aware of what your skin comes into contact with.”

Chastin has some practical advice for other parents struggling with their child’s eczema;

• Stay clear of allergens or products that you know cause flare-ups
• Take note of any foods that cause you to flare up and avoid them
• Treat a flare up as soon as it starts and not to wait until it becomes overly inflamed, irritated, or open.
• It also helps to make sure that moisture zones are kept dry and yet still properly moisturised as dry skin can crack and bleed
• After a swim or bath, ensure the skin is properly dried by way of dabbing or gentle pats rather than rubbing or aggressive towelling
• Avoid high temperatures that could cause the skin to become overly moist in closed areas and in turn irritated

The primary risk factor for dermatitis and eczema is having a personal or family history of eczema, allergies, hay fever or asthma.

Of all the products Chastin has tried on herself and her sons the one that has given them the most relief is a product called Childs Farm, which is specially formulated for eczema and sensitive-prone skin. Childs Farm products are available at Baby City, Takealot, Clicks, Pick ‘n Pay and Toys R Us.