Reading Jessica's comment about how her six-month-old seems to be developing eczema was distressing her reminded me of my own problems with eczema. I had a very bad flare-up last month -- my skin seems to be getting better this week, after more than a month, but it's still very sensitive and itchy -- and I was hugely irritated and only got more testy as the days went by and no relief seemed to be in sight. Fortunately, I suppose, I've lived with this all my life and know by now what to do and what not to do.
There's a lot of information about eczema available out there; the problem is separating the facts from the hearsay. Also, what works for one person may not work for others.
One key characteristic of eczema is the skin's inability to retain water; the skin becomes very dry, red, brittle and itchy. As a kid, I was constantly told to drink more water since my skin is dry. I sort of knew back then that drinking more water, while good for the body overall, wasn't really the answer because it seemed like all I did was to pee more but my skin never got better. But what did a kid know, eh? Since the skin is dry, applying moisturizers to keep the skin moist and supple helps.
What really helped, I've found when I was an adult, was to increase my intake of oil. Not just any type of oil; what's good are more oily fish, nuts, seeds, and especially oil supplements such as evening primrose oil (EPO) and fish oil. EPO, for example, is frequently found in health food stores and is one of the plant-based oils that's high in gamma-linolenic acid (GLA). Not all oils are good; taking more corn oil isn't going to help. Fish oils are high in eicosapentaenoic acid (EPA) and docasahexaenoic acid (DHA), and again, some fish are oilier than others. The deep-sea fishes (cod, salmon) contain much higher levels of such oils than fresh-water fish or those commonly found in warmer waters.
(Note: EPA and DHA are known as omega-3 fatty acids, while GLA is one of the omega-6 fatty acids. Omega-3 and omega-6 fatty acids are known to reduce inflammation. Also known as the 'good oils'.)
Doctors will almost always prescribe hydrocortisone (or cortisone, or steroidal) creams for topical relief but personally I would rather not use it unless I've no choice. They are very effective but they should not be used continuously for long periods of time (defined as 2 weeks) as they weaken the skin and makes it even more brittle. That's pretty dumb, as brittle skin is one of the hallmarks of eczema. When I was a kid, I've seen a lot of doctors, even specialists from the National Skin Centre, and not ONE told me to restrict usage. Come to think of it, they usually spoke to my mother rather than to me, but even then they never told her the contraindications. I only realized this when I was in my late teens and came across one of those information pamphlets in a box of cortisone cream.
A bit of background here: since my mother first brought me to the general practitioners (GPs), they will usually decant the prescription (whether creams or pills or liquids) into little containers. The only information printed on those containers are the drug's name, clinic's name and address, how many times to take the drug, and date of visit. Can't fit much onto a small container about 5cm in diameter after all. To give the GPs the benefit of the doubt, I shall assume that they do so because it is cheaper for them to buy medicines in bulk and decant it at the clinic, and not because of the industry practice known as off-label drug usage (another matter altogether, and not entirely honest). Anyway, I had to discover all these on my own. Luckily, when I was older, I was sent to a specialist centre where, after the doctor's consultation, I would be shuffled to the pharmacy to pick up my prescriptions that were still in their original boxes. How many people read the fine print on those medicines, I wonder.
The 'professional' medical care I've received as a kid convinced me that I have to be responsible for my own healthcare instead of leaving it to a doctor.
That's not to say that taking steroidal creams or anti-histamines are bad. Sometimes they are necessary. But they are not a long-term solution. Some disagree (some have to take anti-histamines for years) but... I really think these drugs are not something you would want to take for the rest of your lives.
Fortunately there are a lot of alternative remedies, and having tried some, I think they work. They're not as immediately effective as a drug but each helps alleviate the symptoms. Put it this way, I've not taken applied a steroidal cream or taken an anti-histamine for over a decade and my skin is overall better than it was when I was a child and dependent on these medicines because I do not know better.
Sometimes I really wished someone told me all these when I was a kid.
I've had eczema almost throughout my childhood -- it was only the severity that varied -- and eczema is something that defined a large part of my life. The reason I switched to computational work was to avoid wet-lab work, for example. On the other hand, it was because of eczema that I took an active interest in my own health, so that's a positive consequence. Ironically, I was never too depressed by my eczema as a kid because I never knew better. However, right now I'm hugely irritated by my most recent flare-up because I have known better -- I have known recent years of good skin so the comparison was distressing.
